FILL IN THE DATA BELOW NAME OF THE EMPLOYEE: K. DEVA SAHAYAM DESIGNATION: SGT SUBSTANSTIVE OR OFFICIATING Substantive DATE ON WHICH OPTION WAS EXERCISED 15.4.2010 TREASURY ID: 0703705 OFFICE: M.P.PRIMARY SCHOOL VILLAGE: BODDIKURAPADU(SC) MANDAL: TALLUR 8 SG(8 Y Rs7,770.00 2 No DDO'S DESIGNATION MANDAL EDUCATIONAL OFFICER DDO'S NAME M. Ramappa, B.Sc.M. Ed., Station TALLUR DDO'S NAME (SHORT) MEO, TALLUR DDO CODE 0 3 DDO OFFICE NAME Mandal Parishad, Tallur Rc. No 19/MEO/2009 Dated 15.4.2010 STO CODE 0 7 STO NAME S.T.O. DARSI HEAD OF ACCOUNT 2 2 MAJOR HEAD X X 0 5 GROUP SUB HEAD SUB HEAD District Prakasam GOVT. BANK NAME SYNDICATE BANK Station: DARSI BANK CODE 3 6 EMPLOYEE'S BANK A/C NO 3671/220/46546 BANK NAME SYNDICATE BANK, TALLUR NLB NAME SYNDICATE BANK, TALLUR 3 ZPPF A/C NO 12405 APGLI NO.(FOR FORM 49) L-2109418 APGLI MONTHLY PREMIUM(FOR FORM 49) 350 SELECT YOUR GRADE O-ORDINARY, 8-SG(8 YEARS), 16-SPP-1, 24- SPP-2 Present Pay (1.7.2008 or Date of Next Increment) Are you Applying for step up in this PRC? 1- Yes, 2- No SELECT NATURE OF SAVINGS (1- GPF, 2- ZPPF, 3- CSS) COMPULSORY SCHE
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FILL IN THE DATA BELOWNAME OF THE EMPLOYEE: K. DEVA SAHAYAMDESIGNATION: SGTSUBSTANSTIVE OR OFFICIATING SubstantiveDATE ON WHICH OPTION WAS EXERCISED 15.4.2010TREASURY ID: 0703705OFFICE: M.P.PRIMARY SCHOOLVILLAGE: BODDIKURAPADU(SC)MANDAL: TALLUR
8 SG(8 YEARS)
Rs7,770.00
2 No
DDO'S DESIGNATION MANDAL EDUCATIONAL OFFICERDDO'S NAME M. Ramappa, B.Sc.M. Ed.,Station TALLURDDO'S NAME (SHORT) MEO, TALLURDDO CODE 0 3 0 8DDO OFFICE NAME Mandal Parishad, TallurRc. No 19/MEO/2009Dated 15.4.2010STO CODE 0 7 0 5STO NAME S.T.O. DARSI
HEAD OF ACCOUNT2 2 0 2
MAJOR HEADX X 0 5 0 1GROUP SUB HEAD SUB HEAD DETAILED HEAD
District PrakasamGOVT. BANK NAME SYNDICATE BANKStation: DARSIBANK CODE 3 6 4 1EMPLOYEE'S BANK A/C NO 3671/220/46546BANK NAME SYNDICATE BANK, TALLURNLB NAME SYNDICATE BANK, TALLUR
3
ZPPF A/C NO 12405APGLI NO.(FOR FORM 49) L-2109418APGLI MONTHLY PREMIUM(FOR FORM 49) 350
SELECT YOUR GRADE O-ORDINARY, 8-SG(8 YEARS), 16-SPP-1, 24- SPP-2
Present Pay (1.7.2008 or Date of Next Increment)
Are you Applying for step up in this PRC? 1- Yes, 2- No
If Yes stepped up pay→
SELECT NATURE OF SAVINGS (1- GPF, 2- ZPPF, 3- CSS)
COMPULSORY SAVINGS SCHEME
D16
Author: EXAMPLE: MEO, SN PADU
D18
Author: Example: Mandal Parishad, SN Padu ZP High School, Ongole
HRA PERCENTAGE 10 ALLOWANCES IN RPS 2005 & RPS 2010 ALREADY DRAWN TO BE DRAWNHM ALLOWANCE 60 75PHC ALLOWANCE 0 0PERSONAL PAY 0READER'S ALLOWANCE 0 0ADVANCE INCREMENTS 100FAMILY PLANNING INCREMENT 0SPECIAL PAY 0CCA 0 0OTHERS 0 0
2537.00Words Two thousand five hundred and thirty seven only. Type here in words
In Cash10193
Words Ten thousand one hundred and ninety three only. Type here in wordsUnder Rs. Ten thousand one hundred and ninety four only. Type here in words by adding one rupee
Amount to ZPPF/GPF/CSS MANUAL TYPING OF DATES IS PREFERRED HERE, SINCE DATE FORMATS
VARY FROM SYSTEM TO SYSTEM
B53
Author: ENTER OPTION DATE EX:1.7.2008 or DATE OF YOUR INCREMENT
B54
Author: ENTER DATE OF SUBSEQENT INCRMENT EX: 1.8.2009, 1.9.2009 etc.,
A64
Author: TYPE IN WORDS HERE
A67
Author: type in words
A68
Author: TYPE UNDER Rs. BY INCREASING ONE RUPEE
Don't fill any thing in blue cellsFill the cells in light green cells
Rs0.00
0 2 7
0 1 1 0 3SUB MAJOR MINOR HEAD0 N V
DETAILED HEAD PLAN/NON-PLAN CHARGED/VOTED
##################
#########
THE ARREARS IN CASE OF CPS ACCOUNT HOLDERS WILL BE CREDITED TO COMPULSORY SAVINGS
SCHEME
#############################################
#########
#########
Type here in words
Type here in wordsType here in words by adding one rupee
ANNEXUREFORM FOR EXERCISING OPTION UNDER THE ANDHRA PRADESH
REVISED SCALES OF PAY RULES, 2010
* I Sri/Smt…………………………………………………………………………………..holding the post
of………………………………………………………………in the scale of Rs. ……………………………………..
in the office of………………………………………………………..………………do hereby elect to continue in the
existing scale of pay.
The option hereby exercised is final and will not be modified at any subsequent date.
Date: Signature:
Station: Name: K. DEVA SAHAYAM
Designation: SGT
Office in which employed M.P.PRIMARY SCHOOLBODDIKURAPADU(SC)TALLUR
Signed before meSignature of Head of Office(with date)(In case of Non-gazetted Officer)
Signature of Another Gazetted Officer(In case of Gazetted Officer)
Note:Separate option should be given in respect of substantive and officiating posts.
Date: Signature: Pay and Accounts Officer/Head of office
(*To be scored out if not applicable.Received the above declaration:(**Strike whichever is not applicable)
(*) I Sri/Smt K. DEVA SAHAYAM holding the post of SGT in the scale of Rs.5750-145-6040-155-65059-170-7015-185-7570-200-8170-215-8815-235-9520-255-10285-280-11125-315-12700-330-13030 in the office of M.P.PRIMARY SCHOOL,BODDIKURAPADU(SC),TALLUR do here by elect to come under the Revised Scales, 2010 with effect from1st July, 2008/date of next increment on__________________________________________/01.07.2008 with/without increment in the existing scale.**
Page 7
APPENDIX-1Statement of Fixation of pay under Andhra pradesh Revised Scales of Pay Rules, 2010
(Circular Memo No. 33327-A/549/A1/PC-I/2009. dated:13.3.2010)Note:1. Separate statement should be prepared for fixation of pay in rspect of substantive and Officiating post.
2 In respect of employees holding Special Grade/Special Promotion Post/Special Adhoc Promotion Post,fixation shall be in the corresponding relevant Revised Scales assigned.
1 Name of the Employee : K. DEVA SAHAYAM
2
Desingation of the post in which Pay is
: SGT,SG(8 YEARS)
to be fixed(the actual nomenclature of post ie., Ordinary/Special Grade/SPP/SAPP held by the employee is to beonly mentioned
3 Whether Substantive or officiating : Substantive
4 a) Whether the employee has opted to : Yes
the Revised Pay Scales of 2010.
b) Date on which option was exercised : 15.4.2010
c) Date from which option was exercised
: 1.7.2008to come over to the Revised Pay Scales,2010 from 01.07.2008/date of next increment
5 a) Existing Scale of Pay of the post on the :
date of entry into Revised Pay scales 2010
b) The pay in the existing scale : Rs7,770.00 (ie., RPS 2005)
c) Special Pay, if any in the existing scale:
ie., RPS 2005
6 a) whether this case attracts first proviso to
: NoRule 6(b) of the Andhra Pradesh Revised
Scales of Pay Rules 2010
b) If so, the stepped up pay (attach CHECK LIST) : 0
7 Existing emoluments on the date of entry :
into Revised Pay Scales 2010.a) 'Basic Pay' ie., pay as defined in
: Rs7,770.00 Fundamental Rule 9(21)(a)(i) including stagnation increments Pay as per 6(b) above
b) Personal Pay under Rule 9(23) (a) of
: Rs0.00 the Fundamental Rules or Rules or Rule 7 (40)(a)of Hyderabad Civil Service Regulations
c) Personal Pay sanctioned under A.P.:
Revised Scales of Pay Rules 2005.d) Dearness Allowance admissible at the
: Rs3,294.00 rate which existed on 1st July, 2008appropriate to 'Basic Pay' referred to at sub item(a) above
Total 7(a to d) : Rs11,064.00
8 Fitment benefit 39% of Basic pay : Rs3,030.00
referred to in item 7(a)9 Total of items 7 and 8 : Rs14,094.00
10 The Revised Scales of Pay 2010 for the :
post in which the Pay is fixed now
11 Revised Pay as fixed in the Revised Scale
: Rs14,440.00
at the stage next above the amount referred to in item 9 above irrespective whether, the amount is a stage or not,in the Revised Scale.
Pay Scales, 2010 in lower/Substantive post:b) The amount of pay fixed in the Revised
: Rs14,440.00 Pay scales 2010(vide item 11 above)
c) The Pay fixed in the Revised Pay Scales,
:
2010 in officiating post as per Rule 6(g)(i)of the Andhra pradesh Revised Scales of Pay Rules, 2010 in case where the pay in item 13is equal or less than pay in item 13(a) above(ie., next stage to the amount of the substantive pay as per item 13(a)above)
The pay of the individual is fixed at Rs.14440 in the time scale of Pay Rs.11530-300-11200-330-12190-360-13270-390-14440-420-15700-450-17050-490-18520-530-20110-570-21820-610-23650-650-25600-700-27700-750-29950-800-32350-850-33200 w.e.f 1.7.2008 in the Revised Pay Scales 2010. He/she is sanctioned subsequent annual increments raising his/her pay from Rs.14440 to Rs. 14860 and from Rs. 14860 to Rs.15280 w.e.f.1.8.2008 and 1.8.2009 respectively, vide proceedings Rc. No19/MEO/2009,dated 15.4.2010 of the MANDAL EDUCATIONAL OFFICER,TALLUR.The arrears due to this pay fixation will be notional from 1.7.2008 to 31.1.2010 ,will be credited to GPF/ZPPF/CSS Accounts from 1.2.2010 to 28.2.2010, will be paid in cash from 1.3.2010 to 30.6.2010.
OTHERS
OTHERS
OTHERS
OTHERS
Page 12 of 35
CLAIM FOR PAY FIXATION ARREARS IN THE REVISED PAY SCALES 2010
S.NO EARNINGS PAY H.M.A C.A C.C.A R.A D.A H.R.A I.R TOTAL P.T NETNAME OF THE EMPLOYEE, DESIGNATION AND OFFICE
Gross Total Rs. 12730.00 Total Non-Govt.Deductions Rs.Less Govt. Deductions Rs. 2537.00
Und
er r
upee
s A.G.Nett Amount Rs. 10193.00A.G.Nett Amount in words:RupeesTen thousand one hundred and ninety three only.
DDO's Signature
FOR USE IN TREASURY / PAY & ACCOUNTS OFFICE ONLYPay _________________ (Rupees _____________________________________________________________________________________________________________ Only) by Cash / Cheque / Draft / Account credit as under and Rs.________________ (Rupees _______________________________________________________________________________ only) by adjustment.
1.Rs._________________ by transfer credit to the SB Accounts of the Employees (as per Annexure-I)
2.Rs._________________ by transfer credit to the DDO Account towards of Non-Govt.Deducations.
Treasury Officer / Pay & Accounts Officer
NBST BANK SEAL
CLAIM FOR PAY FIXATION ARREARS IN RPS 2010 OF K. DEVA SAHAYAM,SGT,M.P.PRIMARY SCHOOL,BODDIKURAPADU(SC)
GOVERNMENT OF ANDHRA PRADESH A.P.T.C.Form - 47
Permanent / Temporary
PAYABLE AT S.T.O. DARSI
Mandal Parishad, Tallur
SYNDICATE BANK, TALLUR
Amount0
0.00
02537
2537.00
FOR USE IN TREASURY / PAY & ACCOUNTS OFFICE ONLY
BUDGET
1. Budget allocation for the year 2010-2011 Rs.
2. Total Expenditure including this Bill Rs.
3. Balance Rs.
Drawing Officer
This bill amount Rs. [10193.00] Rs.Ten thousand one hundred and ninety three only.
only) paid by cash / cheque / draft adjust to account.
Received Cash
Drawing Officer Drawing Officer
REQUIRED CERTIFICATES
1 Certified that this amount claimed in this bill has not been drawn and
paid previously
2
3 Certified that the pay of the employee was fixed as per circular memoNo. 33327-A/549/A1/PC-1/2009, Dated: 13-03-2010
4 Certified that D.A. in this bill has been claimed as per G.O. Ms. No. 63, Finance(PC-1) Department, Dated: 9-3-2010
5 Certified that H.R.A in this bill has been claimed as per G.O. Ms. No. 64, Finance
(PC-1) Department, Dated: 9-3-20106 Certified that C.C.A in this bill has been claimed as per G.O. Ms. No. 65, Finance
(PC-1) Department, Dated: 9-3-2010
7 Certified that C.A in this bill has been claimed as per G.O. Ms. No. 108, Finance(PC-1) Department, Dated: 7-4-2010
8
9 Certified that H.M. Allowance in this bill has been claimed as per G.O. Ms.No. 118, Finance (PC-1) Department, Dated: 7-4-2010
10
11 Certified that necessary recoveries have been made in this bill as per
Government Orders.
DRAWING OFFICER
For the use Of Accountant General Office
Certified that the pay of the employee was fixed as per G.O. Ms. No. 52, Finance(PC-1) Department, Dated 25.2.2010
Certified that the A.A.S of the individual was fixed as per G.O.Ms. No. 96, Finance (PC-1) Department, Dated 3.4.2010
Certified that necessary entries have been made in the Service Register of the Individual.
BUDGET
Drawing Officer
Certified that the pay of the employee was fixed as per circular memo
Certified that D.A. in this bill has been claimed as per G.O. Ms. No. 63, Finance
Certified that H.R.A in this bill has been claimed as per G.O. Ms. No. 64, Finance
Certified that C.C.A in this bill has been claimed as per G.O. Ms. No. 65, Finance
Certified that C.A in this bill has been claimed as per G.O. Ms. No. 108, Finance
Certified that H.M. Allowance in this bill has been claimed as per G.O. Ms.No. 118, Finance (PC-1) Department, Dated: 7-4-2010
Certified that necessary recoveries have been made in this bill as per
For the use Of Accountant General Office
Certified that the pay of the employee was fixed as per G.O. Ms. No. 52, Finance(PC-1) Department,
Certified that the A.A.S of the individual was fixed as per G.O.Ms. No. 96, Finance (PC-
Certified that necessary entries have been made in the Service Register of the
ORDER:In the reference cited 1 above the Government has issued orders revising the scales of
1 Name of the employee: K. DEVA SAHAYAM2 Designation: SGT
3 Name of the office: M.P.PRIMARY SCHOOL,BODDIKURAPADU(SC)
4 Present Scale of Pay:
5 Date of Option in RPS2010: 15.4.2010
6 Pay fixed as on1.7.2008a)Pay as on 1.7.2008 Rs7,770.00 b)D.A. Admissible 42.39% Rs3,293.70 c)Fitment (39%) Rs3,030.30
Total Rs14,094.00
Rounded Rs14,094.00
7 Rs14,440.00
8 Revised Scale of Pay
9 Sanction of subsequent increments
Present Pay
1.8.2008 Rs14,440.00 Rs420.00 Rs14,860.00
1.8.2009 Rs14,860.00 Rs420.00 Rs15,280.00
10 Date of Next Increment: 1.8.2010Necessary entries have been made in the Service Register of the individual. The arrears
due to this pay fixation will be notional from 1.7.2008 to 31.1.2010, will be credited to the GPF/ZPPF/CSS Accounts of the individual from 1.2.2010 to 28.2.2010 and will be paid in cash from 1.3.2010 to30.6.2010.Any audit objection arises in future due to this pay fixation, the amount paid in excess willbe recovered from the individual in lump sum without any prior notice.
MANDAL EDUCATIONAL OFFICERCopy to TALLURThe IndividualThe S.T.O DARSIThe Bill
Education-Elementary Education-Revised Pay Scales 2010-Fixation of Pay of Sri/Smt K. DEVA SAHAYAM,SGT,M.P.PRIMARY SCHOOL,BODDIKURAPADU(SC),TALLUR in the Revised Scales of Pay 2010 as per the option exercised by the individual-Orders issued-Reg
the Employees of State Government w.e.f. 1.7.2008. Detailed instructions were issued for Fixation of Pay and Audit of claims in the Revised Pay Scales Vide Referece 2 cited above.
In pursuance of the G.O. cited above basing on the option exercised by the individual dated 15.4.2010 the pay of Sri/Smt K. DEVA SAHAYAM,SGT,M.P.PRIMARY SCHOOL,BODDIKURAPADU(SC),TALLUR is fixed at Rs. 14440 in the time scale of pay11530-300-11200-330-12190-360-13270-390-14440-420-15700-450-17050-490-18520-530-20110-570-21820-610-23650-650-25600-700-27700-750-29950-800-32350-850-33200 w.e.f 1.7.2008 as shown below
Statement showing the PROFESSIONAL TAX Schedule deduction
made in the Establishment pay bill of teaching staff of Mandal Parishad, Tallur
S.l.No TREASURY ID Name of the Teacher Designation
1 2 3 4 5
1 0703705 K. DEVA SAHAYAM SGT 0.00
TOTAL 0.00
Rupees
MANDAL EDUCATIONAL OFFICERTALLUR
Head of Account 0028 Other taxes on income & Expenditure M.H.107 Taxes on Profession trades S.H:01 Reciepts from Profession trades calling & Employment
Amount of Tax deduction ( in Rs.)
S.No Total
1 12405 0703705 K. DEVA SAHAYAM Rs2,537.00 Rs2,537.00
Rupees Two thousand five hundred and thirty seven only.
MANDAL EDUCATIONAL OFFICERTALLUR
S.No Total
1 12405 0703705 K. DEVA SAHAYAM 0 0
Rupees Two thousand five hundred and thirty seven only.
MANDAL EDUCATIONAL OFFICERTALLUR
SCHEDULE FOR PAY FIXATION ARREARS TO BE CREDITED TO COMPULSORY SAVINGS SCHEME
COMPULSORY SAVINGS
SCHEME A/c No.
TREASURY ID
Name of the subscriber
P.F.Sub- cription
SCHEDULE FOR PAY FIXATION ARREARS TO BE CREDITED TO COMPULSORY SAVINGS SCHEME
COMPULSORY SAVINGS
SCHEME A/c No.
TREASURY ID
Name of the subscriber
P.F.Sub- cription
ANNEXURE-I
(Employee Wise details)
Und
er R
upee
s Te
n th
ousa
nd o
ne h
undr
ed a
nd n
inet
y fo
ur o
nly.
To be furnished by the DDO in triplicate along with the bill
Name of the NPB: SYNDICATE BANK, TALLUR
DDO Code : 0705-0308027 Date:
DDO Designation : MEO, TALLUR Trans-ID No:
S.No. Employee code Employee Name Account No
1 0703705 K. DEVA SAHAYAM 3671/220/46546 10193.00
TOTAL 10193
Rupees Ten thousand one hundred and ninety three only.
DDO Signature Signature of T.O.(with seal) (with seal)
Amount to be credited
ANNEXURE-II(Notified link bank report)
To be furnished by the DDO in triplicate
Name of the NPB: SYNDICATE BANK, TALLUR
Un
de
r R
up
ee
s T
en
th
ou
sa
nd
on
e h
un
dre
d a
nd
nin
ety
fo
ur
on
ly.
DDO Code : 0705-0308027 Date:
DDO Designation : MEO, TALLUR Trans-ID No:
Sl.No. Purpose Amount to be credited
1 Rs.10,193.00
TOTAL:Rs.10,193.00
Rupees Ten thousand one hundred and ninety three only.
DDO Signature Signature of T.O.
(with seal) (with seal)
Name of the NLB
SYNDICATE BANK,
TALLUR
Pay fixation Arrears in RPS-
2010
ANNEXURE- IIIGovernment Bank Report(To be generated by T.O.)
S.T.O./ P.A.O. Code 0705 S.T.O./ P.A.O. Name : S.T.O. DARSI Govt. Bank Br.Code :0890 G.B.Br.Name : SYNDICATE BANK
DARSI
Name of the NLB purpose
1 10193
Total 10193
Rupees Ten thousand one hundred and ninety three only.
Signature of T.O.
Un
de
r R
up
ee
s T
en
th
ou
sa
nd
on
e
hu
nd
red
an
d n
ine
ty f
ou
r o
nly
. Sl.No
Amount to be credited Rs.
SYNDICATE BANK, TALLUR
Pay fixation Arrears in RPS-
2010
A.P.T.C. FORM - 49(See subsidiary Rule 13 under Treasury Rule 10)
PERIODICAL INCREMENT CERTIFICATEANNEXURE
S.No Name
Ap
poin
tmen
t
Su
sp
en
sio
n f
or
mis
con
du
ct
Scale
of
pay
Pre
sen
t p
ay
Am
ou
nt
of
incre
men
t
From To From To
1 2 3 4 5 6 7 8 9 10 11 12 13
1 K. DEVA SAHAYAM
SG
T,S
G(8
YE
AR
S)
Su
bs
tan
tiv
e
1.7.2008 1.8.2008 14440 420
1.8.2008 1.8.2009 14860 420
MANDAL EDUCATIONAL OFFICER
TALLUR
(1) Certified that every Government Servant (s) named below has have been earned and prescribed periodical increment from date / dates noted in column (10) and either I(a) has / have been the incumbent or the appointment indicated against his name / their names for a period not less than _____years since the date in column (5) or (if he has / they have been suspended for misconduct) column (7) after deducting the periods between the dates showing in columns (3) and has (9) and has been subjected in any order of stoppage of increment as panaulty during the periods and during the periods of leave on average pay taken at a time from _____________ to ______________ and from _____________ to _______________ which has / have been counted for increments / in the case of officiating Government servents / Servents named below the / they would have officiated in the post / posts but for his / thier going on leave or __________
Wh
eth
er
su
bsta
nti
ve o
r offi
cia
tin
g
Date
fro
m w
hic
h p
resen
t p
ay
is d
raw
n
Leave without pay and in the case of those holding the post temporarily or in an officiating capacity all kinds of leave other
than leave on average pay during which they would have
continued to officiate in the post but for their going on leave
upto a maximum of four months of such leave taken at
time.
Date
fro
m w
hic
h in
cre
men
t m
ay b
e g
iven
11530-300-11200-330-12190-360-
13270-390-14440-420-15700-450-
17050-490-18520-530-20110-570-
21820-610-23650-650-25600-700-
27700-750-29950-800-32350-850-
33200
A.P.T.C. FORM - 49(See subsidiary Rule 13 under Treasury Rule 10)
PERIODICAL INCREMENT CERTIFICATEANNEXURE
Future pay
14
14860
15280
MANDAL EDUCATIONAL OFFICER
TALLUR
(1) Certified that every Government Servant (s) named below has have been earned and prescribed periodical increment from date / dates noted in column (10) and either I(a) has / have been the incumbent or the appointment indicated against his name / their names for a period not less than _____years since the date in column (5) or (if he has / they have been suspended for misconduct) column (7) after deducting the periods between the dates showing in columns (3) and has (9) and has been subjected in any order of stoppage of increment as panaulty during the periods and during the periods of leave on average pay taken at a time from _____________ to ______________ and from _____________ to _______________ which has / have been counted for increments / in the case of
Note :
CERTIFICATE(As laid down in Government Memo No.104215 A/1620/Pen.11/56-1, Dated 10-1-1977)
of Rs. 350 is being deducted from his salary in accordance with the Rules of compulsory insurance, them applicable to A P State Employees and Sum of Rs.______
towards monthly premium is paid in challan No.___________________________________Dated________________________ towards compulsory insurance
Scheme applicable to Govt Servants as per G.O. Ms. No. 337, F& P dated 3-8-1976.
Certified that the age of Sri has exceeded 45 years and hence he can not insure the life with Government Life Insurance Department.
1. When an increment claimed operates to carry Government Servant over an efficiancy have the claim should be supported by a declaration from the competent authority that it has satisfied itself that the character and efficiency of the Government Servant concerned are such that he is fit to pass the above column (5) and (10) to (14) should be filled up in red ink. 2. The terms leave on average pay upto a maximum of 4 months where ever occuring from includes earned leave upto a maximum of 100 days or 50 days or 30 days in case may be for a Government Servants governed by the Andhra Pradesh Leave Rules, 1988 are concerned. 3. The service of the individuals satisfactor and no disciplinary cases are pending against during the period of increment.
Certified that Sri/Smt K. DEVA SAHAYAM,SGT,M.P.PRIMARY SCHOOL,BODDIKURAPADU(SC),TALLUR whose basic pay is Rs.15280 has already insured under policy No.L-2109418 of the Director of Insurances, Andhra Pradesh, Hyderabad, of its Regional Office and mothly premium
Page 33 of 35
SHORT DRAWN PARTICULARS
S.NO EARNINGS PAY H.M.A C.A C.C.A R.A D.A H.R.A I.R TOTAL P.T NET