PARTICULAR OF PENSIONER

The Manager

Group Insurance

O/o The General Manager

Postal Life Insurance PLI Building Lahore

G.P.O Lahore

Subject: FINAL PAYMENT OF GROUP INSURANCE TO GOVERNMENT SERVANTS AS PER JUDGMENT OF HONORABLE
SUPREME COURT OF PAKISTAN.

1. NO.
2. RANK.
3. NAME.
4. FATHER NAME.
5. CNIC NO.
6. CONTACT NO.
7. DEPARTMENT.
8. PPO NO.
9. BANK/GPO.
10. NAME OF BANK.
11. DATE OF BIRTH.
12. DATE OF JOINING.
13. DATE OF RETIRMENT.
14. TOTAL SERVICE.
15. KIND OF RETIRMENT.
a) Retiring.
b) Compensate ground.
c) Disciplinary Ground.
d) Punishment (if any during service).
16. ARE YOU APPLIED FOR GROUP INSURANCE EARLIER. (Yes/No)
17. ARE YOU RECEIVED GROUP INSURANCE ON RETIREMENT. (Yes/No)
18. YOU DEPARTMENT TAKEN UP THE CASE EITHER OR OTHERWISE. (Yes/No)

DELARATION

I solemnly declared that above facts are true to the best of knowledge and nothing has been concealed.

Dated: /2021. Signature:

LIFE CERTIFICATE

It is certifed that mentioned pensioner is alive up to

Signature:

Dated: /2021. NAME:

Seat: