GOVERNMENT OF INDIA

MINISTRY OF COMMUNICATIONS
DEPARTMENT OF TELECOMMUNICATIONS
O/o THE PR. CONTROLLER OF COMMUNICATION ACCOUNTS
“TELEPHONE HOUSE”
8, HARE STREET, 2ND FLOOR, KOLKATA– 700001.
Phone: (033) 2213 7402, Fax: (033) 2231 3537/ 2213 8824.
Email: pccakolkata@gmail.com

KNOW YOUR PENSIONER FORM (For BSNL/ Telecom Pensioners only)

Sl.
Description Details
No.
01 Name of the person receiving pension

Please give following information related to the (1) above

Sl.
Description Details
No.
02 Whether (1) above is (Write tick mark in (a) Pensioner
appropriate place)
(b) Family Pensioner
03 If (1) above is pensioner, give the name of family (a) Name:
pensioner with date of birth (Proof to be enclosed)
(b) DOB(DD/MM/YYYY) :
04 If (1) above is family pensioner, give the name of (a) Name:
pensioner with date of death (Proof to be enclosed)
(b) DOD(DD/MM/YYYY) :
05 PPO No.

06 Pension received from (a) Bank

(Write tick mark in appropriate place)
(b) Post Office
07 Name of Bank/Head Post Office

08 Name of Paying Bank Branch/Sub Post Office

09 Account No. in which pension is credited

10 Full Present residential address with PIN code

11 Residential phone No. with STD Code.

12 Mobile No.
13 Aadhar No. (Self attested copy to be enclosed)
14 PAN card No.(Self attested copy to be enclosed)
15 Email ID
You are requested to send KYP form with documents to above mentioned address at an early date please. In
case of any query on KYP, please contact Ph. No. 033-22624428 from Monday to Friday during working hours.
Place:
Date :
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Signature of the Pensioner/Family Pensioner