Scribd
Upload
154 views5 pages

Form 18

The document provides details for assessing and authorizing payment of family pension and death gratuity when a government servant dies while in service. It includes sections for personal details of the deceased, service details, qualifying service period, emoluments, government dues, nominee details, provisional payment, and account enfacement.

Uploaded by

dhinesh subramaniam
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
154 views5 pages

Form 18

The document provides details for assessing and authorizing payment of family pension and death gratuity when a government servant dies while in service. It includes sections for personal details of the deceased, service details, qualifying service period, emoluments, government dues, nominee details, provisional payment, and account enfacement.

Uploaded by

dhinesh subramaniam
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
You are on page 1/ 5

40 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II—SEC.

3(i)]

FORM 18
[See rules 78(1), 80(1), 80(3), 80 (5), 80-B (1) and 80-B (5)]
Form for assessing and authorising the payment of family pension
and death gratuity when a Government servant dies while in service

PART I
Section I

1. Name of the deceased Government servant ...


2. Father's name …
3. Husband's name in the case of female Government servant…
4. Date of birth (by Christian era) ...
5. Date of death (by Christian era) ...
6. Religion...
7. Particulars of post held at the time of death
(a) Name of the Office
(b) Post held substantively:
(c) Officiating post:
(d) Scale of pay/Pay Band & Grade Pay
(e) Basic Pay/Pay in Pay Band & Grade Pay
(f) Whether the last post held was under the Government or outside
the Government on foreign service terms
(g) If on foreign service, scale of pay/pay band, pay in the pay band
and grade pay of the post in the parent department

8. Date of beginning of service ...


9. (i) Total period of military service, if any, for which
pension and/or gratuity was sanctioned:
(ii) Amount and nature of any pension/gratuity
received for the military service

10. Particulars relating to service in autonomous body/State Government, if any -


(a) Particulars of service :
Name of Period of service
Post held
Organization From To Period

(b) Whether the above service is to be


counted for gratuity in the Government ... ... ...
(c) Whether the autonomous organization
has discharged its pensionary liability to
the Central Government ... ... ...

11. Amount and nature of any pension/gratuity received for


previous civil service, if any

12. Service qualifying for death gratuity –


(a) Details of omission, imperfection or deficiencies in the Service Book which have been
ignored [under rule 59 (1) (b) (ii) ] -
¹Hkkx IIµ[k.M 3 (i)º Hkkjr dk jkti=k % vlk/kj.k 41

(b) Periods of non-qualifying service – From To


(i) Interruption in service condoned under rules 27 & 28
(ii) Extraordinary leave not qualifying for gratuity
(iii) Period of suspension treated as non-qualifying
(iv) Boy service (2nd proviso to rule 13)
(v) Periods of foreign service with United Nations
bodies for which United Nations pension has
been availed (Rule 31)
(vi) Any other service not treated as qualifying service

Total period of non-qualifying service

(c) Additions to qualifying service -


(i) Civil service (Rule18)
(ii) Military service (Rule 19)
(iii) Benefit of service in an autonomous body

Total period of qualifying service


(d) Net qualifying service

(e) Qualifying service expressed in terms of completed six


monthly periods (Period of three months & above is to be
treated as completed six monthly period (Rule 49)

13. (a) Emoluments reckoning for death gratuity ...


(b) Amount of death gratuity ...

14. Details of Government dues recoverable out of death gratuity -


(i) Licence fee for occupation of Government
accommodation [See rule 80-C]….
(ii) Amount to be withheld as indicated by the Directorate
of Estates [See rule 80-C (i) (v)]….
(iii) Dues referred to in rule 80-C (2) ...

15. Net amount payable as death gratuity

16. Details of the nominee(s) to whom death gratuity is payable

S. Name Share in Date of Address Relationship with


No. death gratuity Birth deceased Govt.
servant
42 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II—SEC. 3(i)]

17. Details of guardian/nominee who will receive payment of death gratuity in the case of
minor/mentally disabled children

S. Name of minor/ Name of guardian Address of guardian Relationship of


No. mentally disabled guardian with
child deceased Govt.
servant

18. The date on which intimation regarding the death of Government servant
was received by the Head of Office

19. The date on which action initiated to -


(i) obtain claim or claims from the claimants in the appropriate form for
death gratuity and family pension as provided in rule 77:
(ii) obtain the `No demand certificate' from the Directorate of Estates as
provided in rule 80-C (1):
(iii) assess the Government dues other than the dues pertaining to
occupation of Government accommodation as provided in rule 80-C (2):
(iv) assess the service and emoluments qualifying for death gratuity and
family pension as provided in rules 78 and 79.

20. Details of payment of Family Pension –

Rate of family pension Amount of family Period for which it is payable


pension From To
Enhanced rate [if service rendered at the
time of death is more
than seven years as in rule 54 (3)]

Ordinary rate
Additional family pension, as on date, to
old family pensioner, if any, under rule
54(2A)

21. Persons to whom family pension is payable -


(i) Name ...
(ii) Relationship with the deceased Government servant ...
(iii) Full postal address ...

22. Details of guardian who will receive payment of family pension in the case of minor/
mentally disabled children

S. Name of minor/ Name of guardian Address of guardian Relationship of


No. mentally disabled guardian with
child deceased Govt.
servant
¹Hkkx IIµ[k.M 3 (i)º Hkkjr dk jkti=k % vlk/kj.k 43

23. Head of Account to which death gratuity and family pension are debitable

Place
Dated the …………………………
Signature of
Head of Office

Section II

Details of provisional family pension and gratuity to be drawn and disbursed by the Head of
Office in accordance with rule 80A.

Provisional family pension ... ... ... Rs................................p.m.

Death Gratuity [amount mentioned in item 13(b) of Section I] Rs......................................

Less
(a) Licence fee recoverable from gratuity for occupation of
Government accommodation [as in item 14(i) of Section I] Rs................................

(b) Amount of gratuity to be held over pending receipt of


information from the Directorate of Estates [as the
item 14(ii) of Section I] Rs......................................
(c) Other Government dues as mentioned in item 14 (iii)
of Section I Rs......................................

(d) Total of (a), (b) and (c) Rs......................................

Place

Dated, the

Signature of
Head of Office
44 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II—SEC. 3(i)]

PART II

Account Enfacement

Section I

1. (i) Total period of qualifying service accepted for Death gratuity ...
(ii) Total period of continuous service accepted for Family Pension

2. Net amount of death gratuity after adjusting Government dues

3. Amount and the period of tenability of Family Pension –

Rate of family pension Amount of Period for which it is


family payable
pension From To
Enhanced rate [if service rendered
at the time of death is more than
seven years as in rule 54 (3)]

Ordinary rate
Additional family pension, as on
date, to old family pensioner, if
any, under rule 54(2A)

4. Date from which family pension is admissible:


5. Head of Account to which death gratuity and family pension are
debitable:

Section II
1. Name of the deceased Government servant ...
2. Date of death of the Government servant ...
3. Date on which pension papers received by the Accounts Officer ...
4. Amount of family pension authorised ...
5. Amount of gratuity authorised ...
6. Date of commencement of family pension ...
7. Date on which payment of family pension and gratuity authorised ...
8. Amount recoverable from gratuity ... ... ...
9. Amount of gratuity held over pending receipt of `No demand certificate'...

Place
Dated, the Accounts Officer

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy