From:

KALAWATTI (221885 ) c/o Nitia Nand

Peon, (Office)Patiala Drainage Circle Patiala
H No 140 Block B New Century Enclave Ablowal Road Patiala
To,
Superintending Engineer
Patiala Drainage Circle Patiala
Irrigation
 
Subject:    APPLICATION FOR SANCTION OF PENSION AND GRATUITY.
Sir,

I am due to Superannuation retire from service, with effect from the

30/09/2023 my date of birth being 20/09/1963, I, therefore, request that steps
may kindly be taken with a view to the Pension and Gratuity admissible to
me being sanctioned by the date of my retirement. I desire to draw my
pension from District Treasury Office, Patiala; Bank Name : PUNJAB
NATIONAL BANK (PUNB0291800) Address : MODEL TOWN , PATIALA

2. I hereby declare that I have neither applied for, nor received any pension
or gratuity in respect of any portion of the service qualifying for this pension
and gratuity as claimed herein, nor shall i submit an application, hereafter
without quoting a reference of this application and the order which may be
passed thereon.

3. I am governed by the Family Pension Scheme 1964 and that the complete
and up-to-date details of my family are as under:
SrNo Name Age Relation Date of Birth Remarks
1 Hansi 43 DAUGHTER 06/09/1980
2 BHOLLA DUTT BHATT 41 SON 10/10/1982
3 Bimla 38 DAUGHTER 04/06/1985
4 Pushpa Rani 34 DAUGHTER 16/09/1989

4. I enclose herewith :

(i) Requisite application forms

(ii) Two specimen signatures of mine duly attested
(iii) Three passport size photographs duly attested and three passport size
photographs (joint with wife) also duly attested.
(iv) Two slips each showing particulars of my height and identification
marks.

5. My Present Address is:KALAWATTI (221885 ) c/o Nitia Nand, H No 140

Block B New Century Enclave Ablowal Road Patiala

6. My address after retirement is: KALAWATTI (221885 ) c/o Nitia Nand, H No

140 Block B New Century Enclave Ablowal Road Patiala

Date:26/06/2023 Signature _____________________

KALAWATTI (221885 ) c/o Nitia Nand
Peon, (Office)Patiala Drainage Circle Patiala
(Dept.) Irrigation
THUMB Impression in case of illiterate employee
 LIST OF ENCLOSURES

1. Form PEN. 1-and form PEN. 15 duly completed

2. Medical certificate of incapacity (if the claims for invalid pension.)

Statement of the savings affected and the reasons why employment could
3.
not be found elsewhere (it claim is for compensatin, pension or gratuity).

4. Service Book (date of retirement to be indicated in the Service Book)

Two specimen signatures, duly attested by a gazetted government

employee or in the case of pensioner not illiterate enough to sign his
(a)
name. Two slips bearing the left hand thump and finger impression,
duly attested by gazetted government employee.
Three copies of passport size photographs with wife or husband(either
(b)
jointly or separately) duly attested by the Head of Office.

Two slips showing the particulars of height and identification marks

(c)
duly attested by a gazetted government employee.
A Statement indicating the reason for delay in case the pension papers are
6. not forwarded before six months of the retirement of government
employee.
Written statement if any of the government employee as required under
7.
rule 9.4.
Brief statement leading to retirement of the government employee in case
8. the of government employee has been reinstated after having been
suspended compulsory retired, removed or dismissed from service.
Note:- When initials or name of the government employee are or is
incorrectly given in the various records consulted this fact should be
mentioned in the letter.
*If a government employee is compulsory retired from service and delay
is anticipated in obtaining from PEN. I from the government employee,
the head of office may forward the pension papers to the Accountant
General Punjab without form PEN. 1. The form may be sent as soon as it is
obtained from the government employee:

**Only two copies of passport size photograph need to be furnished:-

(i) if the government employee is unmarried or a widower or widow;

AND

(ii)If the government employee is governed by rule 6.17 of the Punjab Civil
service Rule Volume II.
 FORM PEN. 15-A
See Rule 9.6(I)

Form of letter of the Accountant General Punjab forwarding the pension

Paper's of a government employees
Date: 26/06/2023
To
Accountant General Punjab,
Chandigarh
Subject: Pension Papers of Smt KALAWATTI (221885 ) Peon, PATIALA
DRAINAGE CIRCLE PATIALA, IRRIGATION for Authorisation of pension.

Sir,

I am directed to forward herewith the pension papers of KALAWATTI

(221885 ) Peon, PATIALA DRAINAGE CIRCLE PATIALA IRRIGATION of this
Department for further necessary action.

2. The detail of government dues which will remain outstanding on the date
of retirement of the government employee and which need to be recovered
out of the amount of death-cum-retirement gratuity are indicated below:
A) Balance of the house building or conveyance advance Rs.0
B) Over payment of pay and allowances including leave salary Rs.0
Income tax deductible at source under the income Tax Act-1961,(43
C) Rs.0
of 1961)
Arrears of license fee for the retention of government
D) Rs.0
accomodation.
E) The ammount of license fee for the retention of government . Rs.0
F) Accommodation for the permissible period of two month beyond
Rs.0
the date of retirement
G) Any other assessed dues and the nature there of Rs.0
Any amount of gratuity to be withheld for adjustment assessed due
H) Rs.0
if any
  Total 0
3. Your attention is invited to the list of enclosures which is forwarded
herewith.
4. The receipt of this letter may be acknowledged and this Department
informed that necessary instructions for the disbursement of pension have
been issued to disbursing authority concerned.
5. The death-cum-retirement-gratuity will be drawn and disbursed by this
Department on receipt of the authority from you. The outstanding
government dues as mentioned in para 2 above will be recovered out of the
death-cum-retirement-gratuity before making payment.

Yours Faithfully
Superintending Engineer
Patiala Drainage Circle Patiala
Irrigation
 FORM PEN.I

[Reffered to in Rule 9.3,9.6(1),9.6(3) and 9.10(1)]

Form for Assessing Pension and Gratuity
(To be sent in duplicate if payment is desired in a different circle of account)
Part I
1) Name of the Government employee: KALAWATTI (221885 )
2) Hasband Name in the case of female Nitia Nand (Husband)
Govt.employee):
3) Date of birth (by Christain era): 20/09/1963
4) Nationality: Indian
5) Permanent residential address showing H No 140 Block B New
Village, Town District and State: Century Enclave Ablowal
Road Patiala
6) Present or Last appointment including Substantive
name of establishment
7) Date of beginning of service: 26-04-1993 00:00:00
8) Date of ending of service: 30/09/2023
9) i) Total period of military service for
which pension or gratuity was sanctioned.
ii) Amont and nature of any pension or
gratuity received for the military service.
10) Amount and nature of any pension or
gratuity received for previous Civil
Service:
11) Government under which service has PUNJAB GOVERNMENT
been rendered in order of employee:
12) Class of pension applicable: Superannuation
13) Date on which action to-
i) Obtain the 'No Demand certificate' from i)
the Directorate of estates as provided in
Rule 9.2.
ii) Assess the service and emoluments ii)
qualifying for pension as provided in rule
9.4 and
iii) Assess the Government dues other iii)
than the dues relating to the allotment of
Govt. Accommodation as provided in rule
9.8

Amount (In
Description
Rs.)
Balance of the house building or conveyance advance 0
Over payment of pay and allowances including leave
0
salary
Income tax deductible at source under the income Tax
0
Act-1961,(43 of 1961)
Arrears of license fee for the retention of government
0
accomodation.
 The ammount of license fee for the retention of
0
government .
Accommodation for the permissible period of two month
0
beyond the date of retirement
Any other assessed dues and the nature there of 0
Any amount of gratuity to be withheld for adjustment of
0
un- assessed dues, if any.
Total 0

14) i) Details of omission imperfections of NIL

Deficiencies in the Service Book which
have been ignored under rule 9.4(b)ii.
15) Total length of qualifying service (for the Years: 30 Months: 5 Days:
purpose of adding towards broken period 4
a month is reckoned as 30 days)
16) Periods of non qualifying service Years: 00 Months: 00 Days:
00

i) Interruption in service condoned under

rule 4.23.
ii) Extraordinary leave not qualifying for
pension.
iii) Period of suspension not treated as
qualifying for pension.
iv) Any other service not treated as
qualifying for pension.
17) Emolument reckoning for gratuity.
18) Average Emolunments drawn during the
Last Ten Months of service
i)
ii) Years: 00 Months: 00
Days: 00
iii)
iv) Years: 00 Months: 00
Days: 00
61774
1 (61774 / 2) 2 (61774 / 3) 3
(61774 / 4) 4 (61774 / 5) 5
(61774 / 6) 6 (61774 / 7) 7
(61774 / 8) 8 (61774 / 9) 9
(61774 / 10) 10 (61774 / 11)

Sr.No Year Month Pay(BasicPay+GradePay+DA+IR+NPA) Total

1. 2022 DEC 44800+0+15232+0+0 60032
2. 2023 JAN 44800+0+15232+0+0 60032
3. 2023 FEB 44800+0+15232+0+0 60032
4. 2023 MAR 44800+0+15232+0+0 60032
5. 2023 APR 46100+0+15674+0+0 61774
6. 2023 MAY 46100+0+15674+0+0 61774
7. 2023 JUN 46100+0+15674+0+0 61774
8. 2023 JUL 46100+0+15674+0+0 61774
9. 2023 AUG 46100+0+15674+0+0 61774
10. 2023 SEP 46100+0+15674+0+0 61774

i) In case where the last ten months include some period not to be reckoned
for calculating average emoluments an equal period backward has to be
taken for calculating average emoluments.
ii) The calculation average emoluments should be based on actual number
of days contained in each month.
19) Date on which Form Pen 15 has been 26/06/2023
obtained from the government
employment (to be obtained eight months
 before the date of retirement of Govt.
employee.)
20) I) Proposed Pension. I) 23050
II) Proposed Graded relief. II)Nill
21) Proposed Death-Cum-Retirement Gratuity 942054
22) Date from which pension is to be 01/10/2023
commence.
23) Proposed amount of Provisional pension,-
If departmental or Judicial proceeding is
instituted against the government
employee before retirement.
24) Detail of Government dues recoverable
out of Gratuity: i) 0
i) Licence fee for the Allotment of ii)
Government accomodation
[see sub-rule(2),(3) and (4) of rules 9.17].
ii) Dues referred to in rule 9.18.
25) Whether nomination made for-
i) Death cum retirement Gratuity. I) Yes
ii) Family pension 1950, If applicable. II) Yes
26) Whether Family Pension 1964 Applies to Yes
the Government employee and if so i)
i) Emoluments reckoning for family
pension.
ii) The amount of Family Pension
becoming payable to the family of the
Government employee and if death taking
place after retirement.
A)Family pension a) 13830
iii) Complete and uptodate details of
family as given (in form3)
  Name of the member Relationship with the
Sr.No Date of Birth
of the Family Government employee
1. Hansi 06/09/1980 DAUGHTER
2. BHOLLA DUTT BHATT 10/10/1982 SON
3. Bimla 04/06/1985 DAUGHTER
4. Pushpa Rani 16/09/1989 DAUGHTER

27) Height 155 (cm)

28) Identification Marks SCAR MARK AT THE
RIGHT SIDE O FACE JUST
CLOSE TO RIGHT EYE
29) Place of Payment of Pension(Treasury) District Treasury Office,
Sub Treasury or Branch of Public Sector Patiala
Bank or the Pay Accounts Officer. IFSC Code- PUNB0291800
Bank Name- PUNJAB
NATIONAL BANK
Branch Name-PATIALA
MODEL TOWN, DISTT. PAT
30) Head of Account to which pension and 2071 - Pension and Other
gratuity are debitable. Retirement benefits.
 Signature of the Head of Patiala Drainage Circle Patiala

PART II

SECTION I
ACCOUNT ENFACEMENT:
1) Total period of qualifying service which has Years: 30 Months: 5 Days: 4
been accepted for the grant of
superannuation or retiring or invalid or
compensation or compulsory retirement
pension and gratuity, with reason for
disallowance, if any (other than disallowance
indicated in part I of this form)
2) Amount of superannuation or retiring or 23050
invalid or compensation or compulsory 942054
retirement Pension and Gratuity that has
been admitted.
3) The date from which superannuation or 01/10/2023
retiring or invalid compensation or
compulsory retirement pesion or gratuity is
admissible.
4) Head of account to which superannuation or 2071-Pension & Other
retiring or invalid compensation or Retirement Benefits 01-
compulsory retirement pension or gratuity isCivil
chargeable. 101-Supernnuation and
Tetirement Allowances
105-Family Pension
104-Gratuites
102-Commuted Value of
Pension
5) The amount of family pension 1964 becoming 13830
payable to the entitled member of family in 23050
event of death or the govt employee after
retirement.

SECTION II

1) Name of the Govt Employee KALAWATTI (221885 )

2) Class of Pension or Gratuity Superannuation
3) Amount of Pension authorized 23050
4) Amount of gratuity authorized 942054
5) Date of commencement of pension. 01/10/2023
6) Amount of family pension in the event of
death after retirement.
A)Family pension i)13830
7) The amount of graded relief admissible on
pension
8) The Government dues recoverable out of 0
gratuity before authorizing its payment
9) The amount of cash deposit of the 0
amount of gratuity held over for
adjustment of un-assessed government dues.
10) Date on which the pension papers 01/10/2023
received by the "Account Officer"
 CALCULATION SHEET

PART A- PARTICULARS
Employee Code: (221885) Husband Name:Nitia Nand
Employee Name: KALAWATTI
Designation: PEON Pay In Pay
Office: PATIALA DRAINAGE CIRCLE (BasicPay+DA+IR+GP+NPA):
PATIALA 46100+15674+0+0+0
PART B- QUALIFYING SERVICE
1. Date of entry into Govt. Service 26/04/1993
2. Date Of Retirement 30/09/2023
Total Period of Service From 26/04/1993 Years Months Days
3.
To 30/09/2023 30 05 04
4. Non Qualifying service 00 00 00
5. Weightage in Service 00 00 00
6. Pre-Joining Qualifying Service 00 00 00
7. Net Qualifying Service for Pension 30 5 4
PART C-PENSION(Average Emolunments For Last Ten Months)
Sr.No Month/Year Pay(BasicPay+GradePay+DA+IR+NPA) Total
1. DEC/2022 44800+0+15232+0+0 60032
2. JAN/2023 44800+0+15232+0+0 60032
3. FEB/2023 44800+0+15232+0+0 60032
4. MAR/2023 44800+0+15232+0+0 60032
5. APR/2023 46100+0+15674+0+0 61774
6. MAY/2023 46100+0+15674+0+0 61774
7. JUN/2023 46100+0+15674+0+0 61774
8. JUL/2023 46100+0+15674+0+0 61774
9. AUG/2023 46100+0+15674+0+0 61774
10. SEP/2023 46100+0+15674+0+0 61774
Average Emolunments Pay in Pay Band____ 61077
Pension for the Maximum Service(50% of AE/Last
23050
Emolunments)
Family Pension @ 30% 13830
Total Death-cum-Retirement Gratuity 942054
Percentage/Amount Of Monthly Pension Commuted 9220
Amount of commuted value of Pension Authorised 906584
Remarks(if Any)
Signature of Head of Office

Superintending Engineer
Patiala Drainage Circle Patiala
Irrigation
 HISTORY OF SERVICE

NAME OF EMPLOYEE: KALAWATTI (221885 )

HUSBAND NAME: Nitia Nand
DESIGNATION: Peon
ESTABLISHMENT OFFICE: Patiala Drainage Circle Patiala
Treasury: District Treasury Office, Patiala
Posting Office: Patiala Drainage Circle Patiala
PERIOD PERIOD NOT
PERIOD OF
APPOINTMENT DATE OF DATE OF RECKONED AS RECKONED AS
LEAVE (EOL) REMARKS
AS JOINING RETIREMENT SERVICE SERVICE
YRS MTHS DAYS YRS MTHS DAYS YRS MTHS DAYS
service
PEON 26/04/1993 30/09/2023 30 5 4 00 00 00 00 00 00
verified
Transaction Effective Order
# Transaction Attachment Remarks
Date Date No.
Initial
1. Appointment 26/04/1993 26/04/1993 1572-77
Order
Service
2. 01/04/2014 01/04/2014 ---
Verification
Service
3. 01/04/2015 01/04/2015 ---
Verification
4. Increment 01/04/2015 01/04/2015 NIL
5. Increment 01/04/2016 01/04/2016 NIL
Service
6. 01/04/2016 01/04/2016 --
Verification
7. Increment 01/04/2017 01/04/2017 NIL
2182/99-
8. ACP 16/03/2018 16/03/2018
E
9. Increment 25/04/2020 01/04/2020 0
10. Transfer 20/04/2021 20/04/2021 3272-74
11. Relieved From 22/04/2021 3272-74
12. Increment 28/04/2021 01/04/2021 1
4657-
13. Relieved From 04/06/2021
58/9E
4657-
14. Transfer 04/06/2021 31/05/2021
58/9E
15. Increment 26/04/2022 01/04/2022 NA
16. Increment 05/04/2023 01/04/2023 NA
Qualifying 26/04/1993 to
30 05 04
Service 30/09/2023
 FORM PEN.15
(Referred to in rule 9.2)

Particulars to be obtained by the Head of office from the retiring

government employee eight months before the due date of his retirement.
1. Name of the government employee : KALAWATTI (221885 )
:Date of Birth: 20/09/1963
2. Date of birth/Retirement  Date of Retirement:
30/09/2023
3. * Two specimen signatures of government
employee duly attested to be furnished in a Attached
separate sheet.
4. Three copies of passport size** joint
photograph of the Government employee and Attached
his/her wife/husband.
5. Two slips each showing the particulars of
height (in cm) and personal identification : Attached
marks duly attested.
6. : H No 140 Block B New
Present Address Century Enclave Ablowal
Road Patiala
7. : H No 140 Block B New
Address after retirement Century Enclave Ablowal
Road Patiala
8. Name of Treasury/Public Sector Bank :District Treasury Office,
through which the Government Employee Patiala/
want to draw his pension. A/c No.- 2918001300003216,
IFSC code- PUNB0291800
Bank Name- PUNJAB
NATIONAL BANK
Branch Name- PATIALA
MODEL TOWN, DISTT. PAT
9. Details of the family as defined in rule 6.17(3) of CSR Vol.II
Name of the member of Relationship with the
Sr.No Date of Birth
the Family Government employee
1. Hansi 06/09/1980 DAUGHTER
2. BHOLLA DUTT BHATT 10/10/1982 SON
3. Bimla 04/06/1985 DAUGHTER
4. Pushpa Rani 16/09/1989 DAUGHTER

Dated: 26/06/2023

Signature of the Employee

KALAWATTI (221885 )
Peon,
Patiala Drainage Circle Patiala ,
Irrigation
* Two slips each bearing the left hand thumb and fingers impression
attested may be furnished by a person who is not literate enough to sign his
name. If such a Government employee on account of physical disability is
unable to give left-hand thumb and fingers impressions, he may give the
thumb and finger impression of te right hand. Where a Government
employee has lost both the hands, he may give his toe impressions. The
impression shall be duly attested.
# Only two copies of passport size photograph of self need be furnished if
the Government employee is governed by rule 6.17 of the Pb. CSR Vol-II and
unmarried or a widower or widow.
** Where it is not possible for a Government Employee to submit a
photograph with his wife/her husband, he/she may submit a separate
photograph. The photograph shall be attested by the Head of office.
Any subsequent change of address should be notified to the Head of
office/audit office.
Applicable only where rule 6.17 of the Punjab CSR Vol-II is applied to the
Government Employee.
 DESCRIPTIVE ROLL

Descriptive Roll of : KALAWATTI (221885 )   (Applicant)

Designation : Peon
Husband Name : Nitia Nand
Establishment Office : Patiala Drainage Circle Patiala
Posting Department : Irrigation
 
Date of Birth (by Christian
1. : 20/09/1963
era)
2. Height : 155 (cm)
3. Personal marks, If any on : SCAR MARK AT THE RIGHT SIDE O FACE
Hand or face JUST CLOSE TO RIGHT EYE
4. Signature or thumb and finger impression:

Specimen Signature of KALAWATTI  (Applicant)

1. __________________________________________

2. _________________________________________

3. _________________________________________

Attested
 FORM Pen 1-C
NOMINATION FOR DEATH - CUM - RETIREMENT GRATUITY.
(when the officer has family and wishes to nominate member thereof)
............................................................................
Employee Name- KALAWATTI (221885 ) c/o Nitia Nand, Peon, Patiala
Drainage Circle Patiala, Irrigation. I hereby nominate the person mentioned
below who is a member of my Family and confer on his/her right to receive
any gratuity and may be sanctioned by the Government in the event of my
death.
Name & address and
Name & Contingencies in the
relationship of the person if
relationship happening of which the
Age any, to whom the right
Address with nomination shall
conferred the nominee
officer. become invalid.
redeceasing the officer
Hansi
43
DAUGHTER
BHOLLA DUTT
41
BHATT SON
Bimla
38
DAUGHTER
Pushpa Rani
34
DAUGHTER
Dated this 26/06/2023 day of ________________________
At___________________________
Signature of the employee.
Witness
1.___________________________

2.___________________________

FORM Pen 1-D

Employee Name- KALAWATTI (221885 ) c/o Nitia Nand, Peon, Patiala

Drainage Circle Patiala, Irrigation. I hereby nominate the persons mentioned
below who are members of my family to receive in order shown below the
family after completion of 5 years service.
Name and Address of Relationship with Whether married or
Age
nominee officer unmarried
Hansi DAUGHTER 43
BHOLLA DUTT BHATT SON 41
Bimla DAUGHTER 38
Pushpa Rani DAUGHTER 34
This nomination supersedes the nomination made by me earlier on
______________________________ which stands cancelled.
N.B. The officer should draw lines across the blank space below the last
emtry to pervent insertion of any name ofter the has signed.
Dated this 26/06/2023 day of ________________________
At___________________________
SIGNATURES OF WITHNESSES:

1.________________________________
2.________________________________

________________________________________________________________________________
(To be filled in by the head of the office in the case of a non-Gazetted Officer)

Nomination____________________________ Signature of Head of the office

Designation____________________________ Date___________________________
Office________________________________ Designation________________________
 NO DUE CERTIFICATE

1 Certified that KALAWATTI (221885 ) c/o Nitia Nand, Peon, Patiala

Drainage Circle Patiala, Irrigation, who has retired from
Government service with effect from 30/09/2023 has made over
complete charge of her/his office and nothing is due from her/him.

2. Further certified that no audit objection/recovery is outstanding

against this official/officer.

3. Further certified that no vigilance enquiry is pending against

her/him

4. Further certified that no judicial proceedings is pending against

her/him

Signature of Head of office

SUPERINTENDING ENGINEER
Patiala Drainage Circle Patiala

Date 26/06/2023

CERTIFICATE

Certified that there is no complaint or inquiry lying pending against

KALAWATTI (221885 ) c/o Nitia Nand, Peon, Patiala Drainage Circle
Patiala, Irrigation, who has retired from Government service w.e.f
30/09/2023 .

Signature of Head of office

SUPERINTENDING ENGINEER
Patiala Drainage Circle Patiala

Date 26/06/2023
 Undertaking under rule 9.15

Declaration to refund the amount of pension and gratuity, if paid in

excess as referred to in the Rule 9.15 of the Punjab CSR, Volumne-II,to be
furnished by the retiring officer or a member of his family or his legal
heirs, as the case may be, to the Authority sanctioning the
Pension/Service gratuity/Death-cum-Retirement Gratuity, arrears of
Pension or gratuity.

Where as MANOJ KUMAR BANSAL (Superintending Engineer) has

consented to grant me/us the sum of Rs.23050 per month as the amount
of my pension/family penson and/or a sum of Rs.942054 as the amount
of gratuity due to (Name: KALAWATTI (221885 )   Designation: Peon)
Husband Name : Nitia Nand Office: Patiala Drainage Circle Patiala Dept.
Name: Irrigation)

(Here give the name and designation of the Govt

Servant)

I/We hereby acknowledge that in accepting this amount I/We fully

understand, that the Pension/Family Pension/Gratuity/Death-cum-
Retirement Gratuity/arrears of pension or gratuity due to KALAWATTI
(221885 ) is subject to revision and on its being found to be in excess of
the amount to which I/we am/are entitle under the rules, and I/we
promise to raise no objection to the recovery of amount paid to me/us in
excess of that to which, I/we may be eventually found entitled.

Witnesses:

Witness
Sr.No. Address Occupation Signature
Name
H No 29, Bhan Colony,
Government
1 Sunita Rani Century Enclave
Employee
Phase-3, Patiala
H no 14, New Century
Mandeep Government
2 Enclave, Ablowal
Kumar Employee
Road, Patiala

Attested by

Superintending Engineer
Patiala Drainage Circle Patiala
Irrigation

Signature of employee
Name: KALAWATTI (221885 )
Designation:Peon
Husband Name Nitia Nand
Establishment Department:Irrigation
 Government of PUNJAB
Irrigation
(Patiala Drainage Circle Patiala)
Superintending Engineer Patiala Drainage Circle Patiala Nabha Road Patiala

Viligance Clearance Certificate

 
This is to certify that the self declaration submitted by KALAWATTI (221885 )
c/o Nitia Nand, Peon (Patiala Drainage Circle Patiala) retiring on 30/09/2023
in the office of Patiala Drainage Circle Patiala Department of Irrigation has
been scrutinized by the undersigned and checked with the Vigilance
Clearance data available on the Viligance Bureau Website. As per this data
there is no Vigilance FIR or Vigilance Enquiry registered/pending against
him.
 
 
 
 
To,
 
(SUPERINTENDING ENGINEER)
Patiala Drainage Circle Patiala
Irrigation
PATIALA
 
 
No.______________________
Date 26/06/2023
 Calculation sheet for Family Pension/Death-Cum-Retirement Gratuity & History
Sheet of Service

Last Pay Certificate of Shri/shrimati/Kumari KALAWATTI(221885), PEON of

the office of PATIALA DRAINAGE CIRCLE PATIALA Proceding on
to_______________.
2. He/She has been paid up to 30/06/2023 at the following rates in the
scale of Rs. Level-3
Allowances Rate of Deductions
Basic 46100 GIS 60
Dearness Allowance 15674 Development Tax 200
Medical Allowance 1000 Total 260
Conveyance Allowance 600 Net Salary 70990
House Rent Allowance 7376
Mobile Allowance 500
Total 71250

3. His/Her GPF Account No. PB-IRR-C-IV-16416 is maintained by the

4. He/She Handover the charge of the office of PATIALA DRAINAGE
CIRCLE PATIALA on the noon of .
5. Recoveries are to be made from the emoluments etc. of the
Government employee as detailed below.
6. He/She is entitled to draw the following:
7. He/She has been sanctioned _________________ leave proceeding joining
time for ___________________ days.
8. He/She finances the insurance policies detailed below from the
Provident Fund :
No. of Policy Amount of Premium Due Date for the payment of Premium
     

9. Details of P.L.I Policy where premium deduction is done from pay bill
10. The Details of the C.P.F./Income-Tax/Profession Tax deduction made
from him/her upto the date from the beginning of current financial
year are noted below.
11. He resided at Government Rented House at . House Rent recovered
upto 30/06/2023.
Bank Acc. No. IFSC Code Mobile No. PAN No.
2918001300003216 PUNB0291800 9855951359 AOXPK5311F

Date: 27-06-2023
Signature ___________________________________
Designation ____________________________________
 (Details of Recoveries)
Total amount of
Name of advance advance Outstanding Rate of Current
involving sanctioned with amount instalments Month
recovery/adjustment date of drawal and recoverable Rs. Deduction
T.V. number
         

Names Pay-leave Fee/Special Amount of

Development
of salary and allowance/Honora income tax Remarks
Tax Deducted
months allowances rium etc. recovered
Rs. Rs. Rs. Rs.
March
200 0
2023
April
200 0
2023
May 2023 200 0
June 2023 200 0
Total 800 0

Signature of the D.D.O __________________________________

Designation ____________________________________
 UNDERTAKING IN TERMS OF RULE 9.15 OF PB.C.S.R. Vol. II

I KALAWATTI undertake that after my retirement i or my heirs will be

responsible to refund to the Govt. of Punjab, the amount of Pension, adhoc
increase / Temporary increase / adhoc relief or any kind of increase in
pension if any paid to me or my heirs erroneously or in excess of that due to
me or to them.

Signature of Employee
Employee Name: KALAWATTI
Employee Code: 221885
Nitia Nand
Designation : Peon
Patiala Drainage Circle
Posting Office :
Patiala
Date : 26/06/2023
Patiala Drainage Circle
Place :
Patiala

Witnesses:

Witness
Sr Address Occupation Signature
Name
H No 29, Bhan Colony,
Government
1 Sunita Rani Century Enclave
Employee
Phase-3, Patiala
H no 14, New Century
Mandeep Government
2 Enclave, Ablowal
Kumar Employee
Road, Patiala

Attested By:
Head of Office/ Pension Authority

(Superintending Engineer)
Patiala Drainage Circle Patiala
Irrigation
 Specimen Signatures/Left Hand Thumb and Finger Impressions

Employee Name: KALAWATTI

Employee Code: 221885
Nitia Nand
Designation: Peon
Posting Office :Patiala Drainage Circle Patiala
Parent Deptartment : Irrigation

Specimen Signature

1. 2.
Left hand Thumb Impression and Finger Impression (Relevant for
Illiterate Pensioner)

Note: If government servant is unable to give left thumb and finger print
impressions, he may give right hand thumb and finger print impressions.
Where an employee has lost his hands, he/she may give his/her toe
impression.
Little Finger Ring Finger Middle Finger

Index Finger Thumb

Certified that the above specimen signature and thumb & finger impressions was / were taken in my
presence.

Head of Office/ Pension Sanction Authority

(Superintending Engineer)
Patiala Drainage Circle Patiala
Irrigation
 Certificate Regarding Military Service

Certified that I have not rendered any Military service nor have received any
pension or gratuity.

Signature of Employee

Employee Name:KALAWATTI

Employee Code:221885

Father:Nitia Nand

Designation:Peon

Posting Office:Patiala Drainage Circle Patiala

Parent Deptartment:Irrigation
Date:26/06/2023

Place:PATIALA

Attested By:

Signature of Head of Office

Officer HRMS Code _________________________

Name of Attesting
_________________________
Officer
Designation of
_________________________
Attesting Officer
 Authority Letter to Recover Govt. Dues from Pension

I hereby authorize pension authority (Irrigation) to recover any Govt. dues

such as overpayment of pay, allowances, leave salary or admitted and
obvious dues such as house rent, postal life insurance premium, outstanding
house building advance, traveling allowances and other advances or any
amount, if any discrepancy in found recoverable from me at any stage from
my pension.

Signature of Employee
Employee Name: KALAWATTI
Employee Code: 221885
Designation:Peon
Posting Office:Patiala Drainage Circle Patiala
Parent Deptartment:Irrigation
Date:26/06/2023

Place: PATIALA

Attested By:

Signature of Head of Office

Officer HRMS Code _________________________
Name of Attesting
_________________________
Officer
Designation of
_________________________
Attesting Officer
 PHOTOGRAPHS

Employee Name : KALAWATTI

Employee Code : 221885
Designation : Peon
Posting Office : Patiala Drainage Circle Patiala
Parent Department : Irrigation

1) Individual Photograph (Duly Attested)

1) Joint Photograph with Spouse (Duly Attested)

 FORM PEN. 14-B

(Referred to in Rule 11.12-A)

Form of application for commutation of Pension without Medical
Examination
To
Accountant General,(A & G), Punjab,
Chandigarh
Subject: Commutation of Pension without Medical Examination.
Sir,
I furnish below the relevant particulars and request that I may be permitted
to commute a part of my pension as indicated below (an attested copy of my
latest photograph on the application and unattested is enclosed):
1) Name in Block Letters : KALAWATTI (221885 )
2) Husband Name : Nitia Nand
3) Designation : Peon
4) Date of Birth : 20/09/1963
Date of retirement on
5) superannuation or extension : 30/09/2023
granted, if any.
Amount of Pension
6) : 23050
Sanctioned.
Fraction of superannuation
7) Pension Proposed to be : 40 %
commuted.
Name of Establishment
: Patiala Drainage Circle Patiala/
8) office/Posting department in
Irrigation
which Employed
Name of the pension
9) disbursing authority from : District Treasury Office, Patiala
which pension is to be drawn
Signature of the Government
10) :________________________________________
Employee

Name: KALAWATTI
(Peon)
Patiala Drainage Circle Patiala/Irrigation
Address: H No 140 Block B New Century Enclave Ablowal Road
Patiala

No.
Dated:26/06/2023
Forwarded in original to the Principal Accountant General, (A & E), Punjab,
(Pen-Section) for authorizing the commuted value of 40 % of total pension.

(Signature of Head of Department)

 DETAILS OF PAN NUMBER AND ADHAAR NUMBER

1) Employee Name : KALAWATTI (221885 )

2) Designation : Peon
3) Name of Establishment : Patiala Drainage Circle Patiala/
office/Posting department Irrigation
4) PAN NUMBER : AOXPK5311F
5) ADHAAR NUMBER :
6) E-MAIL : VOLLABHATT@GMAIL.COM
7) Mobile No : 9855951359

(KALAWATTI)
 FORM PENSION 10

(Referred to in rule 10.11)

OFFICE OF THE PRINCIPAL ACCOUNTANT GENERAL (A&E),PUNJAB
PENSION PAYMENT ORDER
CUM-GRATUITY ORDER-CUM-COMMUTATION PAYMENT ORDER
(PART I & II)
File ID:
Case No.:
Date of Authorization:
Date of Start of Pension/Family Pension: 01/10/2023
Place of Payment (Treasury/Sub Treasury): District Treasury Office, Patiala
Pension Payment Order No.(PPO No.)
Gratuity Payment Order No.(GPO No.)
Commutation Payment Order No.(CPO
No.)
1. Name of the Government employee KALAWATTI
2. Husband Name Nitia Nand
3. Gender Female
4. Employee Unique Code(HRMS ID) 221885
H No 140 Block B New Century
(i) Full Residential Address
Enclave Ablowal Road Patiala
(ii) Mobile No. 9855951359
(iii) Email ID (if any) VOLLABHATT@GMAIL.COM
(iv) Aadhar Card Number N.A.
(v) PAN AOXPK5311F
5. Date of birth of the Govt. Employee 20/09/1963
6. Date of Entry into Govt. Service 26/04/1993
Date of retirement/death/Pre
7. 30/09/2023
Mature retirement.
Post held at the time of
8. PEON
retirement/death
9. Pay Band & GP/Level last held Level-3 & GP Not Applicable
10. Group of the Service last held D
PATIALA DRAINAGE CIRCLE
11. Office from where retired/died
PATIALA
12. Class of Pension Superannuation
13. 2071-Pension & Other Retirement
Debitable to Head of Account
Benefits 01-Civil
101-Superannuation and
i) For Pension
Retirement Allowances
ii) For Family Pension 105-Family Pension
iii) For DCRG 104-Gratuites
iv) For Commutation of Pension 102-Commuted Value of Pension
Punjab Civil Services Rules, Volume
14. Rules Applicable
II
15. i) Total Qualifying Service Years: 30 Months: 05 Days: 04
ii) Non-Qualifying Service Years: 00 Months: 00 Days: 00
iii) Weightage in Service Years: 00 Months: 00 Days: 00
iv) Pre-Joining Qualifying Period Years: 00 Months: 00 Days: 00
v) Net Qualifying Service for
Years: 30 Months: 5 Days: 4
Pension
16. (i) Last Pay Drawn 46100
 (ii) Average Emoluments for
45580
Pension/Family Pension
(iii) Amount of Pension (Basic
Pension) (50% of Row 16 (i) or (ii), 23050
whichever is higher)
(iv) Pension withheld, if any
(v) Cut in Pension, if any
(vi) Net Pension Payable 23050
(vii) Provisional Pension, if any (to
Amount (in Rs.)....................
be adjusted in payable pension)
(viii) Period from............ to.........
17. (i) Commuted Portion of Pension
9220
(Max 40% of the Pension)
(ii) Reduced Pension
(iii) commuted Value Pension 906584
(iv) Date of restoration of Pension
18. (i) Emoluments for DCRG (with Basic Pay 46100
brake up i.e. Pay, DA, NPA etc) Grade Pay 0
DA 15674
IR 0
NPA 0
Total 61774
(ii) Number of completed Half years 61
(iii) DCRG Sanctioned (Amount) 942054
(iv) DCRG withheld 0
(v) DCRG since paid, if any
(vi) DCRG Recovery
(vii) Net DCRG Authorised 942054
19. (i) Emoluments for Family Pension
(ii) Family Pension:
13830
(a) At Normal Rate 30%
(iii) Details of Family members
eligible for Family Pension
Whether
Sr. Date of Disabled/
Name Relationship Handicapped Aadhar Card No.
No. Birth/Age
(with proof
attached)

1 Hansi DAUGHTER 06/09/1980 N.A.

2 BHOLLA DUTT SON 10/10/1982 N.A.
BHATT
3 Bimla DAUGHTER 04/06/1985 N.A.
4 Pushpa Rani DAUGHTER 16/09/1989 N.A.
Instructions:
1. Unit further notice and on the expiry of every month, please pay to
KALAWATTI (Name of the Pensioner), the above said Pension (as Set out
in Part I & II of this order) plus the amount of Dearness Relief as
admissible from time to time thereon after due identification of the
Pensioner, subject to the condition(s) below and Punjab Government
(FD) Notification dated 17.08.2009 (can be seen at www.agpunjab.gov.in
or www.pbfinance.gov.in). Pension includes Interim relief.
2. The Payment of Pension should commence form 01/10/2023
3. Dearness Relief is payable with reference to the amount of pension
before commutation.
4. In the event of death of KALAWATTI (Name of the Pensioner), Family
Pension at enhanced Rate payable from day following day of death till
expiry of 7 years from date of retirement or on completion of 65 years of
age held the retiree survived at a Rs. 23050 per month may be paid to
(Name of Family Pensioner). Thereafter above said normal Family
Pension shall be paid as per condition mentioned in Punjab Civil Service
Rules.
5. Income Tax, where deductible, should be deducted at source.

Specimen Signature (Signature and Designation)

Seal of Pension Payment
Issuing Authority

To,
1. The District Treasury Officer: District Treasury Office, Patiala
A copy of the above is forwarded to: .....................(Designation and
2.
Address of the PSA);
A copy forwarded to:........................ (Name of the Pensioner with the
3.
complete address)

Specific Remarks of Senior Accounts Officer:

1.
2.
3.

(PART III)
Bank Details for Pension Payment
1. Joint Bank Account Number 2918001300003216
2. IFSC PUNB0291800
3. Bank Name PUNJAB NATIONAL BANK
PATIALA MODEL TOWN, DISTT.
4. Branch Name
PAT
5. Branch Code 291800
6. CPPC Code
7. Bank Address MODEL TOWN , PATIALA
8. PIN