State of Odisha - Act
The Orissa Local Fund Service (Pension) Rules, 1980
ODISHA
India
India
The Orissa Local Fund Service (Pension) Rules, 1980
Rule THE-ORISSA-LOCAL-FUND-SERVICE-PENSION-RULES-1980 of 1980
- Published on 3 April 1980
- Commenced on 3 April 1980
- [This is the version of this document from 3 April 1980.]
- [Note: The original publication document is not available and this content could not be verified.]
1.
2.
In these rules, unless the context otherwise requires -3.
These rules shall apply to employees of the Municipalities and Notified Area Councils who come under Local Fund Service constituted under Sub-rule (1) of Rule 3 of the Orissa Local Fund Service Rules, 1975 :Provided that the employees who were in 'service' on the thirty first day of August, 1976 shall have the right to exercise their option in writing to the Director through the Executive Officer of the concerned Municipality or Notified Area Council within a period of 30 days from the date of commencement of these rules, either to continue in the retirement benefits admissible under Orissa Municipal Rules, 1953 or to come over to the pension scheme under these rules.4. Nothing in these rules shall operate.
5.
Except as otherwise provided in these rules, the claim of an employee under the Orissa Local Fund Service for retirement benefits shall be regulated by the rules in force at the time when such employee retires from service or dies while in such service.Chapter-II6.
Every pension shall be held to have been granted subject to the conditions hereinafter contained.7.
8.
The Government or the Director duly authorised by Government in that behalf reserve/reserves the right of withholding or withdrawing a pension or any part thereof whether permanently or for a specified period, and the right of ordering the recovery from a pension of the whole or part of any pecuniary loss caused to Government, Municipality or Notified Area Council if in a Departmental or judicial proceeding, the pensioner is found guilty of grave misconduct or negligence during the period of his service including service rendered on re-employment after retirement :Provided that-9.
10.
No pension may be granted on an employee dismissed or removed from service as a disciplinary measure.11.
An employee compulsorily retired from service as a penalty under Rule 406 of the Orissa Municipal Rules, 1953 may be granted by the authority competent to impose such penalty, pension at a rate not less than two-third and not more than full invalid pension admissible to him on the date of his compulsory retirement.12.
An employee cannot earn two pensions in the same post at the same time or by the same continuous service.Chapter-III Conditions of qualifying service13.
Except for compensation gratuity, an employees service does not qualify for pension till he has completed eighteen years of age.14.
Subject to the provisions hereinafter contained, the service of an employee shall qualify for pension if it conforms to the following conditions, namely :15.
The service of an employee does not qualify for pension unless he is appointed to and his duties and pay are regulated under the provisions of the Orissa Local Fund Service Rules, 1975.16.
The service on an establishment paid from a contract establishment allowance, with the detailed distribution of which the Council does not interfere, does not qualify for pension whether such contract allowance is a fixed amount or consists of fees.17.
The service rendered by an employee of an establishment instituted under any other Act for the time being in force and assets and liabilities of such establishment if taken over by the Council the service of the said employee shall qualify for pension :Provided that the period of service, during which such employee did not subscribe to the contributory provident fund under the rules then in force and applicable to him, whether he was eligible, or ineligible, shall not count for pension.18.
19.
20.
21.
An employee included in the service and appointed in the Council after the 31st August, 1976 may add to his service qualifying for superannuation pension (but not for any other class of pension) the actual period not exceeding one-fourth of the length of his service or the actual period by which his age at the time of recruitment exceeds twenty-five years or a period of five years whichever is least, if the service or post is one-22.
23.
Time passed under suspension pending enquiry into conducts counts in full where on conclusion of the enquiry the employee has been fully exonerated or the suspension is held to have been wholly unjustified; in other cases the period of suspension does not count unless the authority competent to pass orders under Rule 91 of the Orissa Service Code in Its application to this service expressly declares at the time that it shall count and then it shall count only to such extent as the competent authority may declare.24.
25.
An employee who is dismissed, removed or compulsorily retired from service, but reinstated on appeal or revision is entitled to count his past service :Provided that the period of break in service between the date of dismissal, removal or compulsory retirement, as the case may be, and the date of reinstatement and the period of suspension, if any, shall not count unless regularised as duty or leave with allowances by specific order of the authority which passed the orders of reinstatement.26.
An interruption in the service of an employee entails forfeiture of his past service except in the following cases27.
Upon such conditions as it may think fit in each case to impose, the State Government on the application of the employee in consultation with the Council, may condone all interruptions in his service.Explanation - The powers of the condonation specified in this rule carry with the power of reviving service rendered prior to interruptions but forfeited under Rule 25.28.
Upon any condition which it may think fit to impose, the State Government or the Director who shall be authorised by the State Government may condone a deficiency of six months of qualifying service for pension.Note 1 - The following principles shall be observed while considering cases of condonation of deficiencies :28A.
When an employee is required to retire, revert or cease to be on leave on attaining age, the day on which he attains that age is reckoned as non-working day and the employee must retire, revert or cease to be on leave, as the case may be, with effect from and including that day.29.
Pension for service rendered under Local Fund Service are classified in the following categories, namely :30.
If an employee is selected for discharge owing to the abolition of a permanent post, he shall, unless he is appointed to another post the conditions of which are deemed by the authority competent to discharge him to be at least equal to those of his own, have the option-31.
If an employee who is entitled to compensation pension accepts instead another appointment in the Local Fund Service and subsequently becomes again entitled to receive a pension of any class, the amount of such pension shall not be less than what he could have claimed it he had not accepted the appointment.32.
33.
34.
The form of the certificate to be given in respect of an employee applying for pension is as follows :"Certified that I have carefully examined Shri............ son of..........a............... in the.............. office. His age is by his own statement years, and by appearance about years. I consider Shri ................to be completely and permanently incapacitated for further service of any kind in the office to which he belongs in consequence of....................... (here state disease or cause). His capacity does not appear to me to have been caused by irregular or intemperate habits".Note-If the incapacity is the result of irregular or intemperate habits the following will be substituted for the sentence :"In my opinion his incapacity is directly due to.................. and has been accelerated or aggravated by irregular or intemperate habits":(if the incapacity does not appear to be complete and permanent the certificate should be modified accordingly and the following addition should be made) :"I am of opinion that Shri................ is fit for further service of less laborious character than that which he has been doing (or may, after resting for months be fit for further service of a less laborious character than that which he has been doing).35.
An employee who has submitted medical certificate under the foregoing rule of incapacity for further service shall, if he is on duty, be invalidated from service form the date of relief of his duties which should be arranged without delay on receipt of the medical certificate or if he is granted leave on the expiry of such leave. If he is on leave at the time of submission of medical certificate, he shall be invalidated from service on the expiry of that leave or extension of leave, if any, granted to him.36.
An employee who is declared unfit by the medical authority may appeal to the authority competent to invalidate him from service against such decision within one month from the date of receipt of the findings of medical authority appealed against.37.
A superannuation pension is granted to an employee entitled or compelled to retire at a particular age.38.
The provisions relating to the date of retirement on superannuation of an employee as contained in Rule 41 of the Orissa Municipal Rules, 1953 shall apply to an employee under Local Fund Service whether superior or inferior.39.
Save as otherwise provided, a retiring pension may be granted to an employee who is permitted to retire after completing qualifying service for thirty years or on attaining the age of fifty years.Chapter-VI Rules for determination of amount of pension40.
The amount of pension that may be granted shall be determined by length of service as set-forth in Rule 43. Fractions of a year equal to six months and above will be treated as completed six-monthly periods for the purpose of calculation of any pension.41.
A pension including anticipatory pension shall be fixed in rupees. In case where the amount of a pension works out to a certain number of rupees and paise, the amount should be rounded off to the next higher rupee.42.
43.
For the employees under the Local Fund Service the amount of pension is regulated as specified in the Table below :| Completed six-monthly periods of qualifyingservice | Scale of gratuity or pension | Maximum pension (in Rs. per annum) |
| (1) | (2) | (3) |
| Scale of gratuity | ||
| 1 | (a) Gratuity-half month's pay | |
| 2 | 1 month's pay | |
| 3 | 1½ months' pay | |
| 4 | 2 months' pay | |
| 5 | 2½ months' pay | |
| 6 | 3 months' pay | |
| 7 | 3½ months' pay | |
| 8 | 4 months' pay | |
| 9 | 4⅜ months' pay | |
| 10 | 4¾ months' pay | |
| 11 | 5⅛ months' pay | |
| 12 | 5¼ months' pay | |
| 13 | 5½ months' pay | |
| 14 | 6½ months' pay | |
| 15 | 6⅝ months' pay | |
| 16 | 7 months' pay | |
| 17 | 7⅜ months' pay | |
| 18 | 7¾ monthly emoluments | |
| 19 | 8⅛ monthly emoluments | |
| Scales of pension | ||
| 20 | 10-80th of average pay | 3,750-00 |
| 21 | 10½-80th of average pay | 3,937-50 |
| 22 | 11-80th of average pay | 4,125-00 |
| 23 | 11½-80th of average pay | 4,312-50 |
| 24 | 12-80th of average pay | 4,500-00 |
| 25 | 12½-80th of average pay | 4,687-50 |
| 26 | 13-80th of average pay | 4,875-00 |
| 27 | 13½-80th of average pay | 5,062-50 |
| 28 | 14-80th of average pay | 5,250-00 |
| 29 | 14½-80th of average pay | 5,437-50 |
| 30 | 15-80th of average pay | 5,625-00 |
| 31 | 15½-80th of average pay | 5,812-50 |
| 32 | 16-80th of average pay | 6,000-00 |
| 33 | 16½-80th of average pay | 6,187-50 |
| 34 | 17-80th of average pay | 6,375-00 |
| 35 | 17½-80th of average pay | 6,562-50 |
| 36 | 18-80th of average pay | 6,750-00 |
| 37 | 18½-80th of average pay | 6,937-50 |
| 38 | 19-80th of average pay | 7,126-00 |
| 39 | 19½-80th of average pay | 7,312-50 |
| 40 | 20-80th of average pay | 7,500-00 |
| 41 | 20½-80th average pay | 7,687-50 |
| 42 | 21-80th of average pay | 7,875-00 |
| 43 | 21½-80th of average pay | 8,062-00 |
| 44 | 22-80th of average pay | 8,250-00 |
| 45 | 22½-80th of average pay | 8,437-50 |
| 46 | 23-80th of average pay | 8,625-00 |
| 47 | 23½-80th of average pay | 8,812-50 |
| 48 | 24-80th of average pay | 9,000-00 |
| 49 | 24½-80th of average pay | 9,187-50 |
| 50 | 25-80th of average pay | 9,375-00 |
| 51 | 25½-80th of average pay | 9,562-50 |
| 52 | 26-80th of average pay | 9,750-00 |
| 53 | 26½-80th of average pay | 9,937-50 |
| 54 | 27-80th of average pay | 10,125-00 |
| 55 | 27½-80th of average pay | 10,312-50 |
| 56 | 28-80th of average pay | 10,500-00 |
| 57 | 28½-80th of average pay | 10,687-50 |
| 58 | 29-80th of average pay | 10,875-00 |
| 59 | 29½-80th of average pay | 11,062-50 |
| 60 | 30-80th of average pay | 11,250-00 |
| 61 | 30½-80th of average pay | 11,437.50 |
| 62 | 31-80th of average pay | 11,625.00 |
| 63 | 31½-80th of average pay | 11,812.50 |
| 64 | 32-80th of average pay | 12,000.00 |
| 65 | 32½-80th of average pay | 12,000.00 |
| 66 and above | 33-80th of average pay | 12,000.00 |
44.
Government may, by general or special order allow temporary increase in pension subject to such conditions and limitations as they may specify from time to time in this behalf.45.
Notwithstanding anything contained in the preceding rules, in all cases of retirement on superannuation, retiring compensation or invalid pension where the amount of pension together with the benefit of temporary increase in pension comes to less than Rs. 50 per month, the same should be raised to Rs. 50.00 per month.46.
1. Compensatory allowance
2. Messing allowance, working allowance and provisions allowance;
3. Deputation allowance
4. House rent allowance
5. Travelling allowance
6. Dearness allowance.
Explanation - In the case of an employee who during leave with allowance taken at any time within ten months preceding the date of retirement, is promoted substantively to or confirmed in a higher post or who earns an increment which is not withheld, the pay which he would have drawn had he remained on duty should count as 'pay' even though the increase in pay is not actually drawn. But the benefit of higher officiating or temporary pay should be given only if it is certified by the competent authority that he would have continued to hold the higher officiating or temporary appointment but for his proceeding on leave.Chapter-VIIGratuity payable on death or retirement47.
| (i) | wife or wives, in the case of a male employee; | |
| (ii) | husband, in the case of a female employee; | |
| (iii) | sons including step-sons and adopted sons; | |
| (iv) | unmarried daughters including step-daughters and adopteddaughters; | |
| (v) | widowed daughters including step-daughters and adopteddaughters; | |
| (vi) | father | including adoptive parents in the case of individuals whosepersonal law permits; |
| (vii) | mother | adoption; |
| (viii) | brothers below the age of 18 years including step-brothers; | |
| (ix) | unmarried sisters and widowed sisters including step-sisters; | |
| (x) | married daughters; and | |
| (xi) | children of a pre-deceased son. |
48.
49.
Subject to the provisions of Rule 51 without prejudice to the provisions contained in Rule 50 where an employee dies-| Pay of the employees of pay | Amount of monthly family pension | ||
| Percentage | Minimum | Maximum | |
| (1) | (2) | (3) | (4) |
| Rs. | Rs. | ||
| 1. Below Rs. 200 | 50% | 50.00 | 100.00 |
| 2. Rs. 200 and above but less than Rs. 800 | 30% | 100.00 | 150.00 |
| 3. Rs. 800 and above | 15% | 150.00 | 250.00 |
50.
51.
The period for which family pension is payable shall be as follows:52.
53.
54.
Where the deceased employee or pensioner leaves behind more children than one, the eldest eligible child shall be entitled to the family pension for the period mentioned in Clause (ii) or Clause (iii) of Rule 51, as the case may be, and after the expiry of that period the next child shall become eligible for the grant of family pension.55.
Where family pension is granted under this rule to a minor, it shall be payable to the guardian on behalf of the minor.56.
In case both wife and husband are employees under Local Fund Service and are governed by the provisions of these rules and one of them dies while in service or after retirement, the family pension in respect of the deceased shall become payable to the surviving husband/wife and in the event of the death of the husband or wife, the surviving children shall be granted the two family pensions in respect of the deceased parents subject to the limits specified below, namely :57.
"Continuous service" for the purpose of Rule 49 means service rendered in a pensionable establishment and does not include-58.
"Family" in relation the employee means-59.
Nothing contained in this rule shall apply to-60.
Temporary increase in family pension is payable. Government may, by general or special order allow temporary increase in family pension subject to such conditions and limitations as they may specify from time to time in this behalf.Chapter-IXNomination for death-cum-retirement gratuity and family pension61.
62.
63.
64.
65.
An employee shall, at any time, make a nomination in Form 'E' indicating the order in which a family pension admissible under the rules in Chapter VII should be paid to the members of his family and to the extent that it is valid, the family pension will be payable in accordance with such nomination; the provisions of Rules 63 and 64 shall apply mutatis mutandis in respect of nominations under this rule.66.
67.
The provisions in this Chapter regulate the fixation of pay of pensioners who are re-employed in the services and posts under the Council's industrial or commercial undertakings or Corporations owned or controlled by the Government.68.
A person who is in receipt of pension either from Government or from any industrial or commercial undertaking or Corporations owned or controlled by Government or from Council shall not be re-employed or continued to be re-employed except on public grounds with the prior approval of Government.69.
When a person who was previously in employment, it shall be incumbent on him to declare to the appointing authority the amount of any gratuity or pension granted to him in respect of the previous employment.70.
The attention of every employee who is re-employed should be specially drawn to the provisions of these rules by the authority re-employing him but the failure to comply with the provision of this rule shall not be admitted as a ground for condoning any breach of the provisions of this Chapter.71.
The initial pay on re-employment shall be fixed at the minimum stage of the scale of pay prescribed for the post in which an individual is reemployed.In cases where concerned Council considers that the fixation of initial pay of the re-employed employee at the minimum of the prescribed pay scale will cause undue hardship, the pay may be fixed at the higher stage by allowing one increment for each year of service which the employee rendered before retirement in a post not lower than that in which he is reemployed with prior approval of Government.Explanation-Comparison of posts for the above-mentioned purpose should normally be on the basis of scale of pay, but where such comparison results in hardship in individual cases comparison may also be made with reference to the duties and responsibilities attached to the posts, irrespective of the scales of pay.72.
73.
The pay of an employee who has obtained compensation pension or compensation gratuity, if re-employed, shall be fixed in accordance with Rule 71. In case the pensioner elects to count his previous service for pension by forgoing the entire pension, the pay shall be fixed by treating him as if he is not in receipt of any pension. He shall be entitled to receive the benefits of increments in his new scale or promotion to another scale or post without further re-fixation of pay.74.
There is no bar to the re-employment of a person who has regained health after obtaining invalid pension or if an employee is invalid as being incapacitated for employment in a particular branch of the service to his reemployment in some other branch of the service. In such a case the provisions as to refunding gratuity, drawing pension, counting service and fixation of pay on re-employment shall be the same as applicable in the case of reemployment after compensation pension.75.
76.
Subject to the provisions hereinafter contained and to such conditions as it may think fit to impose, the Government may sanction the commutation for a lump payment of a portion, not exceeding one-third of any pension which has been or is about to be granted under Chapters V and VI :Provided that the uncommuted residue of pension shall not be less than Rs. 20 per month :Provided further that in calculating the amount of the uncommuted residue, there may be added to it the uncommuted portion of any other permanent pension or pensions payable to the applicant from the Central Pension Fund :Provided further that an employee against whom a judicial or a Departmental proceeding has been instituted or a pensioner against whom any such proceeding has been instituted or continued under Rule 8 shall not be permitted to commute any part of his pension during the pendency of such proceeding.Note-No portion of the temporary increase on pension shall be commuted for a lump payment.77.
An application for commutation of pension shall be made in Part-I of Form No. 'G' accompanied by two passport size photographs, one duly attested and the other without any attestation and addressed to the Government in Urban Development Department, through the Executive Officer of the Council where he is last employed, if he is still in service or if he was retired but his pension has not yet been sanctioned.78.
On receipt of the application under Rule 77 the concerned Executive Officer should complete Part-II of Form No. 'G' without delay and transmit it with copies of the medical reports mentioned in Rule 81 to the Director of Municipal Administration for obtaining Government sanction79.
The lump sum payable on commutation shall be calculated on whole rupee in accordance with a table of present values prescribed from time to time. For the purpose of this rule, age in the case of impaired lives shall be assumed to be such age not being less than the actual age as the certifying medical authority may direct. In the event of the table of present values applicable to the applicant having been modified, between the date of administrative sanction to commutation and the date on which commutation is due to become absolute, payment shall be made in accordance with the table so modified but it shall be open to the applicant if the modified table is less favourable to him than the table before it was so modified to withdraw his application by notice in writing sent within fourteen days of the date on which he received notice of modification.80.
Upon receipt of the application under Rule 78, the Director of Municipal Administration, Orissa shall send it to Government of Orissa in Urban Development Department for administrative sanction in Part-III of Form No. 'G' and in Part-II of Form G-1, and81.
82.
83.
If the applicant makes any statement found to be false within his knowledge or wilfully suppress any material fact in connection with his medical examination, the Government in Urban Development Department may cancel the sanction at any time before payment is actually made and such statement or suppression may be treated as grave misconduct for the purpose of Rule84.
The Executive Officer on receipt of the completed Forms No. 'G' and G-2 shall arrange forthwith for the payment of the appropriate commuted value and for the corresponding reduction of pension under intimation to the Director of Municipal Administration, Orissa as well as Government in Urban Development Department, provided the medical authority has recommended commutation.85.
If the pensioner dies on or after the day following that on which commutation becomes absolute but before receiving the commutation value, the same shall be paid to his heirs.86.
A commutation, once applied for sanction and given effect to cannot be rescinded.Chapter-XII Sanction of pension87.
88.
Every employee shall submit in writing an application for pension in Form No. 'I' to the Chairman of the concerned Council through the Executive Officer concerned at least one year in advance of the date of his anticipatory retirement. Provided (i) In a case in which the date of retirement cannot be foreseen one year in advance, the application shall be submitted immediately after the date of retirement is settled ; and (ii) An employee, proceeding on leave preparatory to retirement in excess of one year, shall submit the application at the time of proceeding on such leave.89. [ [Substituted vide Orissa Gazette Extraordinary No. 1673/16.12.1992-SRO No. 1410/92/ 15.12.1992.]
The Chairman shall be competent to sanction provisional pension and provisional gratuity to the retiring employees.] [Substituted vide O.G.E. No. 936 dated 28.5.2007.]90.
The concerned Executive Officer shall undertake the work of papers in Form 'J' immediately on receipt of application for pension under Sub-rule (1) of Rule 88 and submit to the Chairman of the Council under whose establishment the employee is to retire under intimation to the Director of Municipal Administration.91.
The Chairman of the Council on receipt of the pension papers shall verify the following particulars with reference to the relevant office records:92.
After verification of the particulars referred to in Rule 91 the concerned Chairman with his recommendation for the payment of pension and gratuity benefits shall forward in Form J-2 along with the employee's Service Book and Service Roll, if any, duly completed up-to-date to the Director for issue of authority and placement of necessary funds at the disposal of the concerned Chairman for making necessary payments to the retired employee.93.
94. [ [Substituted vide Orissa Gazette Extraordinary No. 1673/16.12.1992-SRO No. 1410/92/15.12.1992.]
The Director shall, in his turn after receiving the pension papers, get them verified by the Examiner, Local Accounts and sanction the pension and gratuity.]95. [ [Substituted vide Orissa Gazette Extraordinary No. 1673/16.12.1992-SRO No. 1410/92/15.12.1992.]
96.
It shall be open to the employee to receive the payment of gratuity and pension from the Executive Officer of any Council where he desires to receive payment.97.
The Executive Officer of the Council wherefrom the pensioner receives payment of pension shall on the event of death of the pensioner report along with a death certificate to the Director of Municipal Administration under intimation to the Executive Officer of the Council where the pensioner retired for discontinuing the payment of usual pension and gratuity and family pension, if due.98. [ [Substituted vide Orissa Gazette Extraordinary No. 1673/16.12.1992-SRO No. 1410/92/15.12.1992.]
99.
100.
101.
102.
Where the gratuitant happens to be a minor, payment of gratuity shall be regulated in the following manner :103.
A pension is payable monthly on and after the first day of the following month in accordance with the provisions specified hereunder ;104.
105.
106.
107.
108.
109.
When the reverse of a pension payment order is tilled up or when the pensioner's half is found to be worn, torn both halves may be renewed by the Executive Officer of the concerned Council.110.
If a pensioner loses his half of the pension payment order a new order may be issued by the Executive Officer concerned who should see that no payment is made on the half alleged to be lost.111.
Unless the Government by general or special orders direct otherwise a pension remaining undrawn for more than one year shall cease to be payable.112.
113.
114.
The arrear of pension of a deceased pensioner may be paid to the heirs of the deceased without the production of usual legal authority to the extent of rupees five hundred under the orders of the Collector of the district or such officer as may be authorised by Government after such enquiry into the rights and title of the claimants as may be deemed sufficient. Any excess above rupees five hundred may similarly be paid under the orders of the Government on execution of an indemnity bond in the form prescribed for the purpose with such sureties as they may require if they are satisfied of the right and title of the claimant and consider that undue delay and hardship would be caused by insisting on the production of letters of administration. In any case of doubt payment should be made only to the person producing legal authority.Chapter-XV The Central Pension Fund115.
116.
The Provident Fund Accounts of every employee who comes under the 'service' and who is a subscriber to the existing Contributory Provident Fund maintained by the Council and who as to the pension scheme under these rupee shall be closed just on his coming over to the pension scheme under these rules. The portion of contribution by the Council of the Contributory Provident Fund together with usual interest thereon shall be transferred to the Central Pension Fund forthwith. The portion of subscription by the employees with interest thereon shall be kept under a separate Central Provident Fund Account to be opened for the purpose.117.
118.
119.
All money received from the Council under these rules shall be deposited by the Administrator of the fund in any of the Nationalised Banks which he thinks proper and convenient after an account is opened therefor.120.
Such portion of the balance standing in the fund which is not required for immediate disbursement under these rules shall be invested in Government securities or with the sanction of Government in any of the Nationalised Banks as fixed deposits so as to yield reasonable interest.121.
The Examiner of the Local Accounts, Orissa shall be the Auditor in respect of transactions relating to the fund. The Forms and Registers to be maintained for accounting the transactions will be prepared by the Administrator of the fund after consulting the Examiner of the Local Fund Accounts, Orissa.122.
The State Government may dissolve the fund at any time after providing alternative arrangements for payment of the death-cum-retirement benefits to the employees of the Local Fund Service entitled to it under these rules and in the event of such dissolution the balance standing in the Fund shall be disposed of by Government in such manner as they think fit.123.
124.
Where the Governor is satisfied that the operation of any of the provisions of these rules caused undue hardship in any particular case he may, by order, dispense with or relax the requirements of the said provisions to such extent and subject to such conditions as he may consider necessary for dealing with the case in a just and equitable manner.125.
If any doubt or difficulty arises in the interpretation of implementation of these rules, the question shall be referred to the State Government whose decision shall be final.Form 'A'[See Rule 61 (6)]Nomination for death-cum-retirement gratuityWhen the employee has a family and wishes to nominate one member thereof:I, hereby nominate to the person mentioned below, who is a member of my family and confer on him the right to receive any gratuity that may be sanctioned in the event of my death while in service and the right to receive on my death any gratuity which having become admissible to me on retirement may remain unpaid at my death.| Name and address of nominee | Relationship with employee | Age | Contingencies on the happening of which thenomination shall become invalid | Name, address and relationship of the person orpersons, if any, to whom the right conferred on the nominee shallpass in the event of the nominee predeceasing dying after thedeath of the employee but before receiving payment of thegratuity | *Amount or share of gratuity payable to each |
| 1 | 2 | 3 | 4 | 5 | 6 |
1.
....2.
....Signature of the employee*Note-This column should be filled in so as to cover the whole amount of gratuity.(To be filled in by the Executive Officer of the concerned Council)| Nomination by............ | Signature of the Chairman of the...Municipal Council/NotifiedArea/ Council |
| Designation.......... | Date................ |
| Office.......... | Designation........... |
| Name and address of nominee | Relationship with employee | Age | Amount or share of gratuity payable to each* | Contingencies on the happening of which thenomination shall become invalid | Name, address and relationship of the person orpersons, if any, to whom the right conferred on the nominee shallpass in the event of the nominee predeceasing dying after thedeath of the employee but before receiving payment of thegratuity | *Amount or share of gratuity payable to each |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 |
1.
....2.
....Signature of employee(To be filled in by the Chairman of the concerned Council)| Nomination by............ | Signature of the Chairman of the...Municipal Council/NotifiedArea/ Council |
| Designation.......... | Date................ |
| Office.......... | Designation........... |
| Name and address of nominee | Relationship with employee | Age | Contingencies on the happening of which thenomination shall become invalid | Name, address and relationship of the person orpersons, if any, to whom the right conferred on the nominee shallpass in the event of the nominee predeceasing dying after thedeath of the employee but before receiving payment of thegratuity | *Amount or share of gratuity payable to each |
| 1 | 2 | 3 | 4 | 5 | 6 |
1.
.........2.
.........Signature of employee*Note-This column should be filled in so as to cover the whole amount of gratuity.(To be filled in by the Chairman of the concerned Council)| Nomination by............ | Signature of the Chairman of the...Municipal Council/NotifiedArea/ Council |
| Designation.......... | Date................ |
| Office.......... | Designation........... |
| Name and address of nominee | Relationship with employee | Age | Amount or share of gratuity payable to each* | Contingencies on the happening of which thenomination shall become invalid | Name, address and relationship of the person orpersons, if any, to whom the right conferred on the nominee shallpass in the event of the nominee predeceasing dying after thedeath of the employee but before receiving payment of thegratuity | *Amount or share of gratuity payable to each |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 |
1.
.........2.
.........Signature of employee*Note-1. This column should be filled in so as to cover the whole amount of gratuity.**Note-2. The amount/share of gratuity shown in this column should cover the whole amount/share payable to the original nominees.(To be filled in by the Chairman of the concerned Council)| Nomination by............ | Signature of the Chairman of the...Municipal Council/NotifiedArea/ Council |
| Designation.......... | Date................ |
| Office.......... | Designation........... |
| Name and address of nominee | Relationship with employee | Age | Whether married or unmarried |
| (1) | (2) | (3) | (4) |
1.
...........2.
.......Signature of employee(To be filled in by the Chairman of the concerned Council)| Nomination by............ | Signature of the Chairman of the...Municipal Council/NotifiedArea/ Council |
| Designation.......... | Date................ |
| Office.......... | Designation........... |
| Sl. No. | Name of the members of my family | Date of birth | Relationship with the employee | Initial of the Chairman | Remarks |
| (1) | (2) | (3) | (4) | (5) | (6) |
| 123456789 |
| Questions | Answers | |
| 1. | What is the date of birth ? | |
| 2. | What is the date of retirement ? | |
| ***3. | (a) How much of your pension do you wish tocommute ? (in words) | |
| (b) Have you already commuted a portion of yourpension ? If so, give particulars and state the amount ofpension originally sanctioned. | ||
| (c) Has any application from you forcommutation of pension ever been rejected or have you everaccepted/declined to accept commutation of pension on the basisof an addition of years to your actual age recommended by themedical authority ? If so, give particulars. | ||
| 4. | From which Council do you draw or propose todraw your pension and commutation money? | |
| 5. | State the number of your pension payment order,if you are already drawing your pension. | |
| 6. | Without prejudice to the discretion of thesanctioning authority, from what date approximately do you wishthis commutation to have effect ? | |
| 7. | At what station would you prefer your medicalexamination to take place ? | |
| 8. | State the amount of provident fund money(including any non-refundable withdrawals) and the amount ofdeath-cum-retirement gratuity received by you | |
| 9. | Name of the Executive Officer who authorisedthe payment of Provident Fund money (including anynon-refundable withdrawals) and death-cum-retirement gratuity toyou |
2. Subject to the medical authority's recommending commutation the lump-sum payable will be as stated below :
| Amount of monthly pension to be commuted | Commuted value | ||
| Rs. | Rs. | ||
| If the commutation becomes absolute before the applicant'snext birthday which falls on........... | On the basis of normal age, i.e...... years. Onthe basis of normal age plus 1 year, i.e...... years. On thebasis of normal age plus 2 years, i.e...... years. On the basisof normal age plus 3 years, i.e...... years. On the basis ofnormal age plus 4 years, i.e...... years. On the basis of normalage plus 5 years, i.e....... years. | ||
| If the commutation becomes absolute after the applicant'snext birthday but before his next birthday but one | On the basis of normal age, i.e...... years. Onthe basis of normal age plus 1 year, i.e...... years. On thebasis of normal age plus 2 years, i.e...... years. On the basisof normal age plus 3 years, i.e...... years. On the basis ofnormal age plus 4 years, i.e...... years. On the basis of normalage plus 5 years, i.e...... years. |
3. The sums payable will be a charge on...........
Station.........Date.........Memo No............./U.D.Dated..........the........20......Signature and designationPart-IIIThe Government of Orissa are pleased to accord administrative sanction to the above commutation. A certified copy of paragraph 2 of Part-II of this Form has been forwarded to the applicant in Form G-1.Under-Secretary to GovernmentUrban Development DepartmentMemo No............/U. D.Dated Bhubaneswar, the............20...Forwarded with a copy of Form G-2 and an extra copy of Part-III of Form G-2 and the Medical reports referred to..........to the.........of........in original on..........(date) with the request that he will kindly arrange for the medical examination on the applicant by the proper medical authority...........as early as possible within three months from but not earlier than (date of retirement) and inform the applicant direct in sufficient time where and when he should appear for the medical examination. The applicant's present address is..........*2. The next birthday of the applicant falls on and his medical examination may be arranged before that date but within the period prescribed in the sanctioning order.* To be omitted where the new, birthday falls beyond the prescribed date.Form G-I[See Rule 80]Commutation of pensionPart-ISubject to the medical authority's recommending commutation and the conditions prescribed in Part-II of this Form, the lump sum payable will be as stated below :| Amount of monthly pension to be commuted | Commuted value | ||
| Rs. | Rs. | ||
| Sum payable if the commutation becomes absolute before the applicant's next birthday which falls on.... | On the basis of normal age, i.e...... years. Onthe basis of normal age plus 1 year, i.e...... years. On thebasis of normal age plus 2 years, i.e...... years. On the basisof normal age plus 3 years, i.e...... years. On the basis ofnormal age plus 4 years, i.e...... years. On the basis of normalage plus 5 years, i.e....... years. | ||
| Sum payable if the commutation becomes absolute after the applicant's next birthday but before his next birthday but one | On the basis of normal age, i.e...... years. Onthe basis of normal age plus 1 year, i.e...... years. On thebasis of normal age plus 2 years, i.e...... years. On the basisof normal age plus 3 years, i.e...... years. On the basis ofnormal age plus 4 years, i.e...... years. On the basis of normalage plus 5 years, i.e...... years. |
2. The ..........(here enter the designation and the address of the Chief Administrative Medical Officer) has been requested to arrange for the medical examination and inform Shi.............direct where and when he should appear for the examination. He should bring with him the enclosed Form G-2 with the particulars required in Part-I completed except for the signature.
3. The attention of applicant is invited to the provision of rules.......... and.........of the Orissa Local Fund Service (Pension) Rules, an extract of which is enclosed.
Under Secretary to Government Urban Development DepartmentTo....................(Name and address of the applicant)Form G-2[See Rules 80 to 84]Part-I Statement to be filled In by the applicant for commutation of a portion of his pension under the provisions of the Orissa Local Fund Service (Pension) RulesThe applicant must complete this statement prior to his examination by the...........(here enter the medical authority) and must sign the declaration appended thereto in the presence of that authority.1. State your name in full (in block letters).........
2. State place of birth.........
3. State your age and date of birth...........
4. Furnish the following particulars concerning your family :
| Father's age, if living and state of health | Father's age at death and cause of death | Number of brothers living their ages and state ofhealth | Number of brothers dead, their ages and cause ofdeath | Mother's age, if living and state of health | Mother's age at death and cause of death | Number of sisters living, their age and state ofhealth | Number of sisters dead, their ages and cause ofdeath |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
5. Have any of your near relations suffered from tuberculosis (consumption, scorfula), cancer, asthma, fits, epilepsy, insanity or any other nervous disease ?
6. Have you ever been abroad ?
Where and for what period and how long since ?7. Have you ever served in the Navy, Army, Air Force or in any Government Department ?
8. Have you ever been examined
9. Have you ever been granted leave on medical certificate ? If so, state period of leave and nature of illness...
10. Have you ever-
11. Have you rupture ?
12. Have you varicocele, varicose veins or piles ?
13. Is your vision in each eye good ?
14. Is your hearing in each ear good ?
15. Have you any congenital or acquired malformation, defect or deformity ?
16. When were you last vaccinated ?
17. Is there any further matter concerning your health not covered by the above questions such as presence of albumen or sugar in the urine, marked increase or decrease in your weight in the last three years or being under treatment of any doctor within the last three months and the nature of illness for which such treatment was taken ?
Declaration by applicant(To be signed in presence of the medical authority)I declare all the above answers to be to the best of my belief, true and correct.I wilfully reveal to the medical authority all circumstances within my knowledge that concern my health and fitness.I am fully aware that by wilfully making a false Statement or concealing a relevant fact I shall incur the risk of losing the commutation I have applied for and of having may pension withhold or withdrawn under Rule 7 of the Orissa Local Fund Service (Pension) Rules.Signed in presence of..............Applicant's signature..............Signature and designation of medical authority ................Part-II (To be filled in by the examining medical authority)1. Apparent age
2. Height
3. Weight
4. Girth of abdomen at level of umbilicus
5. Pulse rate-
6. What is condition of arteries ?
7. Blood pressure-
8. Is there any evidence of disease of the main organs-
9. Does chemical examination of urine show (i) albumen (ii) sugar, state specific gravity ?
10. Has the applicant a rupture ? If so, state the kind and if reducible?
11. Describe any scars or identifying marks
12. Any additional information
Part-IIII/We have carefully examined Shri/Shrimati/Kumari.........................and am/are of opinion that-He/She is in good bodily health and has the prospect of an average duration of life.ORHe/She is not in good bodily health and is not a fit subject for commutation.ORAlthough he/she is suffering from.................he/she is considered a fit subject for commutation but his/her age for the purpose of commutation, i.e., the age at next birthday should be taken to be (in words) years more than his/her actual age.Station............Dated....................Signature and designation of examiningmedical authority/reviewing medical authority.Form 'H'[See Rule 87]List of employees employed in the Municipalities/Notified Area Councils........as on the 1st January, 20..........1st July, 20............who are due for superannuation between 1st January to the 30th June/1st July to the 31st December of the next official year(To be sent to the Director, Municipal Administration, Bhubaneswar by the 31st January/31st July at the latest).| Sl. No. | Name of employee | Date of birth | Appointment held in officiating capacity, scaleof pay, etc. | Appointment held in substantive capacity, scaleof pay, etc. | Date of superannuation | If on extension of service, the date of expiry ofthe present extension | Whether the employee has made a formalapplication for pension, if so, the date of receipt of suchapplication |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
2. I hereby declare that I have neither applied for, nor received any pension or gratuity in respect of any portion of the service qualifying for this pension and in respect of which pension and/or gratuity is claimed herein nor shall I submit an application hereafter without quoting a reference to this application and the orders which may be passed hereon.
3. I enclose herewith-
4. My present address is.................and my address after retirement will be............
2. Father's name (and also husband's name in the case of a woman employee)..............
3. Religion and Nationality.................
4. Permanent residential address showing village/town/district and State..................
5. Present or last appointment, including name of establishment...........
6. Class of pension or service gratuity applied for and cause of application ............
7. Pension Rules opted/eligible.................
8. Government under which service has been rendered (in order of employment) :
9. (a) Average emolument......................
10. Pay as defined in Orissa Local Fund Service (Pension) Rules...........
11. Proposed pension..................
12. Proposed gratuity.................
13. Date from which pension is commence.....................
14. Place of payment-
15. Whether the employee has paid all dues payable to the Council.........
16. Date of birth by Christian era of-
17. Height.............
18. Identification marks..............
19. Thumb and finger impressions-
| Thumb | Ring finger | Fore finger | Middle finger |
20. Date on which the employee applied for pension..................
Signature of Chairman of Municipal Council/Notified Area Council Signature of Executive Officer, Municipal/ Notified Area Council*Persons who are literate enough to sign their names in English or the official Regional Language, are exempted from recording their left-hand thumb and finger impressions provided they furnish certified copies of passport size photographs.Part-II Section IDetails of service of Shri/Shrimati/Kumari............Date of birth............| Establishment | Appointment | Officiating / Substantive | Date of beginning | Date of ending | Period reckoning as service-years, months, days | Period not reckoning as service-years., months,days | Remarks by the Chairman of the concerned Council |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| From | To | ||
| 1. | Interruption(s) | ||
| 2. | Extraordinary leave not qualifying for pension | ||
| 3. | Period of suspension not treated as qualifying | ||
| 4. | Any other service not treated as qualifying | ||
| Total |
1. Total period of qualifying service which has been accepted for the grant of superannuation/retiring/invalid/compensation pension/ gratuity, with reasons for disallowance, if any (other than disallowance indicated in second page).
Note-Service for the period commencing from............... and up to the date of retirement has not yet been verified; this should be done before the pension payment order is issued.2. Amount of superannuation/retiring/invalid/compensation/gratuity, that has been admitted.
3. Amount of superannuation/retiring/invalid/compensation pension/ gratuity, admissible after taking into account reduction, if any, in pension and gratuity made by the authority sanctioning pension.
4. Total period of qualifying service which has been approved for grant of special additional pension.
5. The amount of special additional pension, if any, admitted under the rules.
6. The date from which the special additional pension is admissible.
7. The date from which the superannuation/retiring/invalid/compensation pension/gratuity is admissible.
8. Head of Account to which the superannuation/retiring/invalid/ compensation and special additional pension/gratuity is chargeable.
9. The amount of life-time family pension becoming payable to the entitled members of family in the event of the death of the employee after retirement.
Chairman............Municipal Council/Notified Area CouncilSection II1. Date of submission of pension application by the employee.........
2. Name of the employee..............
3. Class of pension or gratuity............
4. Sanctioning authority.............
5. Amount of pension sanctioned.............
6. Amount of gratuity sanctioned............
7. Date of commencement of pension................
8. Date of sanction...........
9. Amount of family pension admissible in the event of death of pensioner ............
10. Dues payable to the Council held over from the gratuity...........
Part-IV Instructions1. Calculation of average emoluments. - The calculation of average emoluments mentioned at item 9 of Part-I should be based on the actual number of days contained in each month.
2. Compensation pension or gratuity. - (a) If the application is for a compensation pension or gratuity the particulars of the savings effected should be duly stated against item 6 of the Part-I.
3. History of service. - (a) Give date, month and year of various appointments, promotions and cessations. For the purpose of addition towards, broken periods, a month is reckoned as thirty days.
4. Identification marks. - Specify a few conspicuous marks, not less than two, if possible.
5. Name. - When initials or name of employees are incorrectly given in the various records consulted mention this fact in the letter forwarding the pension papers to avoid unnecessary reference.
6. Date of retirement. - Shown in the Service Book and the Last Pay Certificate.
7. Reinstatement. - In the case of an employee who has been reinstated after having been suspended, compulsorily retired, removed or dismissed, brief statement leading to his reinstatement should be appointed.
Part-III Good/fair/indifferent/bad1. Remarks of the Chairman of the Council-
2. Orders of the pension sanctioning authority.
The undersigned having satisfied himself that the service of the late Shri/Shrimati/Kumari........was thoroughly satisfactory hereby orders the grant of the full death-cum-retirement gratuity and family pension which may be accepted by the Director, Municipal Administration as admissible under the Orissa Local Fund Service (Pension) Rules to the person(s) mentioned in Part-I of this Form.ORThe undersigned having satisfied himself that the service of the late Shri/Shrimati/Kumari was not thoroughly satisfactory hereby orders that the amount of gratuity and family pension as may be accepted by the Director, Municipal Administration under the Orissa Local Fund Service (Pension) Rules, shall be reduced by the amount specified below before any authority for payment is issued to the person(s) mentioned in Part-I of this Form.Amount of reduction in the gratuityAmount of reduction in family pension.The grant of gratuity or of family pension or of both shall take effect from .........Place.........................Dated the.....................Signature and designation of the pension sanctioning authorityPart IV – Section I
Audit enfacement1. Total period of qualifying service which has been accepted for-
2. Reduction ordered by pension sanctioning authority.
3. Net amount of death-cum-retirement gratuity after taking into account the reduction mentioned in item 2 and other dues payable to the Council.
4. Amount of family pension-
5. Amount of family pension after taking into account the reduction mentioned in item 2 and the period for which it is tenable.
6. The date on which family pension is admissible.
7. Head of account to which death-cum-retirement gratuity and family pension are chargeable.
Director, Municipal Administration, OrissaSection II1. Name of the deceased employee...................
2. Date of death of the employee ...........
3. Date of submission of claim by the family of the deceased employee..
4. Sanctioning authority..............
5. Amount of family pension sanctioned.................
6. Amount of gratuity sanctioned.............
7. Date of sanction............
8. Amount recoverable from gratuity................
9. The amount of gratuity held over for adjustment of unassessed dues payable to the Council..................
Part-V Instructions| 1. | Average emoluments | The calculation of average emoluments, mentioned in item 18 ofPart-I of this Form should be based on the actual number of dayscontained in each month. |
| 2. | Details of service | (a) Give date, month and year of the various appointments,promotions and cessations. For the purpose of adding towardsbroken periods, a month is reckoned as thirty days. |
| (b) All period not reckoned as service should bedistinguished. | ||
| 3. | Identification marks | Specify a few conspicuous marks, not less than two, ifpossible. |
| 4. | Name | When initials or the name of the employee are or isincorrectly given in the various records consulted, mention thisfact in the letter forwarding the pension papers. |
| 5. | Date of death | Date of death to be indicated in the Service Book and the LastPay Certificate, if any. |
| 6. | Alterations | Alterations to be made in red ink under dated initials of aGazetted Government servant. |
1. Form 'K'............. with details of service, etc. and Form 'K-2' containing the orders of the pension sanctioning authority.
2. Medical Certificate for invalidation [if the claim is for (invalid pension)].
3. Service Book.
4. Memorandum of average emoluments reckoning for pension.
5. Last Pay Certificate.
6. (a) Two specimen signatures, duly attested by Gazette Government servant/Executive Officer of the concerned Council or in the case of pensioner not literate enough to sign his name, two slips bearing the left hand thumb and finger impressions, duly attested by a Gazetted Government servant/Executive Officer of the concerned Council, and
7. Application for pension m Form 'J'.
8. Explanation for delay, if any, beyond one month from the date of retirement of the employee in forward in Forms 'K' and K-2.
9. When the fact of service in other offices is not satisfactorily attested in the Service Book duly certified abstract from the Executive Officers of the Council.
10. Statement of the applicant and collateral evidence as required under the rules duly accepted by the authority competent to sanction the pension.
Form J-3[See Rule 95]Form for sanctioning pension(To be sent in duplicate, if payment is desired in a different Municipal Council/Notified Area Council)1. Name of the employee..............
2. Father's name (and also husband's name in the case of a women employee)............
3. (a) Present or last appointment, including name of establishment
4. (a) Orders of the pension sanctioning authority-The undersigned having satisfied himself that the service of Shri/Shrimati/Kumari.............has been thoroughly satisfactory hereby orders the grant of the full pension death-cum-retirement gratuity, service gratuity which may be accepted by the Director of Municipal Administration, Orissa, as admissible under rules; or
The undersigned having satisfied himself that the service of Shri/ Shrimati/Kumari............has not been thoroughly satisfactory hereby orders that the full pension service and/or death-cum-retirement gratuity which may be accepted by the Director of Municipal Administration, Orissa as admissible under the rules shall be reduced by the specified amount or percentage indicated below :2. I am to request that claim for the grant of the gratuity may be submitted by you in the enclosed Form 'M'.
3. Should any contingency have happened since the date of making the nomination, so as to render the nomination invalid, in whole or in part, precise details of the contingency may kindly be stated.
Yours faithfully,Chairman of the Municipality/Notified Area CouncilForm K-1[See Rule 99]Form of letter to the member or members of the family of a deceased employee where valid nomination for the grant of the death-cum-retirement gratuity does not existTo....................................................Subject : Payment of death-cum-retirement gratuity in respect of the late Shri/Shrimati..........Sir/Madam,I am directed to say that in terms of Rule 47 of the Orissa Local Fund Service (Pension) Rules, 1980 a death-cum-retirement gratuity is payable to the following members of the family of late Shri/Shrimati ................. (Designation)............in the Municipality/Notified Area Council of in equal shares2. In the event of there being no surviving member of the family as indicated above, the gratuity will be payable to the following members of the family in equal shares :
| (i) | widowed daughters including step-daughters and adopteddaughters | |
| (ii) | Father | whose personal law permitsadoption |
| (iii) | Mother | |
| (iv) | Brother below the age of eighteen years and unmarried widowedsisters including step-brothers and step-sisters | |
| (v) | Married daughters, and | |
| (vi) | Children of pre-deceased son. |
3. It is requested that a claim for the payment of gratuity may be submitted in the enclosed Form 'M' as soon as possible.
Yours faithfully,Chairman of the Municipality/ Notified Area CouncilForm K-2[See Rule 99]Form at application for the grant of the death-cum-retirement gratuity on the death of an employee(To be filled in separately by each applicant)1. Name of the applicant...............
2. (i) Name of the guardian in case the applicant is minor..............
3. Name of the deceased employee..................
4. Date of death of the employee................
5. Municipality/Notified Area Council in which the deceased served last................
6. Relationship with the employee.................
7. Date of birth of the applicant...........
8. Name of the Municipality/Notified Area Council of which payment is desired............
9. Full address of the applicant............
10. Signature or thumb impression of the applicant
(To be furnished in a separate sheet duly *attested).11. Attested by
| Name | Full Address | Signature |
| (i) | ||
| (ii) |
12. Witnesses -
2. You are advised that claim for the grant of family pension may be submitted as soon as possible in Form L-1.
3. The family pension will be payable till your death or re-marriage whichever event occurs earlier. In the event of your death or re-marriage, the family pension shall be granted to the child or children, if any, through the guardian.
Yours faithfully,Executive Officer of the Municipality/Notified Area CouncilForm L-1[See Rule 99]Form of application for the grant of family pension on the death of an employee/pensioner1. Name of the applicant-
2. Name and age of surviving widow/widower and children of the deceased employee/pensioner :
| Sl. No. | Name | Relationship with the deceased person | Date of birth by Christian era |
| (1)(2)(3)(4)(5)(6) |
3. Date of death of the employee/pensioner..............
4. Municipality/Notified Area Council in which the deceased employee pensioner served last...........
5. If the applicant is guardian, his date of birth and relationship with the deceased employee/pensioner................
6. Full address of the applicant............
7. Name of the Municipality/Notified Area Council at which payment is desired..........
8. Enclosures-
9. Signature or left hand thumb impression* of the applicant..............
10. Attested by-
| Name | Full Address | Signature |
| (i) | ||
| (ii) |
11. Witnesses -
1. Name of the deceased employee..................
2. Father's name (and also husband's name in the case of female employee).................
3. Date of birth (by Christian era)..............
4. Date of death (by Christian era)..............
5. Religion and nationality............
6. Office in which last employed..............
7. Appointment held last-
8. Date of beginning of service.........
9. Date of ending of service.........
10. (i) Total period of military service for which pension/gratuity was sanctioned............
11. Amount and nature of any pension received for previous civil service, if any..............
12. Government under which service has been tendered in order of employment...................
13. Interruption and non-qualifying service.............
14. Length of qualifying service...........
15. Emoluments reckoning for gratuity..............
16. Proposed death-cum-retirement gratuity..............
17. Whether nomination made for-
18. If family pension applies and the employee had rendered more than ten years' qualifying service :
19. Persons to whom family pension is payable Name..................
Relationship with the deceased employee.................Full postal address...........20. Persons to whom death-cum-retirement gratuity is payable-
| Name | Amount of the share of death-cum-retirementgratuity | Relationship with the deceased | Full postal address |
| 1 | 2 | 3 | 4 |
21. Name of the guardian who will receive payment of family pension and death-cum-retirement gratuity in the case of minor(s)...............
22. Dues payable to the Council, if any, outstanding against the deceased employee................
23. Head of account to which family pension and death-cum-retirement gratuity are debatable...............
24. Name of the office of the Council where the payment of family pension and death-cum-retirement gratuity is desired....................
Signature of the Executive OfficerMunicipality/Notified Area CouncilPlace ........Dated the.............Part-II Section IDetails of service (showing interruption) of the late Shri/Shrimati/KumariDate of birth.........Date of death.........| Establishment | Appointment | Officiating / Substantive | Date of beginning of service | Date of ending of service | Period reckoning as service | Period not reckoning as service | Remarks by the Executive Officer |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| Y.M.D. | Y.M.D. |
2. The Executive Officer should record briefly in Column (8) his reasons for disallowing any service claimed; any other disallowance should be recorded with reasons therefor in the Audit enforcement in Section I of Part-IV of this Form.
Section IIDetails of non-qualifying service1. Interruption(s) .........
2. Extraordinary leave not qualifying for pension...........
3. Period of suspension not treated as qualifying...........
4. Any other service not treated as qualifying..................
TotalSection IIIPeriod of service not verified with reference to the Acquittance RollsWhether the above period has been verified in accordance with the provisions of Rule 92 of the Orissa Local Fund Service (Pension) Rules.Part-III Remarks2. Intimation has been received in this Municipality/Notified Area Council that Shri/Shrimati.............died on.............that at the time of death left no widow/widower but was survived by the following children:
| Sl. No. | Name | Son/daughter | Date of birth in Christian era | Date from which family pension ceases to bepayable |
| (1) | (2) | (3) | (4) | (5) |
| 1.2.3.4.5. |
3. In terms of Chapter VII of the Orissa Local Fund Service (Pension) Rules, 1980 the amount of family pension has become payable to the children in the order mentioned above. The family pension will be payable on behalf of the minors to Shri/Shrimati..............who is the guardian.
4. Sanction for the grant of family pension to the children mentioned above is hereby accorded. The family pension will take effect from............... and subject to the provisions of Chapter VIII of the Orissa Local Fund Service (Pension) Rules, 1980 will be tenable till.............
5. The family pension is debatable to the Head...............
6. Attention is invited to the information furnished in the enclosed list.
7. The receipt of the letter may kindly be acknowledged and this Municipality/ Notified Area Council informed that necessary instruction for the payment of family pension have been issued.
Yours faithfully,Chairman of the Municipality/Notified Area CouncilForm 'O'[See Rule 100]Form of letter sanctioning family pension to the child or children on the death or remarriage of a widow/widower who was in receipt of family pensionToThe Director of Municipal Administration...............................................Subject- Grant of family pension to the child/children.SirI am directed to say that Shrimati/Shri................widow/widower of late, Shri/Shrimati/...........formerly...........(Designation) in...........Municipality/Notified Area Council was sanctioned family pension of Rs.......................with effect from the.............The family pension was tenable till the death or re-marriage of the widow/widower.2. Intimation has been received in this Municipality/Notified Area Council that Shri/Shrimati died/re-married on.
3. At the time of death/re-marriage, Shri/Shrimati...................had following children*
| Sl. No. | Name | Son/daughter | Date of birth in Christian era | Date from which family pension ceases to bepayable |
| (1) | (2) | (3) | (4) | (5) |
| 1.2.3.4.5. |
4. In terms of Chapter VIII of the Orissa Local Fund Service (Pension), Rules, 1980 the amount of family pension has become payable to the children in the order mentioned above. The family pension will be on behalf of the minors Shri/Shrimati.................who is the guardian.
5. Sanction for the grant of family pension of Rs..................per month to the children mentioned is hereby accorded. The family pension will take affect from and subject to the provisions of Chapter VII of the Orissa Local Fund Service (Pension) Rules, 1980 will be tenable till...................
6. The family pension is debitable to the head.....................
7. Attention is invited to the information furnished in the enclosed list.
8. The receipt of this letter may kindly be acknowledged and this Municipality/ Notified Area Council informed that necessary instruction for the payment of family pension to the guardian have been issued.
Yours faithfully,Chairman of theMunicipality/Notified Area Council*The names of children should be mentioned in the order of eligibility mentioned in Chapter VIII. Children born as a result of marriage which took place before the retirement of the employee or children adopted legally before retirement should only be included.List1. Permanent address of the guardian
2. Place of payment
Enclosures3. Specimen signature or left hand thumb and finger impression of the guardian duly attested
4. Two attested copies of a passport size photograph of the guardian
5. Descriptive toll of the guardian duly attested
*To be furnished in the case of the guardian, who is not literate enough to sign his/her name.Form 'P'[See Rule 101]Form of claim application for the grant of residuary *gratuity on the death of a pensioner(To be filled up separately by each applicant)1. Name of the applicant..............
2. (i) Name of the guardian in case the applicant is a minor.............
3. Name of the deceased pensioner.................
4. Municipality/Notified Area Council in which the deceased pensioner served last..............................
5. Date of death of the pensioner............
6. Date of retirement of the deceased pensioner.............
7. Amount of monthly pensions **(including ad hoc increase, if any,) sanctioned to deceased pensioner......................
8. Amount of death-cum-retirement gratuity received by the deceased pensioner.................
9. The amount of Pension**, (including ad hoc increase, if any,) drawn by the deceased till the date of death.....................
10. If the deceased had commuted a portion of pension before his death the commuted value of the pensions.......................
11. Total of items 8, 9, 10............
12. Amount of death-cum-retirement gratuity equal to 12 times of the emoluments...................
13. The amount of the residuary gratuity claimed, i.e., the difference between the amount shown against item 12 and item 11........................
14. Relationship of the applicant with the deceased pensioner...........
15. Date of birth of the applicant...................
16. Name of the Council at which payment is desired.......
17. Full address of the applicant...................
18. Signature or thumb impression of the applicant (To be furnished in a separate sheet duly attested)***
19. Attested by-
| Name | Full Address | Signature |
| (i) | ||
| (ii) |