Schedule LIII O.C.S. (COMMUTATION OF PENSION) FORM 3 (See rules 18, 25, 25 read with F.D. Resolution No. 29826, dated the 9th July, 1992 ) FORM OF LETTER TO THE CHIEF DISTRICT MEDICAL OFFICER Serial No.DepartmentDated theTo The Chief District Medical Officer(a)Application in Form-2 in original together with-(i) An unattested copy of the applicant's photograph (ii) Part-IV of Form-2 in original duly completed by the Accounts Officer(b)A copy of Form-4 with a spare copy of Part-III of that Form(c)Report of the statement of the applicant's case if he has been granted invalid pension or has previously commuted a fraction of his pension or has been refused commutation on medical grounds Form No.379(New)Subject - Medical Examination - Commutation of PensionSir,Shri who retired from Service onas (Designation)has applied for commuting a fraction of his pension for a lump sum payment. The following documentsare furnished here with:- In terms of rule 20 Shri should be examined by a Medical Board/Chief District Medical Officer. It is requested that arrangementexamined as expeditiously as possible before his next birthday which falls onGovernment of OrissaDepartment of Public Grievances & Pension Administration1.2. may be made to get ShriPublished on National Portal of India (india.gov.in) 5. The receipt of the letter may please be acknowledgedYours faithfully,Appointing Authority/Authorised Authority Copy forwarded to Shri(Here give complete postal address)with the remarks that subject to the medical authority recommending commutation, he will, on the basis of report of the Accounts Officer, be eligible for the lump sum payment in lieu of the amount of pension to be commuted as follows :- 3. 4. It is requested that arrangements for Medical examination by the medical authority indicated inPara-2 above may be made at the nearest District Headquarters Hospital mentioned byShri The attention of the Medical authority may be drawn to the provisions of rule 22. It is requested that Shrimay be informed direct under intimation to this Depart /Office as to where and when he should in his application in Form-2. appear before the appropriate authority for medical examination. A copy of this letter is beingendorsed to him so that he may comply with your instructions on hearing from you. Published on National Portal of India (india.gov.in) Place : Signature of the Appointing Authority/ Authorised Authority Date : Signature of the Appointing Authority/Authorised Authority The table of the present value, on the basis of which the calculation by the Accounts Officer has been made, is subject to alteration in any time without notice and consequently the basis is liable to revision before payment is made. The sum payable will be the sum appropriate to the applicant's age on his birthday next after the date on which the commutation becomes absolute. On the basis ofNormal age Added years 1st year (i) sum payable if commutation becomes absolute before the applicant's next birthday which falls on (ii) sum payable if commutation becomes absolute after the applicant's next birthday which falls on . Shri should report for medical examination to the medical authority direct hearing from He should take with him the enclosed Form 4 with the particulars required in Part I completed except the signature or thumb or fingerimpressions. Copy forwarded to the Accounts Officer (here indicate designation and address)with reference to his letter No.Date2nd year /-Rs.Published on National Portal of India (india.gov.in)
