Proforma/ Forms for Approval of Family Pension under WBS(DCRB) Rules
GOVERNMENT OF WEST BENGAL
PENSION BRANCH, WRITERS’ BUILDINGS
BLOCK NO.- IV, 2nd FLOOR,
KOLKATA – 700 001
No. 100-F(Pen) Dated, Kolkata, the 28th February, 2022
Subject: Uploading of list of documents along with proforma necessary for the approval of family pension under WBS (DCRB) Rules, 1971
It has been observed that various pension cases received by this department from the end of other Departments/ Sub-Ordinate Offices/ District Offices/ PSAs without proper documents/ information which is causing inordinate delay for smooth processing of those pension cases. The state government is very much keen to early settlement of family pension cases. The matter is under consideration of the government from some time past.
To avoid redundant delay and smooth disposal of such family pension cases, a list of documents along with proforma required for the approval of family pension under WBS (DCRB) Rules 1971 is enclosed herewith for the interest of public service. It is stated that proper proforma must be followed to avoid unnecessary delay of the pension cases.
Sd/- S. K. Ghosh
OS.D & E.O Joint Secretary
to the Govt of West Bengal
List of Necessary Documents for the approval of family pension in terms of Memo. No. 100-F(Pen) dated 28.02.2022
The following documents are required for sanction of Family Pension as per Finance Department Memo. No. 732-F(Pen) dt. 12.11.2008 & Memo. No. 830-F(Pen) dt. 20.09.2010.
1) An original application of the claimant for family pension should be made on plain paper to apply to the Head of Office where her deceased father/ mother served at the time of retirement and duly authenticated by the Pension Sanctioning Authority. (Detailed postal address with mobile no is to be mentioned for communication, if necessary)
2) Original Annexure ‘A’ duly filled in (4 Copies), (in Kolkata Municipal area).
3) Four copies original Annexure-II duly filled in and countersigned by the P.S.A. (containing signature of two persons as witness and two attestations by competent authority). (Format enclosed)
4) Four copies original Annexure-III duly filled in. (Format enclosed)
5) Four copies Passport size photographs duly attested, in four separate Sheets. (The attestation of the Photographs of the Claimant is required to be in such a manner that the signature of attesting officer with the sign should be affixed with the photographs.)
6) Four slips each bearing Three (3) Specimen Signature of the Claimant duly attested, in four separates Sheet.
7) Original Current( not older than six months) income certificate in favour of the Claimant with marital status from a Gazetted Officer Central or State Govt, belonging to Gr. ‘A’ service (other than concerned P.S.A./ Head of Office/ any other officer of the respective Department/ Directorate/ Office from where the concerned employee retired/ deceased) in his own capacity/ responsibility to the effect and the name of the Ex- Govt. Employee along the relation between the Ex- Govt. Employee and the Claimant must be mentioned in the certificate. (Not to be used as per enquiry report of document/ report/ certificate etc. Full name, seal and official address with pin code of the officer who issued the income must be legible). (Format enclosed)
8) A certificate by the P.S.A./ Head of Office to the effect that “there is no other recipient of family pension of the deceased Govt., employee i.e. minor son/ daughters, physically handicapped sons/ daughters of the family” to claim family pension.
9) List of family members of the deceased Govt., employee indicating their Date of Birth, sex, occupation, marital status duly authenticated by the authority other than P.S.A. (Format enclosed)
10) Original Service Book of the concerned Govt. Employee. If Service Book is not available a certificate by P.S.A./ Head of Office to the effect that “Service Book of the concerned Govt. Employee cannot be traced out in spite of thorough search and it is certified that the case will not be submitted again in future.”
11) Attested copy of P.P.O. of deceased Govt. Employee. (If P.P.O is already issued in favour of Govt Employee)
12) Attested copy of death certificate of the deceased Govt. employee duly certified by the Registrar, Birth and Death.
13) Attested copy of death certificate of spouse of deceased Govt. employee duly certified by the Registrar, Birth and Death.
14) Attested copy of age proof certificate of the Claimant. (School Leaving/ Admit card of any recognised board or council/ Birth Certificate/ AADHAR/ Passport/ PAN etc. )
15) Attested copy of Address proof document of the Claimant, i.e. Voter Identity card, Ration card, AADHAR etc.
16) Attested copy of death certificate of deceased husband of the Claimant duly certified by the Registrar, Birth and Death (in case of Widow Daughter).
18) Attested copy of Divorce Certificate issued by the Court of Law. (in case of Divorced Daughter).
19) Name of the deceased husband of the Claimant duly certified by the P.S.A. (in case of Widow Daughter)
20) An original affidavit made by the Claimant, before Ld. 1st Class Judicial Magistrate reg. Declaration family pension. (Copy enclosed) (Affidavit from Notary Public would not be accepted.) (Format enclosed)
No. 100-F dated 28.02.2022, Source
Finance, Family Pension