PROFORMA-A

To _________________________

Sub:Restoration of commuted portion of pension after 15 years - Implementation of the judgement of the supreme court --------------------

Dear Sir,
Kindly restore my commuted portion of pension in terms of Ministry of Personnel,PG & Pension,Department of Pension and Pensioner's Welfare O.M.No. 34/2/86-P&PW dated 5th March 1987; .
Requisite particulars are given below :-
1. Name in Block Letters :
2. Date of Retirement :
3. PG/PPO No. :
4. Amount of original Pension. :
5. Amount of Pension Commuted (if any). :
6. Name of the Accounts officer,viz., the. Authority who issued PG/PPO:
7. Name of the Treasury / post office/PPH/Other Pension disbursing agency:
Signature of Pensioner
Particulars Verified Signature Rubber Stamp of Pension Disbursing Authority
Strike if not applicable
Date:
Postal Address: