Public Sector Bank / Municipal Corporation / New Bank of India / Andhra Bank / Vijaya Bank / Sindh Bank / the Guardian / Punjab / /
Country
India / /
Facility
COUNTERSIGNED Station / /
Organization
Legislative Council / Record Office / Legislative Assembly / Committee of District Board/Zila Parishad / Ministry of Defence Letter / /
Person
Civil / Appendix / Residence Whether / /
Position
Patwari Sub Inspector / officer /Assistant Record Officer / gazetted Officer / Member of Parliament /Member / Record Officer / Village Munsif/Patel/Village Officer / /
CLAIM TO FAMILY PENSION AND CHILDREN ALLOWANCE (To be completed in duplicate by the claimant to family pension and return to Record Office after attestation by any of the prescribed persons listed at page 5).