ANDHRA PRADESH REVISED PENSION RULES, 1980 (As ... - APHB

APNDIX - VII
279
Certified that application/nomination has been received from ...............(Name
of Pensioner) whose address is :
Place : .................... Signature of Pension Disburing Authority/Bank/
Treasury
Date : ................... Accounts Officer/Head of Office
Full address .............................................
FORM - B
To
The Pension Disbursing Authority
Name of the Bank/Treasury/Accounts Officer etc.
Place : ......................................................
I .................................................. hereby make the following
(Name of the Pensioner in Capital letters)
alternative nomination in cancellation of the previous nomination made on
...........................
for the Payment of Arrears of Pension.
Name and address of the nominee Relationship with Date of
pensioner birth
(1) (2) (3)
If nominee is minor Name and address of other Relation-
Name and address of person nominee in case of nominee ship with
who may receive the said under Col.(1) above pre- pensioner
pension during the nominee’s deceases the pensioner
minority
(4) (5) (6)
Date of birth if the other Name and address of Contingency on
nominee is minor person who may happening of which
receive the pension nomination shall
during the other
nominee’s minority
become invalid
(7) (8) (9)