Proposed Common Nomination Forms for Nominations under Pension, GPF, CGEGIS, Commutation, Arrears of Pension Rules
No. 1/12/2013-P&PW (E)
Government of India
Ministry of Personnel, P.G. & Pensions
Department of Pension & Pensioners' Welfare
Lok Nayak Bhawan,
Khan Market, New Delhi
Dated: 1st Nov, 2013
Circular
Sub:
Introduction of Common Nomination Forms for Nominations under various Rules - inviting comments - regarding. The
undersigned is directed to state that as present separate Nomination
Form are being filled for various benefits. With a view to simplifying
the procedure, the Department of Pension &PW proposes to introduce
Common Nomination Form 1 for making nomination for the following
benefits:
1. Gratuity under CCS (Pension) Rules, 1972
2. General Provident Fund (Civil Services) Rules, 1960
3. Amount under Employees Group Insurance Scheme, 1980
2. It is also proposed to use Common Nomination Form 2 for making nomination under
1. CCS (Commutation of Pension) Rules, 1981
2. Payment of Arrears of Pension (Nomination) Rules, 1983
3.
Comments are invited from all concerned, including pensioners and
pensioners' associations on the use of these Forms in place of the
existing Forms. Any suggestions for making the proposed Forms more
simple, user-friendly and compatible with the amended provisions of the
Rules are also welcome.
4. You may forward your comments to Shri
Harjit Singh, Deputy Secretary, Department of Pension & Pensioners'
Welfare, at his e-mail harjit.singh59@nic.in within 15 days of its
updating on the website.
Encl - Common Nomination Forms 1 and 2
sd/-
(D.K. Solanki)
Under Secretary to the Govt. of India
Tel No. 24644632
Copy to: 1. O/o CGA, 7thFloor, Lok Nayak Bhawan, Khan Market.
2. CPAO, Trikoot - II, Bhikaji Kama Place, New Delhi - 66.
with the request to expeditiously look into the Forms and send comments, if any, before 15th November, 2013.
Common Nomination Form 1
[See Rule 53 of CCS (Pension) Rules, 1972, Rule 5 of General Provident Fund (CS) Rules, 1960 and Para 19.7 of Employees'
Group Insurance Scheme, 1980]
Head of Office,
.............................................
.............................................
.............................................
I,
................................................................,
hereby nominate the person/persons mentioned below and confer on
him/her/them the right to receive in the event of my death, to the
extent specified below, amount on account of the following:-
i. any gratuity the payment of which may be authorized under Rule 50 of CCS (Pension) Rules
ii. amount that may stand to my
credit in the
General Provident Fund
iii. any amount that may be sanctioned by the Central Government under the Central Government employees
Group Insurance Scheme, 1980
Name, date of
birth (DOB) and
address of the
nominee
|
Relat-
ionship
with
employee/
pensioner
|
Share
to be
paid to
each
|
If nominee is
minor, name,
DOB and address
of person who
may receive the
amount on behalf
of minor
|
Name, DOB and
address of alternate
nominee in case the
nominee under
Column (1)
predeceases the
employee/ pensioner
|
Relat-
ionship
with empl-
oyee/ pensi-
oner
|
Name, DOB and
address of
person who may
receive the
amount if
alternate
nominee in Col.
(5) is a minor
|
Contin-
gencyon
happening
of which
nomination
shall
become
invalid
|
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| | | | | | | | |
| | | | | | | | |
| | | | | | | | |
These nominations supersede any nominations made by me earlier.
Place and date:
Signature of Government servant
Telephone No.______________
| Note1 |
Separate
copies of this nomination Form may be used for nominating different
persons for different benefits (i)] (ii) and (iii) above by ticking the
intended benefits and striking out the benefits for which nomination is
not intended to be made.
|
Note2
|
The
Government servant shall draw lines across the blank space below the
last entry to prevent the insertion of any name after he/she has signed.
The nominee( s)/alternate nominee( s) shares together should cover the
whole amount.
|
(To be filled in by the Head of Office/ authorized Gazetted Officer)
Received the nominations, dated ..............................., under the following Rules:-
1. CCS (Pension) Rules 1972 for Gratuity
2. General Provident Fund (CS), 1960
3. Central Government employees
Group Insurance Scheme, 1980
made by Shri/Smt./Kumari...................................................
Designation .............................................................
Office ......................................................................................................... .
(Strike out which nomination is not received)
Entry of receipt of nomination(s) has been made in
page ....................... Volume .................... of Service Book.
Name, Signature and Designation of Head of Office/authorized Gazetted Officer with seal
Date of receipt............................... .
The
receiving Officer will fill the above information and return a duly
signed copy of the complete Form to the Government servant who should
keep it in safe custody so that it may come into the possession of the
beneficiaries in the event of his/her death.
The receiving officer shall put his/her dated signature on both pages of this Form.
Common Nomination Form 2
for Arrears of Pension and Commutation of Pension
[See Rule 5 of Payment of Arrears of Pension (Nomination) Rules, 1983, Rule 7 of CCS (Commutation of Pension) Rules, 1981]
Pension Disbursing Authority,
.......................................................
.......................................................
.......................................................
I, ................................................................,
hereby nominate the person/persons mentioned below and confer on
him/her/them the right to receive in the event of my death, to the
extent specified below, amount on account of the following:-
i. Arrears of Pension
ii. Commuted Value of Pension
Narne, date of
birth (DOB) and
address of the
nominee | Relat-
ionship
with
employee/
pensioner | Share
to be
paid to
each
| If nominee is
minor, name,
DOB and address
of person who
may receive the
amount on behalf
of minor | Name, DOB and
address of alternate
nominee in case the
nominee under
Column (1)
predeceases the
employee/ pensioner | Relat-
ionship
with
emplo-
yee/
pensi-
oner
| Name,DOB
and address of
person who
may receive the
amount if
alternate
nominee in Col.
(5) is a minor | Contin-
gency on
happening
of which
nomination
shall
become
invalid |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| | | | | | | | |
| | | | | | | | |
| | | | | | | | |
These nominations supersede any nominations made by me earlier.
Place and date:
Signature of Government servant
Telephone No.
| Note1 | Separate
copies of nomination Form may be used for nominating different persons
for benefits (i) and (ii) above by ticking the intended benefit and
striking out the benefit which is not intended to be made. |
| Note2 | 'The
Government servant shall draw lines across the blank space below the
last entry to prevent the insertion of any name after he/she has signed.
The nominee( s)/alternate nominee( s) shares together should cover the
whole amount. |
(To be filled in by the Head of Office/ authorized Gazetted Officer)
Received the nominations, dated ..............................................., under the following Rules:-
1. Payment of Arrears of Pension (Nomination) Rules, 1983
2. CCS (Commutation of Pension) Rules, 1981
made by Shri/Smt./Kumari........................................ .
Designation ...............................................................
Office .......................................................................
(Strike out which nomination is not received)
Entry of receipt of nomination(s) has been made in
page ................. Volume ......................... of Service Book.
Name, Signature and Designation of Head of Office/authorized Gazetted Officer with seal
Date of receipt............................
The
receiving Officer will fill the above information and return a duly
signed copy of the complete Form to the Government servant who should
keep it in safe custody so that it may come into the possession of the
beneficiaries in the event of his/her death.
The receiving officer shall put his/her dated signature on both pages of this Form.
