FORl"1 6

lSeerule 7-5(15)(a) |
Drtails ot Farnity

l Narne of raihvay ser\rant

2 Desipation

, )ate of blrt-h

.1 Lletails of rhe rnembers o[ familv

a! on-_,__-_____

mernbers o-f lamily

I h€(cby uild.ellbhe to keep lhe aboreparticulad up-ro,date

. ,.
any additton or attdratfgrr.
!y notiryfu:g tD..the Head of.ltro Offcr

SigDs.h]re of ra i lway 6ery80t

Place :
Date:

ppfom submiued ty therqilwry,serv.drq b O Ue rctaincd.,AI

b bcr€d*dr{ iu:sbnirm underr'}re srg-hre d}r;;"}ohiJin-u;iti#; E-TB

origfual Fonif. tlblftmt-; the retirlng ,"il*r" ssrvant

*., a]r i.l,t ..rk;$ ir.^
ffi;"rH; the
Form 8.
ietirlnp rail.way shoulci'srtbririt U,l /^.^:r^ ,f'h#;
aet iis ^. c _ 5- ;;"sTffi;-ffi
Notc 2 -The dgtqib Of Spouse, alt ohildrco and parens (whether eligible for
disabted sr-bihgs (brqgcrs and sisrers) may farnlly pension cn not) and
be giv'en

Note 3' -Tho Hcad of ofliq€ shall indiiorc dre date-of receipi
of corrimuniqatiqn regarding addition g.
alreratioo in rup rllnity ln the 'Rcmarks'column.
the aa reqarding
'- "o disabiliry vr
oq .^ottsL
changc ur
of lrrdlrti'u
marital sra
a fanrily mernberSrciriid '
also bc intlicatcd in fhe.Remarkr,
status of.

r'-ctc 4 Wife and !lu.sbancl shall include judicially scparared wife

nnd hr.rsband_,,

(Auth o ritv: Fire No. 201 5/F(E)l I VI (l y,{ dr- I 7.06. t 6

-......ttB NO-.i0)