FORM-4 Nomination for Family pension: 1954 (See Rule-54(7)) I hereby nominate to the persons mentioned below, who are member of my family to receive in the order shown below the family pension 1954 which may be granted by the Central Government in the even of my death after completion of ten Years qualifying service Name & Address of nominee Relationship with the Government Servant Age Whether This nomination supersedes the nomination made by me earlier on Which stands cancelled. NOTE: The Government servant should draw lines accors be blank space below the last entry to prevent the insertion of any name after he has signed. Dated this at Witness to signature. GOVERNMENT OF JHARKHAND 1. 2. Signature of Govt. servant Designation (To be filled in by the Head of Office) Signature of Head of Office Dated Designation Nomination by Designation Office Published on National Portal of India (india.gov.in) married Unmarried Department of Finance
