Report Date :14/12/2024 11:24 AM

FORM 7
See Rules 58, 60, 61(1) and (3) and rule 65(1)
Form for assessing Pension/Family Pension and Gratuity
[To be sent six months before the Date of Retirement to the PAO]
PART-I
1. Name of the retiring Government : MR. TANAY DAS (120906578)
employee
2. Father's/Husband's name : SUKHRANJAN DAS
3. PAN No. : ASFPD0879H
4. : 179 cm & One black mole left side of
root of [Link] black mole on the left
Height & Marks of Identification
side of face about 1.5 cm lateral to the
lateral canthus of left eye.
5. Date of Birth : 24/05/1991
6. Service to which he/she belongs(Indicate : General Central Service (Border
name of organized service,if any, Security Force)
otherwise say, General Central Service)
7. Particulars of post held at the time of retirement
(a)Name of the Office : 118 BN BSF,
(b )Post held : CT(GD)
(c )Scale of pay / Pay Level of the post : 25500-81100, Pay Level : 4
(d )Basic Pay / pay in the Pay Band & : 33300
Grade pay / Basic Pay in Pay Level
(e)Whether the appointment mentioned : Under Government
above was under Government or outside
the Government on foreign service terms.
(f )If on foreign service, scale of pay/ pay :N.A.
band, pay in the pay band & grade pay of
the post in the parent department
8. Whether declared substantive in any Post : N.A.
under the Central Government
9. Date of beginning of service : 24/04/2012
10. Date of ending service : 10/06/2024
11. : Invalid Pension/Invalidment on Medical
Cause of ending of service
Ground (Rule 38)
12. In the case of compulsory retirement, the : N.A.
orders of the competent authority
whether pension may be allowed at full
rates or at reduced rates and in case of
reduced rates, the percentage at which it
is to be allowed(Please see Rule 40)
13. In case of removal/dismissal from service : N.A.
whether orders of competent authority
have been obtained for grant of
compassionate allowance and if so, at
what rate(Please see Rule 41)
14. Particulars relating to military service, if : N.A.

Bhavishya Date:14/12/2024 11:24 AM

 any
15. Particulars relating to service in : No
autonomous body/State Government, if
any
16. Whether any departmental or judicial : No ()
proceedings in terms of rule 9 of the CCS
(Pension) Rules, 1972 are pending
against the retiring employee. (If yes, in
terms of Rule 69, provisional pension will
be admissible and gratuity will be
withheld till the conclusion of
departmental or judicial proceedings and
issue of final orders.)
17. Qualifying service: :
(a)Details of omission, imperfection or : N.A.
deficiencies in the Service Book which
have been ignored [under rules 59(i) (b)
(ii)]
(b)Period not counting as qualifying : Yes
Sr.N Type of Non Qualifying Service Period
o. From Date To Date
1 Any other period not treated as qualifying service (give details).(227 19/03/2017 31/03/2017
Days dies-non w.e.f 19/03/2017 to 01/11/2017)
2 Any other period not treated as qualifying service (give details).(227 01/04/2017 30/04/2017
Days dies-non w.e.f 19/03/2017 to 01/11/2017)
3 Any other period not treated as qualifying service (give details).(227 01/05/2017 31/05/2017
Days dies-non w.e.f 19/03/2017 to 01/11/2017)
4 Any other period not treated as qualifying service (give details).(227 01/06/2017 30/06/2017
Days dies-non w.e.f 19/03/2017 to 01/11/2017)
5 Any other period not treated as qualifying service (give details).(227 01/07/2017 31/07/2017
Days dies-non w.e.f 19/03/2017 to 01/11/2017)
6 Any other period not treated as qualifying service (give details).(227 01/08/2017 31/08/2017
Days dies-non w.e.f 19/03/2017 to 01/11/2017)
7 Any other period not treated as qualifying service (give details).(227 01/09/2017 30/09/2017
Days dies-non w.e.f 19/03/2017 to 01/11/2017)
8 Any other period not treated as qualifying service (give details).(227 01/10/2017 31/10/2017
Days dies-non w.e.f 19/03/2017 to 01/11/2017)
9 Any other period not treated as qualifying service (give details).(227 01/11/2017 01/11/2017
Days dies-non w.e.f 19/03/2017 to 01/11/2017)
10 Any other period not treated as qualifying service (give details).(28 days 02/02/2018 28/02/2018
RI w.e.f 02/02/2018 to 01/03/2018)
11 Any other period not treated as qualifying service (give details).(28 days 01/03/2018 01/03/2018
RI w.e.f 02/02/2018 to 01/03/2018)

(c) Additions to qualifying service - : N.A.

(d) Net qualifying service: : 11 Years 5 Months 5 Days
(e) Qualifying service expressed in terms : 23 Six monthly Period
of Completed six monthly periods (period
of three months and over is treated as
completed six monthly period(Rule 49)
18. Emoluments:
(a) Emoluments in terms of Rule 33 : 33300
(b)Emoluments drawn during 10 months preceding retirement:
From Date To Date (Pay Band + Grade Basic Rate NPA Rate (Basic +
Pay)/Pay Level NPA) For
Avg.
Emolume
nts

Bhavishya Date:14/12/2024 11:24 AM

 12/08/2023 31/08/2023 4 32300/- 0/- 21533.
33/-
01/09/2023 30/09/2023 4 32300/- 0/- 32300.
00/-
01/10/2023 31/10/2023 4 32300/- 0/- 32300.
00/-
01/11/2023 30/11/2023 4 32300/- 0/- 32300.
00/-
01/12/2023 31/12/2023 4 32300/- 0/- 32300.
00/-
01/01/2024 31/01/2024 4 33300/- 0/- 33300.
00/-
01/02/2024 29/02/2024 4 33300/- 0/- 33300.
00/-
01/03/2024 31/03/2024 4 33300/- 0/- 33300.
00/-
01/04/2024 30/04/2024 4 33300/- 0/- 33300.
00/-
01/05/2024 31/05/2024 4 33300/- 0/- 33300.
00/-
01/06/2024 10/06/2024 4 33300/- 0/- 11100.
00/-
Total 328333
.33/-

Note: If the officer was on foreign service immediately preceding retirement, the
notional emoluments which he would have drawn under Government but for being
on foreign service may be mentioned in items (a) and (b) above (Note 7 below Rule
33)
(c) Average emoluments (Rule 34) : 32834
(d) Emoluments or average emoluments : 33300
(whichever is higher) to be reckoned for
pension (Rule 49)
(e) Emoluments reckoned for retirement : 49950
gratuity/death gratuity (Rule 50):
(f) Pay reckoned for family pension (Rule : 33300
54)
19. Amount of retirement gratuity/death : 287213
gratuity (Rule 50) (Refer S. No.9 of
Calculation Sheet)
20. Details of Government dues recoverable out of gratuity
(a) License fee for Government : refer to Form 8
accommodation(see sub-rules (2). (3)
and (4) of Rule 72):-
(b) Dues referred to in rule 73 : refer to Form 8
(c) Amount indicated by Directorate of : refer to Form 8
Estates to be withheld under sub-rule (5)
of Rule 72
21. (a) Proposed pension/service gratuity : 16650
(Rule 49)
(b )Proposed dearness relief on pension : 50%
(as on the date of retirement):-
(c) Date from which pension is to :11/06/2024
commence(Rule 83)
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22. Rate of family pension:-
(a)Enhanced rate [Rule 54(3)] : 50%
(b)Period for which family pension will be : upto 7 years from the date of death or
payable at enhanced rate till the age of 67 years, whichever is
earlier.
(c)Ordinary rate [Rule 54(2)] : 30%
(d)Date from which ordinary rate of family : from date following the date as in (b)
pension will be payable above or following the date of death,
whichever is later.
23. Commutation of pension:
(a) Whether simultaneously applied for : No
commutation of pension with the pension
application (applicable only in the case of
those who retire on superannuation
pension) ?
(b) The percentage of pension commuted : N.A.
(c) Amount of monthly pension : N.A.
commuted
(d) Commuted value of pension : N.A.
(e) Amount of residuary pension after : N.A.
deducting Commuted portion
(f) Date from which reduced pension is : N.A.
payable.
(g) Date from which commuted pension is : N.A.
to be restored
24. Post retirement address of the retiree : Vill- Akhil Pally, PO-Gobardanga, PS-
Habra, Habra , North 24 Parganas,
WEST BENGAL 743252
25. e-mail ID, if any : tanaydas007@[Link]
26. Mobile number, if any : 9064828221
(RAJESH KUMAR TRIPATHI
COMMANDANT
Contact No. 03329 679674 )

Bhavishya Date:14/12/2024 11:24 AM

 FORM 7 CHECK LIST FOR HEAD OF OFFICE FOR TIMELY PROCESSING OF
RETIREMENT DUES
1. Whether retiring employee is an allottee of Government accommodation No
2. If retiring employee is not an allottee of Government accommodation, date on which
`No demand certificate' issued by the office
3. The date on which action initiated to obtain the `No demand certificate' from the
Directorate of Estates as provided in rule 57-
4. Date of receipt of ‘No demand certificate’ from Directorate of Estates
5. Date on which intimation regarding any recovery/withholding of amount from gratuity
received from Directorate of Estates
6. Date on which action initiated to assess the service and emoluments qualifying for 08/08
pension as provided in rule 59 /2024
7. Date on which action initiated to assess the Government dues other than the dues
relating to allotment of Government accommodation as provided in rule 73 (1)
8. Date on which the retiring Government servant was furnished blank Form 5 along with 08/08
a certificate regarding the length of qualifying service and the emoluments/ average /2024
emoluments proposed to be reckoned for retirement gratuity and pension
9. Whether any objection received from the employee on the above certificate N.A.
10. 14/12
Date on which the employee submitted his application for pension in Form 5
/2024
11. Whether nominations made in Common Nomination Forms for (i) death Yes
gratuity/retirement gratuity (ii) payment under CGEGIS (iii) amount of GPF, if
applicable (iv) arrears of pension (v) commuted value of pension (if applicable)
12. (i) Has the retiring Government servant worked in any of the organisations mentioned N.A.
in sub-rule 3A of rule 8 of the CCS (Pension) Rules, 1972 (ii) If yes, whether an N.A.
undertaking in Form 26 has been obtained along with Form 5 and placed on record
13. Whether Details of family in Form 3 attached Yes
14. Whether Medical certificate of incapacity (for invalid pension) attached. Yes
15. Whether Statement of the savings effected and the reasons why employment could N.A.
not be found elsewhere attached (if claim is for compensation pension or gratuity).
16. Whether the Orders of the competent authority regarding grant of pension in the cases N.A.
of compulsory retirement/dismissal/removal against Item No. 12 or 13 placed on
record.
17. Whether a statement indicating the reasons for delay in case the pension papers are N.A.
not forwarded before six months of the retirement of Government servant attached.
18. Whether brief statement leading to reinstatement of the Government servant attached N.A.
(In case the Government servant has been reinstated after having been suspended,
compulsorily retired, removed or dismissed from service.)
19. Whether the name of retiring employee in bank account is matching with the name in Yes
service book

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 PART-2
1. Date of receipt of pension papers by the
Accounts Officer from Head of Office
2. Entitlement admitted
A. Length of qualifying service
B. Pension
(i) Class of Pension
(ii) Amount of monthly pension
(iii) Date of commencement
C. Commutation of Pension
(i)Portion of pension commuted, if any
(ii)Commuted value of portion of pension
commuted, if any
(iii)Residuary pension after commutation
(iv) Date from which reduced pension is
payable
(v) Date of restoration of commuted portion of
pension subject to the pensioner continuing to
live
D. Retirement/Death Gratuity
(i) Total amount of gratuity
(ii) Amount to be adjusted towards arrears of
licence fee for Government accommodation
and licence fee for retention of Govt.
accommodation beyond retirement (Rule 72(1)
and 72(4)
(iii) Amount intimated by Directorate of Estates
for being withheld on account of unassessed
licence fee (Rule 72(5))
(iv) Amount to be adjusted towards
Government dues other than those pertaining
to Government accommodation (Rule 73)
(v) Net amount to be released immediately.
E. Family Pension
(i) At enhanced rate
(ii) Period for which Family Pension at
enhanced rate is payable
(iii) At normal rate
3. Head of Account to which the amount of
pension, retirement/death gratuity and family
pension are to be debited.
Accounts Officer

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 PENSION CALCULATION SHEET
1. Name : MR. TANAY DAS (120906578)
2. Designation : CT(GD)
3. Scale of pay / Pay Band & Grade pay/ Pay : 25500-81100, Pay Level : 4
Level
4. Date of Birth : 24/05/1991
5. Date of entry in the Government service : 24/04/2012
6. Date of retirement : 10/06/2024
7. Length of qualifying service reckoned for : 11 Years 5 Months 5 Days
pension/gratuity (as indicated in PPO)
8 Emoluments drawn in the last ten months
From Date To Date (Pay Band + Grade Basic Rate NPA Rate (Basic +
Pay)/Pay Level NPA) For
Avg.
Emolument
s
12/08/2023 31/08/2023 4 32300/- 0/- 21533.3
3/-
01/09/2023 30/09/2023 4 32300/- 0/- 32300.0
0/-
01/10/2023 31/10/2023 4 32300/- 0/- 32300.0
0/-
01/11/2023 30/11/2023 4 32300/- 0/- 32300.0
0/-
01/12/2023 31/12/2023 4 32300/- 0/- 32300.0
0/-
01/01/2024 31/01/2024 4 33300/- 0/- 33300.0
0/-
01/02/2024 29/02/2024 4 33300/- 0/- 33300.0
0/-
01/03/2024 31/03/2024 4 33300/- 0/- 33300.0
0/-
01/04/2024 30/04/2024 4 33300/- 0/- 33300.0
0/-
01/05/2024 31/05/2024 4 33300/- 0/- 33300.0
0/-
01/06/2024 10/06/2024 4 33300/- 0/- 11100.0
0/-
Total 328333.
33/-
9.
(1) Emoluments or Average emoluments, :
33300
whichever is more beneficial for pension
(as indicated in PPO)
(2) Pension admissible (if qualifying service is :
16650
ten years or more)
Calculations to be shown as follows :-
Emoluments or Average Emoluments/2 (
33300 /2 )
10.
(1) Emoluments for gratuity (as indicated in :
49950
PPO)
(2) Retirement gratuity admissible Calculation : 287213
to be shown as follows :- Emoluments/4 x
Qualifying Service (In completed six
monthly period, not exceeding 66.) (49950
/4 ) x 23)
11.

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 (1) Pay for Family Pension (as indicated in : 33300
PPO)
(2) Family Pension admissible
Calculations to be shown as follows :-
(a) Ordinary Family Pension : Pay x 30% : 9990
subject to prescribed minimum and
maximum (33300 x 30% )
(b) Enhanced Family Pension Pay / 2 [Subject : 16650
to prescribed minimum and maximum as
per Rule 54].(33300 x 50% )
12. Commutation of pension:
(a) The percentage of pension commuted : N.A.
(b) Amount of monthly pension commuted : N.A.
(c) Commuted value of pension : N.A.
(d) Amount of residuary pension after : N.A.
deducting Commuted portion

Head of Office
(RAJESH KUMAR TRIPATHI
COMMANDANT
Contact No. 03329 679674 )

Countersigned by
PAO
Copy to:-MR. TANAY DAS (120906578),Vill- Akhil Pally, PO-Gobardanga, PS-Habra , Habra
, North 24 Parganas , WEST BENGAL , PIN Code :743252, Mobile No : 9064828221, EmailId
: tanaydas007@[Link]

Bhavishya Date:14/12/2024 11:24 AM