Non-Employment/Re-Employment Certificate Form

Company Name(s): 

FORM “B” ANNEXURE - XVIII
NON-EMPLOYMENT / RE-EMPLOYMENT CERTIFICATE
(To be given by pensioner once a year in November)
(A) Existed – Deleted*
(A) I declare that I have been employed / re-employed in the Offices which is a part of / financed by ___________________________and was in receipt of the following monthly rates of emoluments during the year ended November, 20 __ or during the month of within the said year :
(a) Pay ________________________________________________
(b) Special Pay __________________________________________
(c) Other Allowances / Fees / Honorarium _____________________
(it includes D.A., A.D.A., these to be shown clearly)
Further, that the orders of my re-employment do / do not stipulate my pension being held in abeyance during the re-employment period.
I declare that I have not accepted any commercial employment in India.
Or
I declare that I have accepted commercial employment in India, after obtaining previous sanction of the Central Government and none of the conditions, if any, attached thereto by Government has been violated.
Or
I declare that I have accepted Commercial Employment in India without obtaining the sanction of Central Govt.
NOTE – This declaration is required to be given for a period of two years from the date of retirement.
(B) I declare that I have not accepted any employment under a Govt. outside India / an International Organisation of which Govt. of India is not a member.
Or
I declare that I have accepted employment under a Govt. outside India / an International Organisation of which Govt. of India is not a member after obtaining the previous sanction of the Central Government and none of the conditions attached thereto by the Govt. has been deviated from.
Or
FORM “B” ANNEXURE - XVIII
NON-EMPLOYMENT / RE-EMPLOYMENT CERTIFICATE
2
I declare that I have accepted employment under a Govt. outside India/an International Organisation of which Govt. of India is not a member, without obtaining the previous sanction of the Central Govt.
Place Signature
Date: Name of the Pensioner __________________
P.P.O. No.
Certificates at (B) and (C) are to be furnished only by retired Group ‘A’ Officers in May and November each year.
*CS No.2 – Authority. CGA’s UO No - 1(7)(1)2000/TA/377 DATED 19-8-2002.