Welfare Fund Manual-2012 - Central Industrial Security Force

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Appendix -A
APPLICATION FOR GRANT OF BENEFITS OUT OF CISF RISK-CUM SAVING FUND
SCHEME.
(To be filled by the members 3 months before the date of retirement).
PART - I
1. CISF No. Rank &
Name of the individual
:__________________________________________
2. CISF Unit /Estt. :__________________________________________
3. Date of joining the Scheme :__________________________________________
4. Date of leaving the Scheme :__________________________________________
5. Reason for leaving the
Scheme
6. Address of nominee/
individual where payment is to
be remitted
7. If the nominee is minor, name
of person to whom the amount
will be paid and his/her address.
8. Details of banker:-
a) Name of the Bank
b) Name of Branch & Code No.
c) Account Number.
Place:
:__________________________________________
:__________________________________________
___________________________________________
___________________________________________
___________________________________________
:__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
Date: Signature of Applicant.