CHENNAI PORT TRUST

CHENNAI PORT TRUST
LIFE CERTIFICATE
-
2014
Life Certificate of the Pensioners/Family Pensioners of
Chennai Port Trust will be verified from 01.11.2014 upto 29.11.2014.
The format of Life Certificate is being dispatched to the address declared
by the Pensioner / Family Pensioner. It may also be downloaded from the
Trust’s website www.chennaiport.gov.in
The PPO book, Bank pass book and recent passport size
photograph should be brought for verification while submitting the Life
Certificate in person. In case of Infirm or immobilized pensioners or
pensioners unable to come in person,
Life Certificate may be sent by
speed post addressed to The Accounts Officer, Pension Section,
Finance Department, Chennai Port Trust, No.1, Rajaji Salai, Chennai
600 001. In such cases, a recent passport size photograph may be
affixed on the Life Certificate form along with the Bank seal and certified
by the Branch Manager of the Bank where pension is drawn.
Failure to submit Life Certificate on or before 29.11.2014
will result in stoppage of pension with effect from January 2015.
Sd
FA&CAO
Finance Department
CHENNAI PORT TRUST
LIFE CERTIFICATE - 2014
-------------------------------------------------------------------------------Sir/Madam,
It is requested to produce
the Life certificate for
the year 2014 along
with recent pass port size photo affixed as under either in person or attested
by the bank authorities (Signature, Bank Branch Seal and Full Name in Capital)
from where you are drawing pension
before 29.11.2014 failing
and
which your
the
same
may
be sent by post on or
pension from the month of January, 2015
onwards will be discontinued without further notice.
Sd/Accounts Officer(Pension)
Note:
sent
The affixed passport size photo should be attested by Bank Officials if
through
Speed Post / Couriers Etc.On submitting in person the concerned
should bring the Original PPO book and Bank pass book in which their photo has
been displayed for verification.
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Page 1
LIFE CERTIFICATE
---------------Certified that I have seen the Pensioner/Family Pensioner, and that
He/She is alive on this date.
-----------------------Shri/Smt................................
Holder of PPO No.........................
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Name of Bank/Branch............................
Savings Bank Account No........................
Phone Contact No. 1).............. 2).............
Passport
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Size
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Photo
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Present Address (for communication)..................................
......................................................................
......................................................................
Signature of the Pensioner/Family Pensioner
Signature of Verifying Official
-----------------------------------------------------------------------------I declare that I have accepted / not accepted any employment
I declare that I have been employed / re-employed in the office of w.e.f.
Page 2
Signature of the Pensioner / Family Pensioner
--------------------------------------------I declare that I have been married / re-married on
I declare that I have not been married / re-married
Signature of the Pensioner / Family Pensioner
Page 3
Signature of Verifying official