Download Form of application for final payment from General Provident Fund account (Accountants General Madhya Pradesh)

"FIFTH SCHEDULE" (For Gazetted and non-Gazetted officers) (See Note 3 below rule 29) FORM OF APPLICATION FOR FINAL PAYMENT/BALANCE IN THE PROVIDENT FUND ACCOUNT (TO BE USED BY THE RETIRING/RETIRED GOVT. SERVANT/GOVT. SERVANT TRANSFERRED TO BODIES CORPORATED /OTHER GOVT. /NOMINEES OR ANY OTHER CLAIMANTS WHERE NO NOMINATION SUBMITS) Office of the ..................(DDO) Part-I (Check list For use of Head of office) Sub. : Form for GPF Final payment of Shri/Smt. ...........GPF A/c No. ........(in duplicate) In Part-II, in from, reference to entire in column number : 1 to 10 have been verified and filled in properly. Death certificate/order of resignation is enclosed 11 (A) & (B) Part Final Withdrawls sanctioned and paid with effect from 6.6.72 & Temporary advance have been mentioned or list enclosed. 11 (C) Temporary Advance sanctioned for construction of house its recovery and interest recovered have been stated Major Head of Account under which the interest credited have been mentioned. 11 (D) Life Insurance Policies financed from GPF, Policy No., Amount of Premium & last premium, month/year have been stated (Premium paid in cash by subscriber is stated separately) 12 Certificate enclosed. 13 Details of DPF Accounts ( monthwise deduction withdrawls and interest upto last 31st March) to transfer the balance into GPF have been enclosed. 14 In case of nominations subsist original nomination is enclosed. Nominee is a family member as per definition of MP GPF rules 1955 or out of family member has been stated in proper column. 15 Details of family members of deceased Govt. Servant relationship and age have been stated. 16 In case of amount due to a minor , Indemnity Bond/ Guardianship Certificate is enclosed. 17 In case subscriber has left no family and no nomination subsists, succession certificate/ legal heir certificate in favour of claimant is enclosed. 18 (ii) Payment if desired through treasury, three attested specimen signature, finger and thumb impression, mark of identification and attested photographs has been enclosed. 19 In case of resignation of the subscriber to take up appointment in another department of the State Govt. or under other Govt. or under body corporate owned or controlled by the Govt. details such as PF Account No. of new Deptt/institution , consent of Department/ Institution , designation and address to whom the Bank Draft is payable have been enclosed. OTHER REQUIRED DOCUMENTS (i) Certified original GPF Pass Book (ii) Details of incumbency of the subscriber (iii) Details of the deductions towards GPF for last 12 months prior to his retirement/death/resignation in case GPF Pass Book is not available. Signature of DDO Designation.... (Rubber Seal to be affixed ) PART - II Form for Final Payment of balance in the General Provident Fund Account ( For use of Head of Office) Forwarded to the A.G. (A&E) I,II MP, Gwalior / Bhopal with the request that balance at the credit of GPF Account NO. at the end of as per account slip Rs. ....... Therefore GPF balance may be reviewed and authorised. Necessary details are as below: ­ 1. Name of the subscriber & Designation.................. 2. Name of Father/Husband....................... 3. GPF Account No./ Nos. ......................... 4. Date of retirement/ death ............. resignation/dismissal & date of appointment in new department 5. Order No. & date ............. 6. Name of Claimant................. 7. Address of Claimant/ Subscriber ---------------------------------------------­ 8. Date of commencement of service ----------------------------------------­ 9. Month & Year in which first ---------------------- deduction towards GPF was made 10. Last Fund deduction towards GPF -----------------------------------------­ (i) Pay for the month of -------------------------­ (ii) Bill No. & Vr. No. with date ------------------­ . (iii) Name of Treasury --------------------------­ (iv) Major Head of A/c of pay drawn ---------------------------­ (v) GPF Subscription Rs. ---------------------------------­ (vi) Refund of advance Rs. ----------against advance sanction ) for Rs. ----­ (vii) Arrears deposited in GPF (if any) Rs. -------------------­ 11 (A) Certified that the Part Final withdrawals during the period commencing from 6.6.72 to date were sanctioned and drawn from his/her GPF A/C : Sl. No. DDO MAJOR HEAD VR. NO.& DATE TREASURY AMOUNT (B) Certified that following temporary advance were sanctioned and paid to the subscriber during the 12 months immediately preceding the date of his/her retirement/death/resignation. Sl. No. DDO MAJOR HEAD VR. NO. & DATE TREASURY AMOUNT © Certified that Temporary Advance Rs. --------------- was sanctioned and paid for construction of house etc irrespective of the amount standing at the credit of GPF under rules 15 (5) of MP GPF Rules, 1955 details of recovery of advance and interest are as under. Month and year Amount sanctioned and Paid Amount of Advance recovered Amount of interest recovered Major Head of Account in which Amount of interest is credited Remarks (D) Certified that following withdrawals were made for payment of Insurance premium from his/her GPF Account. Policy No. Premium Rs. First Premium Last Premium drawn Month/Year Month/ Year 12. Certified that no temporary advance/ Part final will be drawn without obtaining prior sanction of AG (A&E)-II MP Gwalior after submission of form for Final Payment of Balance. 13. Certified that his/her DPF A/c has been maintained in the office. Balance at the credit of DPF A/c has not been paid. The details of deduction withdrawals and interest allowed upto 31st March are enclosed. 14. Details of the nominees alive on the date of death of the Subscriber, if nomination subsists: Name of Relation with Share of the Whether nominees is out of nominees subscriber Nominees family member or family member of the deceased (Family as per definition under rule (2) (I) c of MP GPF rules 1955 15. Details of family members of deceased government servant Name Relationship with Age on the date of death of subscriber subscriber 16 In the case of amount due to a minor child whose mother (widow of subscriber) is not a Hindu . The Claim should be supported by Indemnity Bond or Guardianship Certificate as the case may be. 17. If the subscriber has left no family and no nomination subsist, the name of persons to whom the provident fund money is payable, claim should be supported by letter of probate or succession certificate. Name of claimant Relationship with subscriber Address 18 (I) Payment is desired through office -------------------------­ (Name of the office ) (ii) Through Treasury -------------------­ (Name of Treasury) 19 Certified that subscriber has resigned/not resigned Govt. Service to take up appointment in another department of the State Govt. or under other Govt. or under a body corporate owned or controlled by Govt. (In case of resignation made to take up appointment in other Deptt/ Institution as mentioned above, the balance at the credit of GPF A/c. will be transferred to New Provident Fund A/c allotted him/her with consent of the Deptt/ Institution. )Therefore consent of new Deptt/ Institution and new Account No. allotted to him/ her is enclosed. Date Place Signature of DDO Designation (Rubber Seal to be affixed) Note: Instruction to DDO 1. Efforts may be made to forward the application of the subscriber immediately after the last fund deduction to the AG MP Gwalior so as to have sufficient period is left to arrange payment on the date of retirement. Justification therefore, in each case is required where delay occurs. 2. Certificate original GPF Pass book must be attached with the application. 3. Details of incumbency sent in December 1997 (through treasury) may also be appended please. 4. In case of retired Drawing and Disbursing Officer, his final payment application should be forwarded through next higher authority to AGMP Gwalior.