Annexure 'A' for Pension adalat 2020

||||ANNEXURE|—A|we<br>‘|we<br>‘||
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||||FORMAT OFAPPLICATION<br>SMES<br>SE ATI ACA TION|||||
||i|:|NameoftheApplicant<br>(Pensioner /Family Pensioner)||||||
|De|||Nameoftheex-employee&Designation||||||
|3:|||Department /PensionSettledat||||||
|4.|||Date ofRetirement|||||
|Ss|||P.P.O. No.|||||
|6<br>‘<br>7;|||Last Basic pay& scale ofpay at the time of<br>Retirement<br>Present Pension /Family Pension|||||<br>lige<br>||
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||||Details oftheBank Branch /Treasury<br>throughwhichPensionisdrawn||||||
|S),|||FulladdressforCommunicationwith<br>telephone no. /mobile no. and e-mail id<br>-<br>(ifany)||||||
||||ee<br>a et ie Reegael, =<br>ees|ae|||||
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|10|"|||Natureofgrievance<br>(Pull detailstobegiven)|||||<br>||
|11.|||.<br>.<br>Whether<br>thegrievancehasbeenpresentedin<br>|anyearlierPensionAdalat,ifso,detailsto<br>be furnished|||||<br>||
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|12.|||Whetherthegrievance hasbeenpreferredto<br> | any authority before, the detailsmaybe<br>furnished alongwithdocumentary evidences|||||
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||||ee een eencae ease<br>eee...|Fre a||||
||||||Scanaunenneinteenenee,|-|||