STATEMENT

( With reference to order No. F /269/ 2023/ K. Dis Dated 09.10.2023)

Subscriber’s name with designation and official address K.N.THANKAPPAN ACHARY, PTCM
1
in full (Rtd)GLPS MYNAGAPPALLY

2 Date of birth of the Subscriber 27.02.1952

3 Date of entry of the Subscriber into regular service 21.05.1990

4 Date of filling option and date of its acceptance 01.07.1994

Date with effect from which the subscriber opted the

5
scheme(ie, the date of effect of option
01.07.1994

6 Whether the subscriber is a class IV employee, or not NO

@Rs.7 wef 07/1994 to 01/1998 ( 03 Y 07 Month)

Rs.301 /-
7 Rate of subscription
@Rs.25 wef 02/1998 to 02/22 ( 24 Y 1 Month)
Rs.7225/-

8 Date of retirement of the subscriber 28.02.2022

Total number of years and months of service after

27 Years 8 months
9 joining the scheme (counting from the month of effect
of option)
Total amount at the credit of the subscriber(as per the
10 register cum-Broad sheet which is maintained up-to-date Rs.7526/-
duly reconciled)

Government contribution allowed(vide schedules Rs.7 @ = 45 /-

11
attached to G.O.(P)405/77/fin. dated 19-10-1977 Rs.25 @ =6250 /-

12 Total amount due for payment 13,821 /-

Arrear-subscription, if any adjusted recovered towards
13 Family Benefit Scheme from the total amount due for NIL
payment
Specific reason s for the accural of the above arrears.
(here it should also be specified whether the arrears were
14
on account of any/wilful default of the subscriber in v
No
iew of the facxt that a wilful default is not eligible for
Net amount payable (ie. the actual amount sanctioned
15 for the disbursement to subscriber/nominee(s)/legal 13,821 /-
heir(s)
 Whether the deceased subscriber is survived by his/her
‘family’(ie. wife/husband and children) (in the case of a
16 No
subscriber who is survived by a family, nomination in
favour of any others is invalid)
Whether the subscriber has a valid nomination and if so,
17 NA
the date of nomination.
Details of nominees and share payable to each (as per
18 NA
the nomination)
19 Sl.No. Name Age Relationship Address Share payable
1
2

20 Mode of settlement of claim in respect of minors NA

Whether the department/office is a cheque drawing

21 Department and if so, the procedure laid down in NO
G.O.(P) 591/78/fin. dated 28-7-1978 is being followed
If only a part of the amount payable in sanctioned the
reason for withholding the remaining portion and if any
22 portion was previously sanctioned and paid the details of Final Bill
the amount so paid and of the order in which it was
sanctioned

23 Other details, if any

Assi. Educational Officer

O/o the Asst. Edl Office, Chavara
ficer