Notwithstanding anything contained in sub-rule (2) of rule (3), the payment of family pension shall cease on the death of the person entitled to such Pension under the Act and in case the pensioner is elected as a member of the Rajasthan Legislative Assembly, from the date of such election and the Family Pension Payment Order in force for the time being, shall be returned by the person in possession thereof or the pensioner, as the case may be to the Secretary, Rajasthan Legislative Assembly.
(97) Form-I Application for Family Pension (See rule-2) From :
..............................................................................................
W/o/Husband/Son/Daughter of..................................................
Ex-Member, Rajasthan Legislative Assembly/ ...............................................................................................
To, The Secretary, Rajasthan Legislative Assembly, JAIPUR Subject :— Grant of family pension under Rajasthan Legislative Assembly (Officers and Members Emoluments and Pension) Act, 1956 Sir, Under section 4-B of the aforesaid Act, I am entitled to pension as my husband/wife/father/son or daughter Shri/Shrimati...................
....................... remained member of..................................for the following periods :—
(i) Member of Rajasthan Legislat ive Assembly from................ to ..............
2. It is requested that necessary action may be taken to grant pension to me/Shri/Shrimati......................................................
I, Shri/Shrimati..................................................want to take my said pension from public sector Bank Branch..................................
Treasury/Sub-Treasury.
(98)
3. I attach herewith the verified copies of the following documents verified by magistrate I Class/a gazetted officer of Central Government or State Government/existing member of Parliament/Rajasthan Legislative Assembly :—
(1) Three specimen signature.
(2) Three latest photo of passport size.
4. My present address.......................................................
.......................................................................................
My permanent address......................................................
.......................................................................................
5. I hereby declare that :—
(1) I, Shri/Shrimati.................................................am not working on the elected post of President or Vice- President or on the post of a Governor of any State or post of the Administrator of any Union Territory.
(2) I, Shri/Shrimati..................................................am not a member of Council of States or House of the People or Legislative Assembly of any State or Union Territory or of Legislative Council of any State or Delhi Matropolitan Council framed under section 3 of Delhi Administration Act, 1956.
(3) I,..................................................am/is not paid employee of Central Government or of any State or under the ownership of any local authority or of any Corporation controlled by it or I am/we are not otherwise entitled for any remuneration from the said Government or Corporation or local authority.
(4) I,.................am/is working on the post of...................
or member of............................or appointed on the post of.............or in a................ and I ....................
get Rs..................P.M. as a total remuneration.
(99)
(5) I am authorised to submit this application for Shri/Shrimati/ Kumari, because....................................this application as an heir, is only for outstanding amount.
(6) Identification mark of pension receiver........................
(7) I have not been remarried.
Yours faithfully, ........................
(Signature) Name in clear words........................................................
Place..........................
Date...........................
Rajasthan Legislative Assembly Secretariat It is certified that Shri/Shrimati/Kumari.................................
remained member of Rajasthan Legislative Assembly for the following periods :— From...............................To...............................
From...............................To...............................
From...............................To...............................
From...............................To...............................
It is certified that Shri/Shrimati/Kumari............................ (in legible words) remained member of the House of the People for the following periods :- From...............................To...............................
From...............................To...............................
From...............................To...............................
From...............................To...............................
Senior Table Officer, Secretariat of the H.O.P.
(100) It is certified that Shri/Shrimati/Kumari.................................
(in legible words) remained member of the Council of the States for the following periods :— From...............................To...............................
From...............................To...............................
From...............................To...............................
From...............................To...............................
Senior Table Officer, Secretariat of the Council of the States.
Rajasthan Legislative Assembly Secretariat Dated, Jaipur, the.......20 Till further orders and in the end of every month, pay the amount of Rs...............to Shri/Shrimati/Kumari..................................
.........................................................................................
the family pension amount under Rajasthan Legislative Assembly (Officers and Members Emoluments and Pension) Act, 1956 and details of which is as follows :— Amount of family pension payable under Section 4-B of the Act, Rs..........................
Debit remuneration/Pension amount receiving under Section 4(b) of the Act, Rs..........................
Net amount payable of Pension Rs..........................
Payment should be from date..........................................and should be upto date..............................
(Signature........................)
Secretary, Rajasthan Legislative Assembly.
(101) Form-II (See rule-3) Pension Payment Order (In triplicate)
(1) Amount disbursing officers portion.
(2) Pensioners Portion.
(3) Office.
Debitable to the State Government.
Account Head :— Major Head Minor Head Voted Photograph Photo of Ex-MLA/Person authorised under proviso of rule 2 verified by competent officer
1. Pensioner's Name ......................................................
(i) Name of the person authorised.
2. Address of the residence........................
......................................................
Village & Sub-Division.........................
3. Identification mark of the pensioner Signature of Ex-MLA/the person authorised under proviso of rule 2
4. Class of the pension-pension under Rajasthan Legislative Assembly (Officers & Members Emoluments & Pension) Act, 1956
5. Monthly pension amount Rs.............................(in figures) Rupees ............................................(in words)
6. Payment should be made from...................to......................
7. Payment office and place..................................
Principal Secretary, Rajasthan Legislative Assembly, Jaipur.
(102) Amount of pension in rupees................................(in words) to be recorded under every separate payment by the order of disbursing officer.
Month for which 19 19 19 19 pension is due Date of Amount Date of Amount payment disbursing Payment disbursing officer officer signature signature March April May June July August September October November December January February FORM-III Declaration (To be submitted with the pension bill two times in the first and subsequent year i.e. in the months of May and November by the person authorised under rule 2) I hereby declare that :— I...................................................................have been elected/nominated/appointed as a...............................................
from......................to.........................on the remuneration/salary of Rs...........P.M. from the date 22.6.77 or..............(in the case of second or subsequent declaration, write the date of last declaration)
(103)
2. I.................................................................have not been elected/appointed on the post of the President/Vice President or on the post of Governor of a State or on the post of an Administrator of an Union Territory, or
3. I..................................................................am not member of Council of States or House of the People or of any State Legislative Assembly or Council or Delhi Metropolitan Council constituted under section 3 of Delhi Administration Act, 1966, or
4. I.................................................................am not paid employee of Central Government or any State Government or any Corporation owned or controlled by Central or State Government or any local authority, or I/Shri/Shrimati/Kumari......................am not entitled otherwise to get remuneration from said Government or Corporation or local authority, or
5. I.........................................................................am working on the post of...............................or am member of..........................or am appointed as a...........................(write here the name of the office of Central Government/State Government/ Local authority/office of the corporation owned, controlled by Central Government or State Government) ..................and I am receiving total remuneration Rs....................... P.M.
6. I have not been remarried.
........................................
Signature Address..............................
..........................................
..........................................
(104) Form-IV (A) Rajasthan Legislative Assembly Family Pension Bill Rs. P.M...........................................Pension payment order No......................................dated........................................
Memo :— Use this form for submitting next bill.
Months.......................................
Vouchers of the list of payments for the year......................
.................................................
Distt.................................................................Accounts Item No................................
I received my due pension for the month.............20................
amount Rs.....................
Income Tax deduction Rs..................................................
Net amount Rs................................................................
(Rs. in words).......................................................................
Place...........................
Date............................
Address of the Pensioner Received payment Identify (Revenue Stamps) (Signature) Pensioner
(105) (A-I) Certificate to be given when one does not appear in person (except where such certificate is not essential under any rule or order) It is certified that I have seen the pensioner that he/she is alive and that he/she has signed this bill.
Name.....................................
Date................................. Designation...........................
Endorsement to be signed by the pensioner Please, pay to.....................................................pensioner For the use of Treasury Bank/Treasury.......................................................................
Pay Rs................................................................................
Debited in the accounts............................................................
Acctt. T.O. or Sub-T.O.
Date.............................
Receipt of the receiver Received the payment I identify Signature of the Bearer or agent Signature.........................................
Designation and Address.....................
.......................................................
For Bank/Treasury Payment made for Rs....................(in words..............................)
Bank/Treasury For the use of in the office of Rajasthan Legislative Assembly Granted Rs................................................................
objection for Rs.........................................
Auditor Suptt. Principal Secretary