NON - MARRIAGE CERTIFICATE

I do hereby solemnly affirm that I Mst:

W/O Designation EX- drawing Rs. /- as

pension/W.W.Fund from MEPCO not yet re-marrried and still widow.

I thereby request that the sanction amount of Rs.____________

for the month of ________ to ____________may kindly be remitted to me.

Name of Widow Mst:

Signature: __________________

NON - MARRIAGE CERTIFICATE

I do hereby solemnly affirm that I Mst:

W/O Designation EX- drawing Rs. /- as

pension/W.W.Fund from MEPCO not yet re-marrried and still widow.

I thereby request that the sanction amount of Rs.____________

for the month of ________ to ____________may kindly be remitted to me.

Name of Widow Mst:

Signature: __________________