FORMAT FOR SPECIAL AWARD DATE:

1. DEPARTMENT/ SECTION
2. PERIOD OF ACTIVITY FROM TO
3. NUMBER OF PERSONS : EXE NON-EXE
4. NAME OF THE JOB (WITHIN 15 WORDS):

5. SUMMARY OF THE PROPOSAL (WITHIN 50 WORDS) :

6. BRIEF DESCRIPTION OF THE PROPOSAL :

( What was the problem and its impact, how you have arrived at the final idea of
implementation, etc)

7. JUSTIFICATION FOR SPECIAL AWARD ( Financial & Non-Financial benefits):

8. AWARDS PROPOSED:
9. LIST OF PERSONS FOR SPECIAL AWARD (USE SEPERATE SHEET IF REQUIRED) :

EX/ NON-
SL NAME Designation PL.NO. Deptt. Section
EX

10. WHETHER ALREADY AWARDED OR SUBMITTED FOR AWARD IN ANY OTHER

SCHEME OF R.S.P:

YES/NO (If yes, please give details).

11. PROPOSER’S DETAILS :

Deptt : Name: Signature:

Tel.No. : Designation:

12. COMMENTS OF HIGHER AUTHORITY: