CONSENT FORM To, The Director of Pension, Assam Housefed Complex, Dispur-781006 Sub: Request for assessment of Excess drawal if any and consent thereon to recover the same Sir, I have the honour to request you kindly to finalise my pension case by assessing excess drawal of pay and allowance drawn if any during the service period at your end. In this connection, I do hereby give my consent for recovery of the same in lump sum or in monthly installment as deemed convenient and for which myself or in the event of my death my successors shall have no right whatsoever to raise any objection hereinafter for the said recovery. Pension Case Mark No: Yours faithfully Name of pensioner