N.R.No. I.Card No. GRANT OF FINANCIAL ASSISTANCE FROM DISABLED ARMY PERSONNEL WIDOWS ORPHANS FUND Name of widow : 1. Particulars of the Ex-serviceman: a) Regtl.No., Rank and Name b) Date of enrolment c) Date of Discharge / Death d) Cause of Discharge / Death e) Home address : : : : : f) Age at the time of Pension/ Discharge/Death : Particulars have been checked with sheet roll and found correct as per the yard stick laid down vide Appendix ' A ' to Army Headquarters letter No.A/03123/AG/PS-3, dated 02.12.1967, the applicant is eligible for the grant as shown under:- 2. Present circumstances : a) Whether Pensioner or Non Pensioner : b) If, Pensioner, the amount : c) Amount of children allowance : d) Details of relief grants already paid or under consideration to the individuals/family/dependant with details: 1) Army relief : 2) Retl. Corps. Fund : 3) Army Central Welfare Fund : 4) Disabled Army Personnel widows & Orphans fund : 5) Death Gratuity : 6) Any other fund : e) No. of dependants as recorded on Service Book: Name Relationship Date of Birth/Age Sex 3. (a) Purpose for which grant applied for is required : Signature of the widow ( or ) Thumb Impression RECOMMENDATION OF THE BOARD OF OFFICERS: Recommend a lumpsum grant of Rs. ( Rupees PRESIDING OFFICER ORDER OF THE OIC RECORDS Sanctioned / Not Sanctioned