(Obverse)
Last Pay Certificate of Shri/Shrimati.
..............................................................................................................
of the office of
...............................................................................................................................................................
proceeding on
................................................................................................................................................................
to
............................................................................................................
2. He/She has been paid upto............................................................................................................................ at the following rates:
| Particulars | |
| Substantive Pay | |
| Officiating Pay | |
| Special Pay | |
| Personal Pay | |
| Leave Salary | |
| Allowances: | |
| (a) D.A./A.D.A. | |
| (b) C.C.A. | |
| (c) H.R.A. | |
| (d) ............... |
(Rate of Deductions)
G.P.F......................................................................... I-TAX .............................................................. C.G.E.I.S/ C.G. Employees Group Insurance Scheme, 1980............................................................................................................
(a) Composite rate.
or (b) Insurance rate only
Licence fee for Govt. accommodation @...................................P.M.
3. His General Provident Fund Account/GPF Account No. ...................................... is maintained by the Pay and Accounts Office/DDO/AG ......................................................... {Refer Correction Slip 19}
4. He made over charge of the office of.......................................................................................... ..........................on the........................noon of.................................................................................................................................
5. Recoveries are to be made from the emoluments etc. of the Government servant as detailed on the reverse.
6. He is entitled to draw the following:
7. He has been sanctioned leave proceeding joining time for.............. days.
8. He finances the insurance policies detailed below from the Provident Fund:
| Name of Insurance Company | No. of Policy |
Amount of Premium |
Due date for the payment of premium |
9. Details of P.L.I. recovery through pay bill:
10. The details of income-tax recovered from him upto the date from the beginning of the current financial year are noted on the reverse.
Signature .............................
Designation ..........................
Dated ..................19............
(Reverse)
| Name of advance involving recovery/ adjustment |
Total amount
of advance sanctioned with month of drawal
Rs. |
Outstanding
amount recoverable
Rs. |
Rate of
Instalment
Rs. |
| Pay advance ................................................... | |||
| T.A. Advance ................................................ | |||
| H.B. Advance
................................................ ................................................ ................................................ ................................................ |
|||
| Licence fee arrears Rs. ................................................for the period from............................................. to................. | |||
Name of months |
Pay/Leave Salary & allowances |
Fee, Honorarium etc. |
Funds &
other deductions |
Amount of
I-Tax recovered |
Remarks |
| Rs. | Rs. | Rs. | Rs. | ||
| April 19... | |||||
| May 19... | |||||
| June, 19... | |||||
| July, 19... | |||||
| August, 19... | |||||
| September, 19... | |||||
| October, 19... | |||||
| November, 19... | |||||
| December, 19... | |||||
| January, 19... | |||||
| February, 19... | |||||
| March, 19... |
Signature..........................................
Designation..........................................