1/2 T.N.T.C .FORM .75-C - Nagapattinam District

T.N.T.C .FORM .75-C(See Rule S.R.74(b) under T.R.16)Bill form for drawal of Provisional Pension/Gratuity/Death-cum-Retirement Gratuity by the Head Office.District : Nagappatinam Head of Account Voucher No.For listReceived the amount of Provisional due toThiru/Tmt/Selvi/… ………………………………………………………..…………………………………………………………………………….For the Month of… ……………….and Gratuity/Death-cum-RetirementGratuity /provisional pension Sanctioned vide letter No… ……………………………………………………………..................................................…………………………………………………………………………………..dated… ……… of the Accountant General Chennai-18.LESS DEDUCTIONS:-Rs.Income TaxTotal DeductionsRs.Rs.Net amount payable in words. … ……………………………………………………..…………………………………………………………………………………………Certificate from the pensioner regarding non-employment is attachedCertified that the amount drawn in the last month bill has been duly disbursedAnd the receipt obtained from the Pensioner/Gratuitant.Station:-Date :-Examined and enteredTreasury AccountantPay Rs. RupeesCashRs.IV Taxes on IncomeRs.DaredTreasury OfficerAdmittedObjectedRs.Rs.For use in A.G.s OfficeAuditorSuperintendent1/2

CERTIFICATE1) Certificate from the Pensioner regarding Non- Employment his been obtained andfiled in this office2) Certified that the amount drawn in last month bill has been duly disbursed and the receipt obtained from theGratuitant.3) Certified that the amount claimed in this bill was not drawn and paid previously.4) Certified that no event has occurred after forwarding the Pension Papers toAccountant General Chennai which has bearing to revise the Pensionary benefits downwards5) Certified that printed forms are not supplied . Hence by computer print form isused.6) Certified that there is no dues to the Employees Co-Op .Society.7) 7.Certified that there is no dues to the Government.2/2