CHAPTER 1 - Border Roads Organisation

RESTRICTED
To :
*The
Form 6
Sir,
Subject :- APPLICATION FOR PAYMENT OF AMOUNT DUE TO
LATE SHRI . . . . . …………… UNDER THE CENTRAL
GOVERNMENT EMPLOYEES‟ GROUP INSURANCE
SCHEME 1980
With reference to your letter No . . . . . . dated . . . . I, hereby reqest that the
full/ . . . . . . percent of amount due to late Shri .. . . . . . . under the Central
Government employees‟ Group Insurance Scheme may be paid to me.
Yours faithfully,
*Name and address of the office where Form No 5 is received.
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RESTRICTED