DA dw bkwieAw ………….. qoN ………...

q`k
jI pI jI pI
lVI fI.ey. fI.ey. Awmdn AdweIgI
krmcwrI dw jI pI ku`l PMf PMf kul
nM mhInw gRyf byf gyf py byisk pY (Due) (Drawn) Diff. kul joV kr dI Xog
nW PMf mhIny klws klwscw ktOqI
% % ktOqI rkm
iqMn r
mu~K AiDAWpk dI 10300-34800 dy gRyf ivc 1 AswmIAw
1

mwstr/imstRYs dIAw 10300-34800 dy gRyf ivc 8 AswmIAw

1
2

4
5
6

sI/vI kwfr dIAw 10300-34800 dy gRyf ivc 3 AswmIAW

1

3
drjwcwr krmcwrIAw dIAW 4900-10680 dy gRyf ivc 1 AswmI
1
kul joV
qsdIk kIqw jWdw hY ik ies ib~l dI ie~k kwpI dPqrI irkwrf leI r~KI geI hY[
qsdIk kIqw jWdw hY ik Awift pYirAw dw imlwn kr ilAw igAw hY
qsdIk kIqw jWdw hY ik imlx vwly B~qy pMjwb srkwr dIAW hdwieqw Anuswr kFvweuy jw rhy hn[
qsdIk kIqw jWdw hY ik …………….. mhIny dOrwn Kjwny ivco kFvwieAW rkmW nwl imlwn kr ilAw igAw hY[
qsdIk kIqw jWdw hY ik pMjwb srkwr dy p`qr nM. …………….., dated …………. dy Anuswr mihMgweI B~qw …...% qo …...% dw bkwieAw
klym
It is certifiedthat concerned Govt.employees will continue to hold kIqw jw and
their post irhwthe
hYsanctioned
[ for the continuance thereof has been applied for the necessary
provision.
The same has been in the budget esimate for the year ………....
 DA dw bkwieAw ……... qoN ……...q`k

jI pI
lVI fI.ey. jI pI PMf PMf Awmdn AdweIgI
nM krmcwrI jI pI byisk fI.ey. (Drawn) ku`l klws klwscw kr dI kul Xog
dw nW PMf mhInw gRyf byf gyf py pY (Due) % % Diff. mhIny kul joV iqMn r ktOqI ktOqI rkm
mwstr/imstRYs dIAw10300-34800 dy gRyf ivc 1 AswmIAw
1
sI/vI kwfr dIAw 10300-34800dy gRyf ivc 1 AswmIAW
1

kul joV

qsdIk kIqw jWdw hY ik ies ib~l dI ie~k kwpI dPqrI irkwrf leI r~KI geI hY[
qsdIk kIqw jWdw hY ik Awift pYirAw dw imlwn kr ilAw igAw hY[
qsdIk kIqw jWdw hY ik imlx vwly B~qy pMjwb srkwr dIAW hdwieqw Anuswr kFvweuy jw rhy hn[
qsdIk kIqw jWdw hY ik ………... mhIny dOrwn Kjwny ivco kFvwieAW rkmW nwl imlwn kr ilAw igAw hY[
qsdIk kIqw jWdw hY ik pMjwb srkwr dy p`qr nM. ………….., dated ………... dy Anuswr mihMgweI B~qw …..% qo ….%
dw bkwieAw klym kIqw jw irhw hY [
 DA dw bkwieAw ……. qoN AkqUUbr …... q`k
lVI fI.ey. Ayn pI Awmdn AdwiegI
nM krmcwrI dw jI pI mhIn gRyf gyf fI.ey. (Drawn) ku`l Ays jI pI PMf kr dI kul Xog
nW PMf w byf py byisk pY (Due) % % Diff. mhIny kul joV 8342 klwscwr ktOqI ktOqI rkm
mwstr/imstRys dIAW 10300-34800 dy gRyf iv~c 1AswmI
1
kUl joV

qsdIk kIqw jWdw hY ik ies ib~l dI ie~k kwpI dPqrI irkwrf leI r~KI geI hY[
qsdIk kIqw jWdw hY ik Awift pYirAw dw imlwn kr ilAw igAw hY
qsdIk kIqw jWdw hY ik imlx vwly B~qy pMjwb srkwr dIAW hdwieqw Anuswr kFvweuy jw rhy hn[
qsdIk kIqw jWdw hY ik……….mhIny dOrwn Kjwny ivco kFvwieAW rkmW nwl imlwn kr ilAw igAw hY[
qsdIk kIqw jWdw hY ik pMjwb srkwr dy p`qr nM. ………., dated ……. dy Anuswr mihMgweI B~qw …..% qo …..% dw
It is certifiedthat concerned Govt.employees bkwieAw
will continue klym kIqw
to hold their jwand
post irhw hY [
the sanctioned for the continuance thereof has been applied for the
necessary provision.
The same has been in the budget esimate for the year ……...…...
 P .F. 4
This form shoud be usedFrom S.T.R.17
for transaction for General Provident Fund
1 deductions
In remarksonly
column give reasons for disconitinuance of subscription
2 such as Proceeded on Leave T
Transferred to_____________Office_____________District resumed
subscripition
Designation of Account maintaining
authority__________________________________

Designation of f D.D.O________
No___________________________________Date_______________
_______
Net Amount of the Bill_______________________Total Amount G.P.F
Schedulle_________
Cheque No__________________Date_____________Token
No_____________Date__________
Try Vr No________________Date___________Date of
Encashment____________
Period of deduction_______________________Payable
Month___________________
Head of Account______________________________________

Pay or Monthly
Sr Account Name of the /Leave Subscription No of Total
No. No. Subscriber Salary Amount instalments realised Remaks
1
2
3
4
5
6
7
8
9
10
11
12
ku`l joV
(kyvl …………………………………………. rupey)
 P .F. 4
From S.T.R.17
1 This
In form shoud
remarks columnbegive
used for transaction
reasons for GeneralofProvident
for disconitinuance Fundsuch
subscription deductions only
as Proceeded
2 onLeave T
Transferred to_____________Office_____________District resumed subscripition
Designation of Account maintaining authority__________________________________

Designation of f D.D.O_

Bill No_____________________________Date___________________________
Net Amount
Cheque of the Bill_______________________Total Amount G.P.F Schedulle_________
No__________________Date_____________Token
No_____________Date__________
Try Vr No________________Date___________Date
Period of Encashment____________
of deduction____________________________________Payable
Month___________________
Head of Account______________________________________

Monthl
y
Pay or Subscri No of
Account Name of the /Leave ption Amoun instalm Total
Sr No No. Subscriber Salary t ents realised Remaks
1 0 0
2 0 0

kul joV 0 0
(kyvl…………………………………... rupey)