CERTIFICATE OF RE-MARRIAGE / MARRIAGE
I hereby declare that I have not got re-married and I undertake to report such any event promptly to the Pension DisbursingAuthority/Bank.(Application only for widow recipient of family pension and to be furnished only once)OrI hereby declare that I am not married/ I have not got married during the past six months.(To be submitted by widowers and unmarried daughters once every six months in May and November)
Signature
Name of the pensioner
P.P.O. No.
Place:
Date:
I certify to the best of my knowledge and belief that the above declaration is correct.
Date:
Place:
Designation
Name
Signature of a responsibleOfficer or a well-known person