Form 10 — CCS

(c) A person, while claiming family pension on death of a Government servant or a pensioner or a family pensioner, shall indicate against the specific column in Form 10 whether or not he or she is already in receipt of a family pension in respect of another Government servant or pensioner and, if so, the amount of family pension being received by him or her.

(14)

(a) A child of a Government servant or a pensioner, while claiming family pension on death of the said Government servant or pensioner, shall indicate against the specific column in Form 10 whether or not he or she is eligible for another family pension under this rule in respect of the other parent and, if so, the amount of family pension admissible to him or her from that source.

Death of Government servant Death of Pensioner Death of Family Pensioner Ineligibility of Family Pensioner Disappearance of Government servant Disappearance of Pensioner Disappearance of Family Pensioner

FORM 10 [See rules 50, 71 , 74, 76, 79 and 80 ] Application to the Head of Office for Family Pension on Death of a Government Servant or Pensioner or on Death or Ineligibility of a Family Pensioner or when a Government Servant or Pensioner or Family Pensioner goes missing

Application for family Pension on : (Tick one box)

1. Signature 2. Signature: Name: Name: Address: Address: Date: Date: FORMAT 10 [See rules 60, 74 and 80]

2. You are advised that a claim for the grant of Family Pension may be submitted in the enclosed Form 10 along with an undertaking to the Bank in enclosed Format 9 and an Indemnity Bond in enclosed Format 8 (in the case of missing Government servant only).

*Applicable only in the case of death of Government servant Yours faithfully, Encl : (1) Format 9 (2) Form 10 (3) Format 8 (In case of missing Government servant)