FACE SHEET FOR GRANT OF FINANCIAL ASSISTANCE
1.
Name of
deceased Govt. Employee; _____________________
2.
CNIC
No.____________________ 3. Father' s Name___________________________
4.
Designation.
___________BPS No._____ Regular/Contract /Ad hoc_____________
5.
Date of
Birth___________ (Attach SSC/First page of S/Book_______________
6.
Office
/Institution________________________________________________
7.
Date of
appointment: __________________Present Grade/BPS No.____in Govt.service
8.
Date of
posting at last station___________________9.
Claim Rs. _________________
10
Date of
Expire / Attached Death Certificate.
11
Detail of Total Service: - Years _________Month.
________ Days. _____________
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Sr. No. |
Name of Office/ Institution |
From |
To |
BPS. No. |
Designation |
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12. List of Family/Families
members of the deceased.
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Sr. No. |
Name |
Relation |
%age/Ratio
of Share |
CNIC
NO. |
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i.
Certified
that the above particulars are correct and verified with the office record.
ii.
In case
of any false/bogus/fake & fictitious / particulars detected subsequently,
the undersigned will be responsible for the consequences.
No. _________Dated. ______________ No. _________Dated. ______________
Counter Signed and forwarded, please. Signature. ________________________
Signature. ________________________ Name of DDO. _____________________
Name of CEO/DEO_________________
Designation Official Stamp____________
Designation Official Stamp___________
Dated. ____________________________