The Administrators,

Retirement Benefits Team,

Asia Building 4th Floor,
Standard Chartered Global People Service Pvt Ltd.
No.1, Haddows Road, Nungambakkam,
Chennai-600006

Dear Pensioner,

Standard Chartered Grindlays Bank Limited Indian Staff Pension Fund

Declaration – Certificate of Existence – 2021

I Mr / Ms…………………………………………………………hereby declare that I am the Pensioner / Widow of Late

……………………………………………..., an Ex-Employee of the Bank and the legitimate beneficiary for receiving monthly pension from the
above-mentioned pension scheme.

I also declare that I am not remarried since the date of receiving my pension and undertake to keep the administrators informed of any changes in
my marital status (applicable in case of widow pensioners only).

Pension No
Date of Birth
Gender
Age (If Date of Birth is not available)
Marital Status
Present Address

Permanent Address

Contact number Land Line / Mobile

Email Address (if any)
Date of leaving / Last working day at SCB**
Account Number
IFSC Code
Note:
• In case you wish to make any changes in the bank account where you get your pension, please submit a cancelled cheque and a Bank
Passbook copy containing IFSC Code with this form. Inputs for above fields are to be provided mandatorily.
• **In case of widow pensions, the date of leaving husband (ex-employee) may be given. In case of child pension, the date of father
(ex-employee) may be given.

I declare that the above information is true to the best of my knowledge and belief.

Your’s Faithfully,

Name and Signature / Left Thumb Impression

Place: -
Date: -
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Certificate of Existence – Witness Declaration

I hereby certify that Mr. / Ms………………………………………….who was an ex-employee of the Bank is widow of
……………………………………………….Ex-Employee of your Bank has appeared before me in person this day.

I hereby confirm that above Declaration was signed and completed in my presence

Yours Truly,

Name / Designation / Seal and Signature

The survival certificate may be signed by the Magistrate/ Gram Panchayat Pradhan/ Official of The Bank/ Certified Medical