s0444h4s06essss44s1440446ie

1) siYurÜT (PAN) 64c5

2)

3)

372dT
 Letter of undertaking to be obtalned from Pensioners whose pension is paid by the Bank
under the scheme for payment of pensions by publlc sector banks.
To,
The Branch Manager,
State Bank of India,

In consideration of the State Bank of India having agreed at my request to credit to my

from
Savings Bank/Current Account in my single/joint name the amount of pension, payable to me
time to time by the Government of India, as it falls due, under the scheme for payment of pensions
of State / Central Government pensioners by public sector banks. I, the undersigned, Shri/lSmt./Ku

--Aged-- --- (years]of

--[address]agree and undertake to refund or make good to the Bank any
amount to which lam not entitled or any excess amount which may be credited to my account over
that to which Iam or would be entitled and agree that the amount of money when demanded by
the Bank from me as due and payable to the bank in respect thereof shall be conclusive as to the
amount and shall be binding on me. Ialso hereby so as to bind myself and my heirs, executors and
administrators - agree and undertake to indemnify the bank from and against any loss, costs,
charges, damages and expenses suffered or incurred by the Bank in so crediting my pension to my
authorize
account under the scheme and to forthwith pay the same to the bank and also irrevocably
the bank to recover the amo0unt in respect thereof by debit to my said account or any other deposit
belonging to me in the hand of the bank.
[U Witness:
Signature of the Pensioner
Signature
Account no.
Name
Mobile no.
Address
Mobile no

[2] Witness:

Signatures
Name
Address-

Mobile no
NOTE - Witness are required in the case of illiterate Pensioner/Family Pensioner only

2/ 34+ yr a faazi af GaT faà Pension Seva portal J4TT F,

https://www.pensionseva.sbi ye a f I
2/

Tas 1
TT^ 2
 with
PPO. [Gender
e] illiterate Íc] IMPORTANT-
[b] la)
ALONGWITH
PROPOSALPLEASE -
Pensioner
9. 8. 7. 6. 5. 4. 3. 2. 1.
Please Before LetterAccount Mobile
Telephone/Mobile no.]Xerox
code and individuals
notarized by In
Letter no. ]
Death hiattached)
Life Forwarding
s Application
case
2 name
gazetted Certificate SEND CHECK
also sending is put of No. Copy Certificate
of
Male undertaking account
Undertaking and
isname PLEASE
ensure his/her not of of inand from letter
FOLLOWING LIST
or joint Dealing officers SS
proposal, ENSURE
is
PPO case form
was on
Female [Duly no. the on
that thumb. same No. [Duly of Prescribed FOR
with Central V not & claimantBranch
is officer of & in for Branch
the verified any in
BEFORE attested VIcase jointrefund attested FAST
butplease PPO Pensioner. signed
date Govt. ofwith format letter PAPERS
not other and seal for
by and MP of by CREDIT
of null,ensure SENDING dealing deceased
by grant head.
branch family /Defence/Railway/Telecom by Overpayment
State branch
birth in BranchPensioner [Duly
CBS. of WITHOUT
is that Clerk. Govt. OF
FAMILY official attested family
seeded officialmember. official Pensioner, FAMILY
the Pensioner
and
[Format with pensioner
Marital if PENSION with
witnessed by FAIL
in the PENSION
CIF form his Branch
his or
and status pensioner attached]. name [Format
PROPOSAL name duly 42
Pensioner by official
matched and
is and 2signed A
Widow, is Ss with
SS
 1/
2/
3/
4/

6/

6/
SRI HAIQd!
7/
8/
 (TOBE SUBMITTED ON BRANCH LETTER HEAD]

To,
The Assistant General Manager,
State Bank of India,
Centralized Pension Processing Cell,
Govindpura, Bhopal
Dear sir,
PENSION PAYMENT BY CPPC BHOPAL- DECEASED FAMILY PENSION
We are forwarding herewith the original PPO/Corrigendum PO/Xerox Copy of
PPOalong with the under noted documents in respect of following pensioner.
Please do the needful.
1. Name of the family pensioner
2 Family Pensioner account no.
Type of Pension DECEASED FAMILY
4 Name of the deceased Pernsioner
5 Deceased Pensioner Account number
6 Category of Pension STATE/ DEFENCE/CIVIL/RAILWAY/TEUAUTO
7 Application from family Pensioner YES/NO
enclosed
Life Certificate Enclosed YES/NO
Letter of Undertaking YES/NO
10. Death Certificate Enclosed YES/NO
11. Original PPO/Xerox Copy of PPO YES/NO
enclosed
12. Amount of Overpayment Paid or YES/NO
Recovered by the Branch
13 IF YES, give details
14. | Pension conmmencement date [Provide
date]
15. Remarks
We certify that KYC norms have been observed in respect of above pension
account.

Yours faithfully,

Branch Manager
Encl: as above