..

(Ministry of Human Resource Dpvpl"I"''''1l11

Deptt. of School Education F. LiteliHY(Govt. of lndia]

REGIONAL OFFICE,BORING ROAD, PATNA - 13Tell': 0612 - 226tiOR5!2266';SR

NAVODAYA VIDYALAY SAMITI

F.NO.4-9.36/P&E/NVS(PTR)/2010_11/ \...(·l~-·L Date-07.01.201.1

To,

The Principal

All Jawahar Navodaya VidyalayaUnder Patna Region(Bihar, Jharkhand & W. Bengal)

Sub.. Guidelines for finalization of retirement benefit of Ex-employee.

Sir/Madam,

On the subject captioned above, it ISl0 Inte,: Ii )IOU that timely settlement of retirementbenefits is not only a social obligation on the part of the S'Cli"iti uut also a right of the ernplovr-»who has spent long years and served the organization. But it has been observed that in spite ofseveral gUidelines/instructions issued by this office the field units have either not thought abuut01 failed to comply with the guidelines. In this connecuon, in order to ensure timely settlementof post retirement benefits, the following actions may be initiated before 6 months of .111

elllployee's retirement.

l. Up date the service book completely in all respects regularly.

2. Please see that the service verification has been done for the entire service continuoustvand no span of any period is left to be verified. Arrange to complete the verific<ltion ofun verified position, if any.

3. Up date the leave record corr~rt".'.

4. Obtain application for gratuity in prescribed apJ.l/ir:ati·,~"",form·D,E&F( whichever casemay be) [Ref. NVSHqr. 1-18/2001-NVS{Admn.)/604 dt. so" May, 2008]

5. Obtain application for leave encashment& .

6. Obtain nomination for GIS if not already done (please (heck for all regular employees)'l . Obtain application fbr settlement c~SIS in prescribed form (available in compendium II)

8. Obtain an application for settlement of CPF in prescribed form (ilVaili-lblp jll

compendium-II)

9. Please check if there is any pending audlr recovery against him/her. If there art: snvdu-action may be initiated for settlement of the outstanding Para.

10. Obtain month wise subscription of CPF/GIS from all JNV where the employe" it".worked/posted.

11. Settle all outstanding advances, it any against hll' 'I)e;

12. If any dues of the employee is lying rending in JNVs t;.c same must be settled (, mOIlII1'

before superannuation.

- ..

It has been also observed that the Principals are sending proposal for settlement ofretirement claims of employees in a casual manner ignoring the guidelines of Hqrs/R.O.

In this regard kind, attention is invited to this office circulars/letters issued from time totime with the advice] to send the proposal separately under separate covering with allenclosures as under:For Gratuit'i

1. Application in prescribed form i.e. form- D,E,F(whichever applicable)

2. Copy of superannuation order/ resignation acceptence order/ death certificate.3. Copy of relieving order.

4. No dues certificate issued at the time of relieving.5. Vigilance clearance certificate.

6. Copy of documents regarding encashment from other department (if the employeerendered service in other organization.)

For leave Encashment

1. Application from employees or his/her nominee on plain paper (As no applicationfrom has been prescribed).

2. Copy of. superannuation order/acceptance of resignation/ Death Certificate of theemployees.

3. Copy of relievit;1gorder.

4. No dues certificates issued at the time of relieving.5'. Vigilance clearance certificate.

6. Copy of documents regarding encashment from other Department. (if the employeerendered service in other organization).

For settlement of CPF'and GIS

Please refer to this office letter no. 1-8/~ ~~ (:BItft~)/'1fcm(trc;.n) / 10--11/8941- 9U22 lit.25/5/20 10& send the proposal as per instruction.

It is reiterated that ro osa's must be scnd to this office se )anttcl ' undcr sc l:IratcC()ycring letter for issue of sanction order and release of CI>F/GJS contributiou. The-C0l11111onletter for release or rctirer'1'::nt benetit i.e. Gratuity. Leave cncashmcn!. (.'PI-"& (il Sshall not be entertained and no action shall be initiated from this end. Delav caused due !o. .'clubhing or subjects/claims will be the·sole responsibility of the Principal (~ his office and thesame shall be reflected in their ACRs dossier Ior Stich lapses.

Please treat this as inost importnnt compliance in futurc.

Copy to: - 1. All the Asstt. Commissioners under Patna Region.2: CPF/GIScell, r'lVS,RD, Patna. for information & records.

Yours faithfully,~<-!

[Akhil Kumar Shukla]Deputy CommisSioner

Deputy Commissioner

0/( (J/)71,1

,: jI

: " I ~'.'~',

',~. -!'< -I: I,tr"

FORM '0'

[See sub-rule (1) of Rule VI]

Application of gratuity by an employee

To .

[Give here name or description of the establishment with full Address]

Sir,

I beg to apply for payment of gratuity to which I am entitled under sub-rule(1) of Rule VI of NVSPaymentof Gratuity Rules,2007 on account of my superannuation/retirement/resignation after completion of not less thanfive years of continuous service/total disablement due to accident/total disablement due to disease with effectfrom the Necessary particulars relating to my appointment in the establishment are given in the statementbelow.

Statement1. Name of the employee in full

2. Address in full.

3. Department/Branch/Section where last employed.

4. Post held.

5. Date of appointment.

6. Date and cause of termination of service.

7. Total period of service.

8.9.

Amount of wages last drawn.Amount of gratuity claimed.

I was rendered totally disabled as a result of[Here give the details of the nature of disease or accident]

The evidences/witnesses in support of my total disablement are as follows:

[Here give detai Is]

Payment may please be made in cash/open or crossed bank cheque.

As the amount of gratuity payable is less than rupees one thousand, I shall request you to arrange forpayment of the sum due to me at the address mentioned above.

Yours faithfully.

PlaceDateNote: I. Strike out the words not applicable.

2. Strike out paragraph or paragraphs not appl icable.

Signature/Thurn b impressionof the appl icant employee.

----------------------~~----------'---.::::::--'

.For Gratuity calculation,-------------------. --- -----i >Jame8z Designation of official: Sh.lMs/Sm1.. _~IN\I 'r----1- .Date of joining in Samiti ~=_I/ __ /( __i 'j Date ofdeath/resig.! termination : /1__ 11 _

-; Total period of service in Samiti : __ Y__ M __ Do Less EOL on without Me: Y M 0-- .- ..- ---,,; Total qualifying period: __ Y__ M__ D

Period round of in yrs. Yrs.Basic pay as on date ofDeath/resignatiou/terruination : Rs, 1-

7_ Dearness Pay 50% B/Pay : Rs, /..D_A as on date ( %): Rs. I-Total Rs. /.,---

Rs. /.lO. Whether DiL or depn?!i. Calculation:-

I

II,!

I'--'-1________ ... _ ..J

X 15} =Rs..---26

• l\Il':/ Graru I'! payable: Rs.1..---_ .._. .~.:!__ ._' • _

Principal

For Leave Encashm..!1!1!;. 'alculationi .Name of Employee'2. Desi nnarion

"', .Date ~)fjoinjng in the l'·JVS4.Dale of Absorption-,.Date 0 f Birth!).Date of retirement/Resignation7_Tot:_~j no.f credited ELF..Basic pay on the date of retirement/resignation(\.EL encashement avail during entire service'0. if year for which period. '-

.r

Jasic Pay + DA admissible on the

iatt (~ftetirementlresignati~_ X No. of days of unutilized EL atcrecit subject to a maximum of 300 days

Principal

NAVODAYA VIDYALAYA SAMITI, REGIONAL OFFICE, PATNA

FORM OF APPLICATION FOR FINAL PAYMENT OF BALANCE CREDITED INNAVODAYA VIDYALAYA SAMITI CPF ACCOUNT

00 be submitted bl' ,he subscriber'hl'Ough t~P/'in£iJJaI, JNJ',/Depull'. CO"'lIIissione.LJ,·Q!J£e""~cfl

Tn

Sir.

The Deputy Commissioner,Navodaya Vidyalaya Samiti,CPF Cell,Boring Road, Patna - 800 013.

I have resigned finally/have retired/have been dismissed/ have been terminated

from the service of the Navodaya Vidyalaya Samiti with effect from

request that the entire amount at my credit with interest due under the Rules may

please be paid to me. My relevant particulars are given below:-

Name of the Ex-employee

(In Capital Letters)

Designation in the Samiti

Place of last posting in the Samiti

NVSCPF Account Number

Mode of appointment on regular

basis in the Samiti.

01

0203

~0405

06

07

08

-09

Date of joining on direct recruitment:

Cause of leaving the service of theSamiti (Documentary proof to beEnclosed invariably)Date of relieving from the servicesFrom the Samiti (Copy of relieving orderto be enclosed)

Place. (s) of postings during the service in the Samiti. : S.No. Place of Postings Duration

10 Pre nt postal address(In c pital Letters)

Place:- --r----~-Date:- /-/--

. I

DIRECT/ ABSORPTION

Resigned/ Retired/ Dismissed/Terminated

--/--/---

1.

2.

3.

4.

PIN _

(Signature of claimant)

FOR USE BY HEAD OF OFFICE

Forwarded to the Deputy Director Navodaya Vidyalaya Samiti, CPF Cell PATNAfor release of final payment in respect of CPF Account No. _

o I. Certified that Mr/ Ms. has been relieved from theservices of the Navodaya Vidyalaya Samiti, on account ofretirement/resignation/termination/dismissal with effect from _

0'2. Certified that the particulars given in the application are correct, as perrecords.

03. Certified that the last deduction of CPF subscription was deducted fromhis/her pay_8sper followingdetails.-

Pay Blll Subscription Arrear Refund of TOTALMonth subscription Advance

04. Certified that he/she drawn the following advances/part withdrawal duringlast 24 month period to the date of cession of his/her service from his/herNVSCPF Account.

~ Month of drawls Amount of advance/part withdrawal

06.

Certified that his/her basis pay on the date of relieving from the services ofthe Samiti was Rs. . (A copy each of pay fixation orders onabsorption/promotion may be attached.Certified that nothing is due for recovery from the subscriber. (Thecontrolling Officer should carefully examine before submitting the case tothe Navodaya Vidyalaya Samiti CPF Section that nothing is due against theex-subscriber otherwise he / she will be personally responsible for overpayment, if any.)

05.

(Signature of Principal, JNV/Deputy Commissioner, Concerned)

Dated:- __ / __ / _

FOR USE TN REGIONALOFFICE/VIGILANCE CELLAT HQRS.

Cetlufied that no vigilance case is pending/ contemplated againstMr/M+._______________ who was working in the Samiti as

at and relieved from theservic of the Navodaya Vidyalaya Samiti on account ofretire ent/registmtinn/dismissal/termination and there is no objection for release offinal ayment of his/her own subscription as well as the Samiti's Contribution, ifadmis ible, to him/her.

(Deputy Commissioner, Regional Office/CVO (Hqrs.)

-- -----------------------------------------------------------'

NAVODAYA VIDYALAYA SAMITI

GROUP SAVING LINKED INSURANCE SCHEME CELLM'r"'I~ATlON FORM FOR CLAIJIIIIG BENEFITS PAYABLE UNDER lfYS-GROUP LINKED INSURANCE SCHEME -AGAINST ffVS - GROUP SAVlIIG LIllKED INSURANCE SCHEME - AGAINST NVS -MASTE POLICY NUMBER -GSL".181~O-, ----.------------- -------.-

fl.No.

----------------------------------------r----------

~c·~~,~~~~~=_~~~~~P~a~rt~l~c~u~la~B~-~~_=~~~~~~~~~+_--------- _NAMe- 0" TIlE JNV /R.O./OFFICE (WHERE THE EMPLOYEE RETIRED, RESIGNI':D,TE~!1IN~TED, EXPIRE ETC.'['ULL NAME OF EX-EMPLOYEE (IN CAPITAL LETTERS) ----------------.----- --.----._-----.----

flATE 0" IJIRTH AS PER RECORD (ATIACH ATIESTED COPY OF DATE 0" BIRTH.~C,'~E~,R~T~IF~'IC~A7.T7.E=,I.~~~~~~~~~~~~~~~~~~~~~~~~~_+ _IJATI': OF INITIAL JOINING IN THE SAMITI (ON REGULAR BASIS) Ii.e. DATE, MONTI! &YEAR)

.!

DESIGNATION OF EX-EMPLOYEE (ON THE DATE OF INITIAL JOINING IN TilE SAMITION REGULAR BASIS!.

7

I~D~AT~E~'~O~F~E~N~T~R~Y=I~N~T~O~-~N~V~S~-~G~S~L~I-~S~C~H~E~M~E~.~~~~~~~~~~~~~~r_---------CATEGORY OF THE POST FOR NVS-GSLI-SCHEME (AS PER THE INITIAL REGULARPOST) ~/B/C/D/

-" ---- DETAILS OF REGULAR PROMOTINS OF EMPLOYEE IN THE SAMITI (IF ANY} --

R -~--~ I N f th t IDate of ICategory IAmount of contribution---. __ " o. ame 0 e pos Joining of post made as_p_erPBRS.9 DESIGNATION OF EX-EMPLOYEE (ON THE DATE OF EXIT FROM THE NVS-GIS-SCHEME)

20 DATE, MONTH & YEAR OF LAST CONTRIBUTION (RECOVERED THROUGH PBR &REMITIED TO NVS GIS CELL.

21 ~ "AMOUNT OF LAST CONTRIBUTION (RECOVERERED THROUGH PBR & REMITTED TO____ .NVS GIS CELL)

12 WHETHER ANY OIS PREMIUM REMAINS UNPAID DURING MEMBERSHIP IW SO,GIVEDETAIL-~I

BANK NAME FULL ADDRESS WHERE THE CLAIMANT WANTS HIS/HER PAYMENT DRAFT TO BEPREPARED & PAID.

PAll': -----------------PARTICULAR. VERIFIED SIGNATURE OF EX-EMPLOYEE

FULL NAME & ADDRESS -------------------

J.Q... CATEGORY OF THE POST (AS ON EXIT DATE) A/B/C/DI I AMOUNT OF INSURANCE COVERLl- -cpr ACCOUNT NUMBER (ALLOTED BY THE SAMITI-CPF -CELL)11 nUE DATE FOR PAYMENT OF THE FIRST GSLIS-MONTHLY CONTRIBUTION (INDICATE. DAY, MONTH & YEAR)1';- -'AMOUNT OF FIRST MONTH CONTRIBUTION (RECOVERED THROUGH PBR & REMITIED TO

NVS-OIS CELL) .V-ATE OF RETIREMENT/RESIGNATION/TERMINATION/DISMISSAL ETC (ATTACHE

1.~__ COPY OF ORDER)

I () DATE OF RELIEVING FROM HIS/HER DUTIES {ATTACHCOPYOF RELJEVlNGORDER)--=-+~::=-~==-=::::-c::-::-::-::=-=-=::-:-=--'------------------+----------l17 DATE OF EXIT FROM SCHE~E

DATE OF DEATH AS PER RECORDS (PLEASE ENCLOSE ORIGINAL DEATH CERTIFICATE IN111 Form No. 10·1

NOTE:- THE LANGUAGE OF THE CERTlFlCATE SHOUW BE EITHER ENOUSH. HINDI OR. ~TED IN ENGUSH (IN CASE IT IS IN REGIONAL LANGUAGE).

19 CAUSE OF DEATH

-.-.-+--~-~-----------------------+--------iWAS THE MEMBER ABSENT ON THE GROUND OF ILL HEALTH ON THE DATE OF ENTRY INTO

~.1_ -;-T~H-;-E-:-:S:::-C-:::H-=Ec:M=E-=,{=-IF'-=S-=O:,;.'G==JVE=::;-TH,::E==D:::E;.:T:-:A1==LS=O~F':=:LE::-A~V~E:::&:o-A:-:1T=A-=C:-:-II;-:T:::cH:c:E-:-,!.;:-EA-,:VE-::::-::S:-;:AN:-;:C:::T::::IO:::N:-c0""R",D-:oE:::R~)-===;;--t---------NAME OF THE BENEFICIARY AS PER NOMINATION DULY ACCEPTED BY COMPETENT=~~A":U~T~H~O~Rr.I~TY~{~IIN~C~AS=E~O~F~D~E7.A~T~H~U~~~~~~~~~~-------------t-~-------------~

25 RELATIONSHIP OF THE NOMINEE WITH THE EX-EMPLOYEE'~-~S~E~R~V~lc~t~D~ET~N~LS~~~~ITH~~~A~Tf~O~N~O~F~ro~~~fN~G~AN~D~ffi~ru~O~O~O~F~S~TA~'~'A~T~E-A~C~H-~-A~T~fO-N-'---------+--------------~

I: I PEruODOF ~AY IS.NO. NAMEOF STATION I FROM I TO J

Il!,(ll ITY COM MISSIONER/PRINCIPAL PIN CODE ---------------------------------------PHONE NO. -------------------------------------

NAVODAYA VIDYALAYA SAMITI

GROUP SAVING LINKED INSURANCE SCHEME CELL

ANNEXURE-8PROFORMA FOR INDEMNITY BOND

This is to certify that GSLI Scheme final claim in respect of Sh./ Smt. ----- _

... ------------------------------------ who, retired / resigned / terminated / dismissed /

expired on -------------- date ------------------ month ------------------ year has not been

submitted earlier to the Principal/Deputy Commissioner / GIS Cell / Life Insurance

Corporation of India. The detailed reasons for non submission of the GSLI Scheme claimin time are as under:-

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

No I / We hereby request to the Principal/Deputy Commissioner / GIS Cell / LIC

of India to consider the claim. I do hereby solemnly declare and affirm that it the GSLI

claim in respect of Sh. / Smt. ------------------------------------------ Designation _

------------------ Ex-------------------c--- of JNV / Office --------------------- holding the CPF

A/C No. ---------------------- is found settled earlier by NVS / LIC under Group Insurance

Scheme of Samiti, I / We will refund the entire amount along with interest thereon in

lump sum to NVSGSLI Cell within 30 days from the date of receipt of notice.

Signature: - -------- ------------------ -----

Name: (In block letters):- -----------------------------

Designation: - ------------ ------- ..------ ----

Full Address: -

Phone no. :------------------------------------------ ----

Principal/ S.O./ A.C. I D.C.With Office seal

NAVODAYA VIDYALAYA SAMITI

GROUP SAVING LINKED INSURANCE SCHEME CELL

RECEIPTED BILLANNEXURE-C

I MR.I MRS. -------------------------------------------------------" RECEIVED THE SUM

(>F Hs. ------------------------------------------------------------- ON ACCOUNT OF THE FINAL

~~f:TTLEMENT OF INSURANCE CLAIM IN RESPECT OF MR./MRS. --------------------------

--- ----------------------- EX- (DESIGNATION) ----------------------- FROM THE INSURANCE

FUND ADMISSIBLE UNDER THE NAVODAYA VIDYALAYA SAMITI GROUP SAVING

LINKED INSURANCE SCHEME NO. GSLI-48730.

DATE ----------------- MONTH ----------------- YEAR -----------------

SIGNATURE OF RECEIPIANT(S):- -------------------------------

NAME IN BLOCK LETTERS:- ----------------------------~---------

FULL ADDRESS: -

------------------------------------------------------------ ~.\

Phone no. :- ----------------- ------------ ----------------

VERIFIED BY

Principal 1 S.O.I A.C. 1 D.C.With Office seal

l'lAVODAYA VIDYALAYA SAMITI, REGIONAL OFFICE, PATNA

JPl of application for final payment of balances in the provident fund account of a::;qbscriber" to be used by the nominees or any other claimants where No nomination

subsists.

The Deputy Director,Navodaya Vidyalaya SamitiCPF Cell, Chandigarh,(Applythrough proper channel only)

It is requested that arrangements may kindly be made for the payment of the""('l1mulations in the contributory provident Fund Account No. (*certificate No. 06to Iw furnished in the case of Contributory Provident Fund only. ** Please score out if notnecessary.] of Shri/Smt/KumariThe necessary particulars required in this connection are given below:-

01 Name of the Government servant

02. Date of birth __ 1_-1---03 (i) Post held by the Government Servant

[ii] Date of Joining in the Samiti (On Direct Basis) --'-1__1 _[iii] Last drawn Basic Pay

04 Date of Death

Rs. _

--1_-/-_-05 Proof of death in the fonn of a death

Certificate issued by the MunicipalAuthorities. Etc. if available.

06 Provident Fund Account No. allotted tothe subscriber by Samiti

07 Amount of Provident Fund money standingto the credit of the subscriber at the time ofhis death, if know.

08 Details of the nominees alive on the date ofdeath of the subscriber if a nomination subsists

ISR

Rf03

NAMEOF THE NOMINEE RELATIONSHIPWITHTHE SHAREOFTHESUBSCRIBER NOMINEE

(Attach onelattested copy 01 the nomination as per.service records'09 In case the nomination is in favour of

h h be ha pe~f~n ot er t an a mem r of t e familythe d tails of the family if the sub-scribersubs uently acquired a family. .

R. ! NAME RELATIONSHIPWITHTHE AGEONTHE DATEOFO. \ SUBSCRIBER DEATH1-~-2--3

10 In ca e ino nomination subsists, the details of :the s rHving members of family on the date ofdealt of the subscriber. In the case of a daughteror a at ghter of a deceased son of the subscriber,marr Fd before the death of the subscriber,if she ul be stated against her name whether herhusb m.~was alive on the date of the subscriber.

1

-

SNoo\§

Contd ... 2/- .....

..2 ..

O}

Name Relationshi~ith the subscriber Age on the date of death.~.- ..

---- "-----

11 In the case of amount due to a minor child whosemother (Window of subscriber) is not a Hindu,the claim should be supported by Indemnity bond01" Guardianship certificate, as the case may be .

12. If the subscriber has left no family and no nomination:subsists, the names of persons to whom the Providentfund money is payable (to be supported by certificate, etc.) .....

No. Name Relationshi~ with the subscriber Address

--

.-----.-- ---

Sr.01

02

0,1

13 Religion of the claimant (s)

14 The payment is desired through theOfIiceof _

through the _

Treasury/Sub-treasury in this connectionFollowing documents duly attestedBy a Gad. Officer, in service/Magistrate areAttested.

(i) Personal marks of identification _

(ii) Left/Right hand thumb or fingerimpressions (in the case of illiterate claimants)

(iii) Specimen signature in duplicate(in the case of literate claimants)I

Yours faithfully,

(Signature of Claimant)(Full name & Address)

....3....

Forms

(For use of head of office/ department)

Forwarded to the Navodaya Vidyalaya Sarniti, CPF Cell for necessary action. Theparticulars furnished above have been verified carefully and found correct.

02 The provident fund Account No. of Shri/Ms.jKumari(as verified from the annual

statements furnished to him/her) is )He/She died on A death certificate issued bythe Municipal authorities has been produced/is not required in this case asthere is no doubt about his/her death.The last fund deduction was made from his/her pay for the_________ drawn in this Office Bill No.

for Rs. _

03

04 month ofdated

(Rupeesbeing Rs.

________________________________________ ) and(Rupees

-/-/_--_______________________ ) of the amount of deduction

05

recovery, on account of refund of advance of Rs.---------------------------------)Certificate that he/she was neither sanctioned any temporary advance or anyfinal withdrawal from his/her provident Fund Account during the 12 monthimmediately preceding the date of his/her death.

Certified that subsists the following temporary advances. Final withdrawalswere sanctioned to him/her provident fund Account' during 12 monthsimmediately preceding the date of his/her death.

Sr. No. Amountof advances/withdrawals Date and place of encashmentOJ0203

Vouchers number

06. Certified that no. amount was withdrawn/the followmg amounts were withdrawnfrom his/her Provident Fund Account during the 12 month immediately preceding thedate of his/her death for payment of insurance premium or for the purchase of a newpolicy-

Policynumber and name of the Companyo. Amount Date Voucher Number.~.---

I

-_.. i

Sr. NOJ0203

07 In re rence to all records and audit report, it is certified that no demand /follo ing demands of Government is/are due for recovery against the abovesaid mployees, the final due amount of payment may be relished after makingrecov ry of Rs. ( ) with amountany r covery.

(SUGNATUREOF HEADOF OFFICE! DEPTT.)