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Government Of Assam Pension & Public Grievances

Checklist for Pensioners

Family Pension (death while in service)

Points/ Enclosures to be Verified/ Checked:

    • *Application for grant of family pension / death gratuity( Form 21).
    • *Photograph of claimant (passport size) in triplicate, duly attested by the Head of Office.
    • *Two specimen signatures or left hand (in case of females)/right hand (for males) thumb impression mark in duplicate, duly attested by a Gazetted Government servant.
    • *Particulars of identification, height and personal marks of the claimant in duplicate, duly attested.
    • Assessment of family pension and death gratuity ( Form 20).
    • No Demand/No Dues Certificate from the Department and Directorate of Estates.
    • *Annexure related to SGEGIS (one copy pre receipted) in duplicate.
    • *Date of birth certificate of children .
    • DCRG nomination, duly attested.
    • SGEGIS nomination, duly attested.
    • Sanction for encashment of leave by the competent authority (containing amount involved and number of days leave at credit).
    • Statement for verification of service and SGEGIS along with Service Book page number.
    • Entry in Service Book for payment of pension and leave salary contribution as admissible.
    • Statement showing details and total period of non-qualifying service spell and year-wise breakup.
    • *Details of family members ( Form 1 A) duly countersigned.
    • Whether photocopy of Service Book and Pension file has been kept.

    Note: Items marked * are to be submitted by/obtained from the claimant.

Pension case of a retiring Government Servant

Points/ Enclosures to be Verified/ Checked:

    • *Particulars of the retiring Government servant (Form 1).
    • *Application for commutation (Form A).
    • *Details of Family, duly countersigned (Form 1A).
    • Assessment of pension and gratuity (Form 2).
    • *Single or joint (with spouse) passport size photograph, in triplicate, duly attested by the Head of Office.
    • *Two specimen signatures or left hand (in case of females)/right hand (for males) thumb impression mark in duplicate, duly attested by a Gazetted Government servant.
    • *Two slips showing the particulars of height and personal identification marks (not less than two), duly attested by a Gazetted Government servant.
    • Retirement order.
    • No Demand/No Dues Certificate from the Department and Directorate of Estates.
    • Disciplinary/vigilance clearance certificate.
    • *Annexure related to SGEGIS (one copy pre receipted) in duplicate.
    • *DCRG nomination, duly attested.
    • * SGEGIS nomination, duly attested.
    • Pension calculation sheet.
    • Sanction for encashment of leave by the competent authority (containing amount involved and number of days leave at credit).
    • Statement for verification of service and SGEGIS along with Service Book page number.
    • Entry in Service Book for payment of pension and leave salary contribution for eligible retirees.
    • *Declaration for non-employment after retirement in case of Group ‘A’ pensioners, if the pension is drawn from PAO.
    • Statement showing details and total period of non-qualifying service spell and year-wise breakup.
    • *Nomination for payment of arrears of pension.

    Note: Items marked * are to be obtained from the retiring Government servant.