Athax KHOVEL EITE - FORM 7 Pension (inter-active)
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FORM 7

 

FORM 7
[See Rules 58, 60, 61(1) and (3) and 65 (1)]
Form for assessing Pension / Family pension and Gratuity

PART 1

1. Name of the retiring Government employee    
Name of the retiring Government employee
2. Father’s/ Husband’s name    
Father’s/ Husband’s name
3.
Height
   
Height
4. Marks of Identification    
Marks of Identification
5. Date of Birth    
Date of Birth
6. Service to which belongs    
Service to which belongs
7. Particulars of post held at the time of retirement:      
 
(a) Name of the office
   
Name of the office
  (b) Post held    
Post held
  (c) Whether the appointment mentioned above was under Government or outside the Government on foreign service terms?    
Government 
8. Whether declared substantive in any post under the Central Government?    
YES/NO. 
9. Date of beginning of service:    
Date of beginning of Service. 
10. Date of ending of service:    
Date of ending service. 
11. Cause of ending of service    
Superannuation etc. 
12. In the case of compulsory retirement, the orders of the competent authority, whether pension may be allowed at full rates or at reduced rates and, in case of reduced rates the percentage at which it is to be allowed    
Not applicable 
13. In case of removal/ dismissal from service whether orders of competent authority have been obtained for grant of compassionate allowance and if so, at what rate,    
Not applicable 
14. Particulars relating to military service, if any---      
  (a) Period of military service    
from date to date 
  (b) Terminal benefits drawn/being drawn for military service towards civil pension?    
Rs./- 
  (c) Whether opted for counting of military service towards civil pension?    
Yes/NO 
  (d) If answer to (c) above is in the affirmative whether the terminal benefits have been refunded.    
Yes/NO/NA. 
  (e) In case of ex-servicemen who are eligible for Family pension under the armed forces Rules, whether opted to retain family pension under the Armed Forces Rules or to draw family pension    
N/A. etc 
15.

Particulars relating to service in Autonomous body, if any

   
 
  (a)Particulars of Service:    
Not Applicable or Applicable 

 

  Name of Organisation Post held Period
  Row     From To
 
Not applicable 
Not Applicable 
n/A 
n/A 

 

  (b) Whether the above service is to be counted for pension    
YES/NO 
  (c) Whether the Autonomous organization has discharged its pensionary liability to the Central Government?    
YES/ NO 
16. Whether any departmental or judicial proceedings are pending against the retiring employee    
YES?NO 
17. Qualifying Service -----      
  (a). Detail of omission, imperfection or deficiencies in the Service Book which have ignored [under    
Details 
  (b). Period not counting as qualifying service    
nonqualifying service 
  i. Boy Service (2nd provisio to Rule 13)    
boy service 
  ii. Extraordinary Leave not counting as qualifying service (Rule 21)    
EOL not counting for as qualifying 
  iii. Periods of suspension not treated as qualifying service (Rule 23)    
suspension not treated as qualifying service 
  (iv) Interruption in service [Rule 27(1)(b) and Rule 28(c)]    
Not applicable or State. 
  (v) Periods of foreign service with United Nations bodies for which United Nations pension has been availed    
Periods of foreign service
  (vi)Any other period not treated as qualifying service (give details)    
Any other period not treated as qualifying service (give details)
  (c) Additions to qualifying service ---      
  (i)Military Service (Rule 19)     Military Service (Rule 19)
  (ii)War Service (Rule 20)     War Service (Rule 20)
  (iii)Weightage on voluntary retirement on being declared surplus (Rule 29)     Weightage on voluntary retirement
  (iv) Weightage under Rule 30     Weightage under Rule 30
  (v) Benefit of service in an Autonomous Body (rule 37)     Benefit of service in an Autonomous Body
  (vi)Weightage under Rule 48-B     Weightage under Rule 48-B
  (d)  Net qualifying service     Net qualifying service
  (e) Qualifying service expressed in terms of completed six monthly periods (period of three months and over is treated as completed six monthly period)     Qualifying service expressed in terms of completed six monthly periods

 

18. Emoluments---      
  (a) Emoluments drawn during 10 months preceding retirement  
  From To Rate of Pay Amount
 
Date
Date
Rs.
Rs.

 

   (b) If the officer was on foreign service immediately preceding retirement, the notional emoluments which he would have drawn under Government but for being on foreign service.    
Not applicalbe etc
  (c) Average emoluments reckoned for pension.    
Rs.
  (d) Emoluments reckoned for retirement gratuity/death gratuity    
Rs.
  (e) Emoluments reckoned for family pension    
Rs.
19. Date on which the retiring employee submitted his application for pension in Form 5.    
Some Date

 

20. Complete and up to date details of the family as given in Form3                       ADD ROW DELETE
  Sl. No. Name of the Member of the family Date of Birth Relationship with the Govt. Servant
 
--
--
--
--

 

21. Whether Nomination made for death gratuity/retirement gratuity    
Yes/NO.
22. The date on which action initiated to    
 
  (a) Obtain the ‘No demand’ certificate from the Directorate of Estates as provided in Rule 57.    
Some Date /YES.
   (b) Assess the service and emoluments qualifying for pension as provided in Rule 59    
Some Date /YES..
   (c) Assess the Government dues other than the dues relating to the allotment of Government accommodation as provided in Rule 73(1)    
Some Date /YES.Rs.
23. Details of Government dues recoverable out of Gratuity :--      
  (a) Licence fee for Government accommodation    
Rs.
  (b) Dues referred to in Rule 73    
Rs
24. (a) Proposed pension / service gratuity    
Proposed Pension
  (b) Proposed dearness relief on pension (as on date of retirement)    
Proposed DR
  (c) Date from which pension is to commence    
Date pension commence
25. Rate of Family pension :--      
  (a) Enhanced rate    
Rs. enhance rate
  (b) Period for which family pension will be payable at enhance rate.    
Period enhance
  (c) Ordinary rate    
Rs. Ordianry rate
  (d) Date from which ordinary rate of family pension will be payable    
Date ordinary
26. Amount of retirement gratuity / death gratuity.    
Rs. Amount
27. Commutation of Pension      
  (a) Period for which family pension will be payable at enhance rate Whether simultaneously applied for commutation of pension with the pension application (applicable only in the case of those who retire on Superannuation pension.)    
Period enhanced
  (b) The portion of pension commuted    
Portion commuted
  (c) Commuted value of pension    
Amount in Rs.
   (d) Amount of residuary pension after deducting commuted portion.    
Amount in Rs.
  (e) Date from which reduced pension is payable.    
Some Date
28.  Name and address of Bank/ Pension accounting office from where pension is to be drawn    
Name & Add. of  Bank
29.  Head of account to which pension and gratuity are debitable    
"266 - Pension & ORB"
30. Post retirement address of the retiree    
Post retirement Address
         
        Signatue of the Head of Office

 

PART II
1. Date of receipt of Pension Papers by the Accountant Officer from the Head of Office    
Some Date
2. Entitlements admitted      
  A. Length of Qualifying Service    
Years Months etc
  B. Pension      
  (i) Class of Pension    
Class ofpension
  (ii). Amount of Monthly Pension    
Rs. Some amount
  (iii) Date of Commencement    
Some Date
  C. Commutation of Pension :-      
  (i) Commuted value of portion of pension commuted, if any    
Commuted value
  (ii) Residuary Pension after commutaion.    
Residuary pension
  (iii) Date from which reduced pension is payable.    
date payable
  (iv) Date of Restoration of commuted portion of pension subject to the pensioner continuing to live    
some date
  D. Retirement./ Death Gratuity      
  (i) Total Amount Payable    
Rs. Some amount
  (ii) Amount to be adjusted towards govt. dues.    
Some amount
  (iii) Amount to be withheld for adjustment of unassessed dues    
Some amount or NIl
  (iv) Net Amount to be released    
Rs. Some amount
  E. Family Pension:-      
  (i) At enhanced rate.    
Rs. enhanced rate
  (ii) Period for which family pension at enhanced rate is payable.    
Period of enhanced rate
  (iii) At normal rates.    
Normal rate
3. Head of account to which the amount of pension, retirement / death gratuity and family pension are to be debited.    
"266 - Pension & ORB"
         
         
        Accounts Officer





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