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TAU DEVI LAL OLD AGE PENSION OLD AGE ALLOWANCE The State Govt is giving emphasis for

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TAU DEVI LAL OLD AGE PENSION OLD AGE ALLOWANCE The State Govt is giving emphasis for Powered By Docstoc
					OLD AGE ALLOWANCE

The State Govt. is giving emphasis for providing social security to the 60 years or above
senior citizen of State in the shape of OA ALLOWANCE @ Rs.300/- PM per person: -

APPLICATION FORM FOR OLD AGE ALLOWANCE

1      Name of the applicant                        Sh./Smt……………………………..
2      Father/Husband Name                          Sh…………………………………..
3      Date of birth/Year(certificate               Age…………………Certificate……
       if available)
4      Permanent address                            Village/City………. House No……..
                                                    P.O./Ward………….Block…………
                                                    Tehsil………………Distt…………..

5.             Whether Haryana domicile               Yes                 No
6.             a) Whether getting any financial
      assistance/pension                              Yes
      b) If yes, income per month                                         No
7     Whether belongs to SC/BC                      Yes/No         BC            SC
      If yes, category/caste
8     Whether applicant’s children are in             Yes                 No
      Govt. service or Local Bodies or
      Class-I/Class-II officer or similar in
      the organizations of Public Sector.
      1 Whether applicant’s children are posted           Yes             No
      in Private Sector and getting salary equivalent
      to Class-II officer or similar.
10    Whether applicant or his children are in any      Doctor/regd. Medical practitioner
      service shown against this column. If yes,        /Advocate/C.A/I.T Consultant/
      Tick the related one.                             Financial/Management Advisor/
                                                        Dentist/Engineer/Architect/
                                                        Contractor, any other
11.   Whether applicant or his children are
      Income Tax payee                                    Yes             No
12.   Whether applicant/his children Ex or Present/
      M.P/MLA, Chairperson of Boards/Banks/               Yes             No
      Corpn.

                                          Signature of Applicant/Thumb impression
                                    DECLARATION

        I Sh/Smt. ……………………………… S/D/W/o ………………………………...
resident of village/city……………………… P.O ……………….. Tehsil………………..
District …………………….. affirm that the above particulars are true to the best of my
knowledge and belief and nothing has been concealed.
Signature of Namberdar/Ward Representative
Name …………………………………                         Signature of Applicant/Thumb impression
Date …………………………                            Date ………………………
                 SCRUTINY COMMITTEE RECOMMENDATION

   1. Age …………………………….
   2. Whether applicant is eligible for
      Old age pension                             Yes              No


   3. Signature of member of Scrutiny Committee ………………………….

       ………………….                      ………………….                   ………………….
       Signature                     Signature                  Signature

       (Name/Designation)            (Name/Designation)          (Name/Designation)




                                     ENQUIRY

                      ………………………… …………………. ………………….
Inspecting Officer-   1. Deputy Commissioner 2. SDO (Civil) 3. Tehsildar

REPORT…………………………………………………………………………………..

       NOTE: -1.      The salary of eligible applicant against column 9 will be taken
                      equal to the salary of Rs.4,000/- of Class II Gazetted Officer.

                2.    Please tick the column like this
PROCEDURE

Eligibility criteria          Who are ineligible            How to apply & where

1. Eligible husband & wife    1.Income tax payee            Panchayati Raj Institutions/
   will get the pension                                     Municipal Committee,
   separately.                                              Officer, Doctor & DSWO are
                                                            the members of the Distt. /
                                                            City Scrutiny Committee for
                                                            sanctioning the pension.

2. Eligible wife of Ex-       2.Whose children are the      The interested persons for
   Service man will also        class I & II gazetted       pension may reach to the
   be entitled for pension.    officer in Govt./non-        fixed place of village/city for
                               Govt.organizations.          enrollment for which pre
                                                            announcement being made.

                              3. Whose children are         The pension is disbursed on
                                 businessmen                or before of 7th of every
                                                            at doorstep by the Panchayati
                                                            Raj Institutions & Municipal
                                                            Committee.
                              4. Who themselves or their
                                 children are sitting MP/
                                 Ex-MP/MLA/Chairman
                                 of Board or Corpn.

Please contact Director, Social Justice & Empowerment Department, Haryana or
Concerned District Social Welfare Officer for any complaint/suggestion.

				
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posted:8/9/2011
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