Re-Marriage/Marriage Certificate Form

Company Name(s): 

ANNEXURE-XXVI
(See para 25.1 page 22)

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 Disbursing Authority I 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: Date:

Place: Date:

Signature. _ 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
Name _ Designation
_