G. A. R. 44

(See rule 180)

RECEIPTED BILL

    Received the sum of Rs.................... .(Rupees..................) being the total of entitlement of Rs............ from the Insurance* Fund and /or of Rs..................... from the Savings Fund, accrued to................................ Name........................................................................Designation....................* Group A/B/C/D under the Central Government Employees' Group Insurance Scheme, 1980.

Dated........................

Signature(s) of Recipient(s)..........

(Name in Block letters) 

FOR USE IN DEPARTMENTAL OFFICE

(a) Relevant biodata of the member

1. Type of group of the member (i.e. lowest group) viz. D/C/B/A on initially joining the scheme on................. .(date).

2. Year of acquiring membership of higher group:— 

* (i) C         —19........

(ii) B         — 19........

(iii) A         —19........

(b) Countersigned for payment of Rs.................... .(Rupees....................................) to claimant(s)

Crossed cheque/demand draft to be issued in favour of claimants):

Signature................ ........

Date..............................

Designation of D.D.O..............

FOR USE IN PAY AND ACCOUNTS OFFICE

Passed for payment of Rs........................ .(Rupees........................)

Payment through Cheque (s) No.(s)....................date....................

Pay & Accounts Officer


* Delete whichever is inapplicable.