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Telangana Annual Pension Verification Form

This document is an annual verification certificate for pensioners in Telangana. It requires pensioners to provide identification details, pension payment details, employment and income details if applicable, and a declaration that the information is true. The certificate includes sections for the drawing and disbursing officer to certify payment details and for a gazetted officer or bank manager to certify that the pensioner is alive. Pension payments will be stopped if the annual verification certificate is not received by April 1st.

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3K views2 pages

Telangana Annual Pension Verification Form

This document is an annual verification certificate for pensioners in Telangana. It requires pensioners to provide identification details, pension payment details, employment and income details if applicable, and a declaration that the information is true. The certificate includes sections for the drawing and disbursing officer to certify payment details and for a gazetted officer or bank manager to certify that the pensioner is alive. Pension payments will be stopped if the annual verification certificate is not received by April 1st.

Uploaded by

Seshu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

REVISED PPO ID -

GOVERNMENT OF TELANGANA
(ANNUAL VERIFICATION CERTIFICATE)
( To be downloaded only from Treasury Department Website)
(as per Govt. Memo.No. 240/PSC/2013, Dtd:26-10-2013)
1. i) Type of Pension : Service Pension / Family Pension
Recent Photo of the
ii) Name of the individual :
individual (To be
iii) S/o D/o W/o H/o : attested by the

iv) AADHAAR No : Gazetted Officer /

Bank Manager or
2. Date of Birth/Age :
Notary)
3. PPO Number :

4. Name of Bank :

5. Name of Bank Branch :

6. i) Bank Account Number(Mandatory) :

ii) MICR CODE :

iii) IFSC CODE :

7. Employment particulars : (Applicable if Re-Employed after retirement & employed pensioners only)

a) Name of the Office :

b) Date of employment / Re employment :

c) What is the DA is drawn on employment :

d) Date from which DA is drawn :


8. Remarriage Particulars if any
a) Date of Remarriage :
b) Name of the Spouse :
9. i) present Residential Address with Phone Number / Mobile Number
ii) e-Mail Address :
10. Income Tax PAN Number :
(Mandatory if minimum pension exceeds 15,000/-)
DECLARATION OF THE PENSIONER
I hereby declare that
i) I am not drawing any other pension, ii)
ii) I am not drawing other pension through PPO No and PPO ID:
iii) I am not drawing any DR on that pension
iv) The particulars mentioned above are true to the best of my knowledge and belief
v) If the above particulars proved wrong at any time, I am liable for disciplinary/criminal action as per rules.
Date:
Place:
Left hand thumb impression of the pensioner (signature of the pensioner)
----------------------------------------------------------------------------------------------------------------------------------------------------------------
ACKNOWLEDGEMENT
Received the Annual Verification Certificate dated …………………… of Sri/Smt ………………… ………………holder of PPO
No. ……………...........................…………..
Receiver Signature, Date & Stamp
CERTIFICATE – I
(To be issued by the Drawing and Disbursing Officer)

Certified that Smt/Sri …………………………………………………………………………………………….W/o, H/o, Late

………………………………………….was appointed as ……..………….………………………… She / He is being paid the

Dearness Allowance eligible to her/his at the rates sanctioned by the Government from time to time.

As per the declaration filed by the individual, she – he is not drawing any D.R.I, on the family pension

being drawn vide PPO No ……………………………………..……….from the Sub Treasury /Pension Payment Office.

Station :

Date : Signature & Office Seal.

CERTIFICATE – II

Certified that I have seen the pensioner as on ………………………….. and he / she is alive on this date.

Date :

Place: Signature of the Gazetted Officer.

(Bank Manager ((with name of Seal / Notary)

Signature of the Treasury Officer,

i.e .. STO/ATO/APPO
(With Name & Seal)

NOTE :
i) The pension Disbursing Officer can sign the Certificate if the pensioner appears personally before the

pension Disbursing Officer.

ii) If pensioner does not appears personally before the pension Disbursing Officer the Certificate shall be

signed by any Gazetted Officer/Bank Manager.

iii) The Annual Verification Certificates are obtained from 1st November onwards.

iv) In the event of Non – receipt of the Annual Verification Certificate the pension shall be stopped from 1 st

April onwards ( i.e., ) March payable on 1st April.

* * * *

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