87 ‘¡’Éæ¾ø ïÀåó ¡å¨îºø ÀºòÆ

General 87 - A
*
(A4 S. & E) 12/83
(Internet Version)

Éæ¾à¼Åê ÀêÇæË Íå ¡¾ºà ¼Çæ —ÊòåÄ Éæ´êÀà ¨òÄÆ

WIDOWERS’ AND ORPHANS’ PENSION SCHEME
¼Çæïɨëïªà ¢À¼ûÄ ïÍåà —ÉåÍÆ ïÍåà ÄÇ¸Æ ªæ¾ ïÍåà ¼åÆú¨åÉïªà ÌàÉå•ÀêÇæËÆåïªà
¼ú¨¨
à Ìå¼ÑÄ ïÍåà ÄÇ¸Æ ªæ¾ ¼æ¾àÑÄ
Notification of Birth, Marriage or Death of a Child or Divorce, or Death of Husband of Contributor

¾øȽåÖ¾øÆïªà ̊ÀìÚ¸ ¾Ä ........................................................................................................................................................................

Full Name of Officer

º¾ºëÇ ...................................................................................................................................................................................................................
Designation

ï¼ÀåںàºëÉ ........................................................................................................................................................................................................
Department

ÄͺàÉÇæ¾ø,
SIRS,
Éæ¾à¼Åê ÀêÇæË Íå ¡¾ºà ¼Çæ —ÊòåÄ Éæ´êÀà ¡ÇÄê¼È ÀèÎè¿ ¡å³åÀ¾ïºà (1983 ¡â¨ 24 ) 6 Éæ¾ø Íå 7 Éæ¾ø ɪ¾àºø Æ´ïºà ÌæÀÆúÆ Æêºë
—ÌàºÇ ïÄÍú ¡¾ø¨à Àè´êïŒ ¼¨àÉå ¡æº.
THE particulars required to be furnished under Sections 6 and 7 of the W. & O. P. Fund Ordinance (No.24 of 1983) are shown overleaf.

.........................................................
¼åÆú¨åÉïªà ¡ºà̾.
Signature of Contributor.
Éæ¾à¼Åê Íå ¡¾ºà ¼Çæ —ÊòåÄ Éæ´êÀà ¨òÄïÆà
¡½ñ¨àËÉÇæ¾à ïɺ´Æú. ¼ú¾Æ
The Directors, ...................................
Date
Widows and Orphans Pension Scheme.

H - 022255 (2004/10) Êòé Èâ¨å Ç°ïÆà Äê÷¸ ï¼ÀåںàºëÉ [¡. Àè. Â./ P.T.O.
 1 2 3 4 5 6

¼ÇæÉå ¤À¾à/ ÃåÚÆåÉ諭à

¼ÇæÉåïªà ÄÉïªà ¾Ä —ÉåÍ Éì/ •ÆªúÆ* ¼ú¨à¨Ìå¼ Éì/
¼ÇæÉåïªà ¾Ä Ìàºòé ÀêÇæË ÃåÚÆåÉïªà ¾Ä ÃåÚÆåÉ •ÆªúÆ*
Name of Mother of Child ¼è¾Æ
Name of Child ÃåÉÆ Date of Birth/
Name of Wife
¼è¾Æ
Sex Marriage/ Death* Date of Divorce/
of Child Death* of Wife

Ìæ. Æê. _ ¼Çæ ¤Àº¨à ªæ¾ ¼æ¾êŠ ¼ûÄ´ ¾Š 1 Éæ¾ø, 2 Éæ¾ø, 3 Éæ¾ø Íå 4 Éæ¾ø ï¨å´êÉÈ Èè—Æ ÆêºëÆ. ¼Çæïɨëïªà —ÉåÍƨà ïÍåà ÄǸƨà
ªæ¾ ¼æ¾êŠ ¼ûÄ´ ¾Š 1 Éæ¾ø, 2 Éæ¾ø Íå 4 Éæ¾ø ï¨å´êÉÈ Èè—Æ ÆêºëÆ. ÃåÚÆåÉïª¾à ¼ú¨à¨Ìå¼ÑÄ¨à ªæ¾ ïÍåà ÃåÚÆåÉïªà ÄǸÆ
ªæ¾ ¼æ¾êŠ ¼ûÄ´ ¾Š 5 Éæ¾ø Íå 6 Éæ¾ø ï¨å´êÉÈ Èè—Æ ÆêºëÆ.
* ¡¾ÉÊñ É®¾ ¨Àå ¼Ä¾à¾.
N.B. – To notify the Birth of child, fill in columns 1,2,3 and 4.
To notify the Marriage or Death of child, fill in columns 1, 2 and 4.
To notify the Divorce or Death of wife, fill in columns 5 and 6.
In case of divorce of wife, a certified copy of the decree of divorce should be forwarded.
* Delete what is not applicable.
Éæ¾à¼Åê Íå ¡¾ºà ¼Çæ —ÊòåÄ Éæ´êÀà ¨åÚÆåÈïÆà, ïÈਊ ½êǾà½Ç ª¸¨å“¨åÖ Äͺå ïɺ´Æú,
ïŠ ¾øȽåÖÆåïªà Éæ¾à¼Åê Íå ¡¾ºà¼Çæ —ÊòåÄ Éæ´êÀà ïÈ੾ ¡â¨Æ .................................. Æ.
The Secretary & Accountant, W. & O. P. Office,
Forwarded. The W. & O. P. Register number of the officer is .....................................................

.........................................................
¼ú¾Æ ...................................
ï¼ÀåںàºëïŒ Àò½å¾ ºæ¾.
Date Head of Department.