IFPMS

Employee ID : {{EmpData.EmpID}}

Employee Name : {{EmpData.EmpEng_Name}}

Category : Gazetted Non Gazetted

Case Type

Service Category

PPAN No

PRAN No

Pay Commission Year

Employee Name

Title*

Employee Name *

Father/Spouse Name

Title *

Father/Spouse Name *

Administrative/Parent Department

Department *

Department

Designation *

Designation

Date of Birth

Date of Joining

Date of Retirement

Date of Death

Religion *

Caste Category *

Caste *

Height(CM.)

(KG.)

Identification Mark

Aadhaar 12 Character

PAN 10 Character

Were you subscriber of work charged employees Contributory Provident Fund (CPF) Scheme ? Yes No

CPF No

Re-Employement Yes No

Re-Employement Department

Re-Employement Designation

Opt for Commutation ? Yes No

Commutation Share in %

Employee ID : {{FamEmpId}}

Employee Name : {{EmpData.EmpEng_Name}}

Details Of Family (See FORM 3 and Rule 74)

Definition ‘Family’ for the purpose of these rules shall include the following relations of the Government servant :-

Wife, in the case of a male Government servant and husband, in the case of female Government servant.
A judicially separated wife or husband, such separation not being granted on the ground of adultery.
Unmarried son till her attains the age of 25 years or earning a monthly income exceeding Rs 9500/- per month, whichever is earlier.
Unmarried daughter upto the date of her marriage or earning a monthly income exceeding Rs.9500/- per month, whichever is earlier.
Widowed/divorced daughter of any age upto the date of her remarriage or till the date she starts earning a monthly income exceeding Rs.9500/- per month whichever is earlier.
Parents who were wholly dependent upon the Government servant when he/she was alive provided the deceased employee had left behind neither a window nor a child and the income of parent is not more than Rs.9500/- per month.

Sr.No.	Name of family member	Date Of Birth	Sex	Relation	Married	Disorder/Disable	Address	Action

{{$index+1}}	{{x.E_Title}} {{x.Eng_Name}}	{{x.DOB}}	{{x.ShwGender}}	{{getFullRelation(x.Relation)}}	{{getMarital(x.Marital)}}	{{x.ShwHandicap}}	{{x.NAddress}}

Nomination under Rule 4 of the Payment of Arrears of Pension (Nomination) Rules, 1996 (See FORM A)

Help for pension Arrear & Gratuity (A)Pension Arrear Nomination of share to the extent for admissible Pension Arrear to the family / non family member by the government servant in the event of his/ her death while in service or before receiving 1st Payment.
Alternative nominee for payment of Pension Arrear Nomination of share to the pension to whom receipt conferred on the nominee shall pass in the event of the nominee pre-deceasing before receiving of 1st Payment by government servant
(B) Gratuity/Death Gratuity Nomination of Gratuity / Death Gratuity share to the extent for admissible retirement gratuity / death gratuity to the family / non family member (s) by the government sevant in the event of his/her death while in service or before receiving payment of gratuity.
Alternative nominee (s) for gratuity / death gratuity – Nomination of share to the person (s), to whom right conferred on the nominee shall pass in the event of the nominee pre-deceasing the government servant or the nominee dying after the death of the government servant but before receiving payment of gratuity.

Sr.No.	Name of family member	Date Of Birth	Sex	Relation	Married	Handicap	Pension Arrear	Alternate Nominee Share	Address	Contingency on happening of which nomination shall become invalid.	Action

{{$index+1}}	{{x.E_Title}} {{x.Eng_Name}}	{{x.DOB}}	{{x.ShwGender}}	{{x.ShowRelation}}	{{getMarital(x.Marital)}}	{{x.ShwHandicap}}	{{x.PNomineeShare}}	{{x.LTANomineeShare}}	{{x.NAddress}}	Any Other {{x.Remarks}}

Nomination for Retirement Gratuity/Death Gratuity (See FORM 1 and Rule 59 (1))

Sr.No.	Name of family member	Date Of Birth	Sex	Relation	Married	Handicap	Gratuity Arrear	Alternate Nominee Share	Address	Action

{{$index+1}}	{{x.E_Title}} {{x.Eng_Name}}	{{x.DOB}}	{{x.ShwGender}}	{{x.ShowRelation}}	{{getMarital(x.Marital)}}	{{x.ShwHandicap}}	{{x.GNomineeShare}}	{{x.CNomineeShare}}	{{x.NAddress}}

Select	Name of family member	Relation
	{{x.MinorFamily.E_Title}} {{x.MinorFamily.Eng_Name}}	{{x.MinorFamily.ShowRelation}}

Select

Name of family member

Relation

Sr.No.	Select	Name of family member	Relation
{{AlterTyp}}
{{$index+1}}		{{x.E_Title}} {{x.Eng_Name}}	{{x.ShowRelation}}

Employee ID : {{LoanEmpId}}

Employee Name : {{EmpData.EmpEng_Name}}

Sr.No.	Kind of Advance	Amount sanctioned	Amount Paid	Due Amount	Action
1.
{{$index+1}}	{{getFullName(x.LoanName)}}	{{x.SanctionAmt}}	{{x.RecoveryAmt}}	{{x.NetPayAmt}}

Employee ID : {{ServiceMasterData.EmpID}}

Employee Name : {{EmpData.EmpEng_Name}}

Employee 's Current Address
House No *
Address *
Pin Code *
District *
State *
Email

Permanent Address	Same as Current Address





Mobile *

Office Id
Department *
Address *
District *
State *


Pin Code *
Email
Phone No

Bank Details

Treasury Name *
Sub Treasury *
District *
Bank Name *
Branch Name *
Account Number *

Witness 1

Name *
Address *
District *
State *
Witness Mobile No *

Witness 2

Employee ID : {{EmpData.EmpID}}

Employee Name : {{EmpData.EmpEng_Name}}

Help Document to be uploaded by employee

*
*
*
If Unmarried, Or Spouse is not Alive
*
*
*

Document : {{DocName}}

Documents

Upload document should be self attested with date
Upload file format in ".JPG/.PDF".
Upload file size (except SB)should be up to 150KB.

S. No.	Upload documents	By Applicant	By Head of Office	Format
1.	Last Pay Certificate (LPC) Slip	Yes	Yes	.pdf
2.	Retirement Order	Yes	Yes	.pdf
3.	Applicant Signature	Yes	Yes	.jpg
4.	Single / Joint Photograph	Yes	Yes	.jpg
5.	No dues for Long term advances	Yes	Yes	.pdf
6.	No dues for Govt Accommodation	Yes	Yes	.pdf
7.	Witness Signature	Yes	Yes	.jpg
8.	Employee Death Certificate	No	Yes	.pdf
9.	Account Person Certificate	No	Yes	Pdf
10.	NPA Statement(Medical Cases)	No	Yes	Pdf
11.	Other Documents	-	-	.pdf

Entry by Employee

Details Of Family (See FORM 3 and Rule 74)

Nomination under Rule 4 of the Payment of Arrears of Pension (Nomination) Rules, 1996 (See FORM A)

Nomination for Retirement Gratuity/Death Gratuity (See FORM 1 and Rule 59 (1))

Employee 's Current Address

Permanent Address

Bank Details

Witness 1

Witness 2

Help Document to be uploaded by employee