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Life Certificate

1) The document is a certificate submitted by a pensioner of the State Bank of India branch in Muktsar. 2) It includes a life certificate signed by an authorized person confirming the pensioner is alive. It also contains additional identification and contact details provided by the pensioner. 3) The pensioner must declare their employment status, including if they have received any other income or have accepted employment without permission. 4) The pensioner must also declare their marital status and agree to inform the bank immediately if they marry or remarry within the next six months. 5) An authorized officer or well-known person also signs to certify the pension

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3K views1 page

Life Certificate

1) The document is a certificate submitted by a pensioner of the State Bank of India branch in Muktsar. 2) It includes a life certificate signed by an authorized person confirming the pensioner is alive. It also contains additional identification and contact details provided by the pensioner. 3) The pensioner must declare their employment status, including if they have received any other income or have accepted employment without permission. 4) The pensioner must also declare their marital status and agree to inform the bank immediately if they marry or remarry within the next six months. 5) An authorized officer or well-known person also signs to certify the pension

Uploaded by

Dollar Khokhar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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(Annexure-A)

CERTIFICATE TO BE SUBMITTED BY PENSIONER


STATE BANK OF INDIA ANNEXURE-VI
Branch Name: MUKTSAR Branch Code: 00683
SB Account No.............................. Category: Def/Central/Rail/Telecom/State

I. LIFE CERTIFICATE
Certified that I have seen the Pensioner ..............................................................................................................................
holder of Pension Payment Order No......................................... and A/c No.................................................... and that he
is alive on this date.

Signature with SS No...........................


___________________ Date .....................................
Signature of Pensioner Name .....................................
Name: Designation .....................................
Place: Muktsar Seal .....................................
ADDITIONAL INFORMATION
I submit herewith additional details as under:
1. AADHAR No______________________________
2. Income Tax Permanent Account No(PAN):___________________
3. (a) Mobile:____________________________
(b) Alternate Mobile Number:_____________________
4. Date of Birth of the Spouse:_______________________( Proof of Date of Birth Attached)

____________________________
Signature of the Pensioner
Name of the Pensioner:_________________
Savings Bank A/c No.____________________
II. NON EMPLOYEMENT CERTIFICATE
*I declare that i have not received any remuneration for serving in any capacity in the establishment of the central
Government or a State Government or a Government undertaking or from a Local Fund during the Period November
to April, 2015, May to October, 2015.
*I declare that I have been employed/re-employed in the office of..............................................
and was in receipt of the following emoluments during the period(To be specified)
*I declare that I have not accepted any employment under any Government outside India or Commercial Employment
after Obtaining/Without Obtaining sanctioning of the Director/CSIR (To be furnished by Class I Officer Only).
*Strike out whichever is not applicable

Place: Muktsar ____________________________


Date: ....................... Signature of Pensioner

III.CERTIFICATE OF RE-MARRIAGE/NON-MARRIAGE
I hereby declare that I am not married/I have not been re-married during the past six months and shall inform the
Bank as soon as I marry/re-marry.

Place: Muktsar ____________________________


Date: ...................... Signature of Pensioner

I certify to the best of my knowledge and belief that the above declaration is correct.

____________________________
(Signature of the responsible Officer or a
Well-Known Person)
Place: Muktsar Name: .................................................
Date: .................. Designation: .......................................

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