CERTIFICATE OF RE-MARRIAGE/MARRIAGE

I hereby declare that I have not got re-married and I Undertake to report such an event promptly to the pension Disbursing Authority/bank.
(Applicable only for widow recipient of family pension and to be furnished only once)
or
I 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)
PLACE:_____________________
Signature_______________________________
DATE:____________________
Name of the Pensioner____________________
P.P.O No. _____________________________
I certify to the best of my knowledge and belief that the above declaration is correct.
Signature of a responsible officer or a well-known person
PLACE:_____________________
Name______________________
DATE: __/__/____
Designation _________________