www.prtumedak.

org GROUP INSURANCE FINAL PAYMENT

Name of the Employee Designation Place of Working Mandal Date of Retired Year of Subscription Started Enhanced Year(1 st Time) Enhanced Year(2nd Time) Enhanced Year(3nd Time) Enhanced Year(4th Time) Prcoceedings Issued By Place of the Officer working Prcoceeding No Name of the Officer & Desgn DDO Code DDO Designation STO Place Mandal Parishad Tekmal A2/15/2011 18022202149 MEO Jogipet Proc.Date 25.06.2011 Amount Rs. Amount Rs. Amount Rs. Amount Rs. Amount Rs. KALIDINDI N.RUBEN Father's Name Venkatesham

Sri.P.Veersangappa,B.Sc.,B.Ed.

Programme Design

R.RAMES

Use A4 Papers

MENT

nkatesham

Group Group Group Group Group

25.06.2011

Programme Designed by

R.RAMESH

Proceedings of The Mandal Educational Officer,Mandal Parishad Tekmal Present Sri.P.Veersangappa,B.Sc.,B.Ed.

Proc.No A2/15/2011 Date 25.06.2011

Sub:-

Final Payment of Group Insurance Scheme in respect of Sri.N.RUBEN,PG.HM.Gr-II,ZPHS .,Mandal KALIDINDI-OrdersIssued

Ref:-

G.O.Ms.No 293. Fin & Plg.Dept.Dated 08.10.1984 G.O.Ms.No 323.Fin & Plg.Dept.Dated 12.11.1984 G.O.Ms.No 148 Fin & Plg.Dept Dated 06-06-2012 3.Application of the Individual.

ORDER

Sri N.RUBEN,PG.HM.Gr-II,ZPHS . retired from Service on 31.5.2013due to attainig the age of superannuation by completed 58 years. Sri N.RUBEN has applied for Sanction of Group Insurance Final payment on verification of Service Register.It is found that he is a Subscriber to Group Insurance Scheme with effect from November1984.He Paid Rs.Two Units i.e @Rs20/ p.m w.ef.November.1984 to 1994 His Subscription has enhanced as follows ", November 1998 to 2013@ Rs.60 p.m Group "B", ,

As seen from the orders vide above references.He is eligible for the Group Insurance Scheme beneftis worked out as in the Annexure enclosed.The amount caluculated Sum of Rs.31794/-.(Thirty one Thousand Seven Hundred and Ninety four rupees only),viz.Rs6333/-(Six Thousand Three Hundred and Thirty three rupees only) and Rs.25461/-interest of Saving fund under GIS . Therefore,the Mandal Educational Officer,Mandal Parishad Tekmal.is pleased to sanction G.I.S Final payment amounting to Rs.31794-(Thirty one Thousand Seven Hundred and Ninety four rupees only) The Sanction orders entry is made in the in the S.R of the individual.If any excess payment is found in future while audit,the same will be recovered from his pensionary benefits.
The Expenditure is debitable to the following head of Account. 8011 : Insurance and Pension Fund 107 : State Govt.Employees GIS 02 : Group Insurance 001 : Insurance Fund (Disbursement) 002 : Saving Fund (Disbursement) 003 : Interest from (Disbursement) Mandal Educational Officer R,.Ramesh,Tekmal,9989663755 Mandal Parishad Tekmal

Up to Date Amendments as per Budget Manual 1987

As per G.O.Ms.No 323 Date : 12-11-1984

FINANCE & PLANNING (Fin.Wing Accts.II) Dept. ANNEXURE - C

N.B : Separate bill shall be prepared for each employee Retd. a sum of Rs. 31794 (Thirty one Thousand Seven Hundred and Ninety four rupees only) for payments to the subscribed/or the nominees of subscriber as per Particulars below. 1.Name of the Employee/Member : N.RUBEN 2.Designation of the post held immediately : PG.HM.Gr-II before retirement 3.Group of which the employee/member : D belonged. 4.Name of the beneficiaties in the event of : the death of the employee/member

Relevant Bio-Data of employee/member a) Date of commencement of Insurance : November 1984 cover/membership and the group to which he belonged intially. b) Year of acquiring membership in : November 1994 higher group. c) Date of retirement : 31.5.2013 Certified that in respect of the amount claimed into this bill subscriptions to the Group Insurance Scheme have been covered regularly at appropriate rates from the date of the subscribers admission to the Scheme to the month of cessation of duties. Mandal Educational Officer Mandal Parishad Tekmal
R,.Ramesh,Tekmal,9989663755

GIS ANNEXURE
1.Name of the Employee 2.Designation 3.Name of the office fromwhich retired SUB SCRIPTION DETAILS : N.RUBEN : PG.HM.Gr-II : ZPHS . : November 1984 to October 1994 @ Rs.20 p.m Group "D" November 1994 to October 1998@ Rs.30 p.m Group "C" November 1998 to 2013@ Rs.60 p.m Group "B"

Table

Period
1. 11.1984 to 31.10.1994 ACS 1388 1.11.1994 to 31.10.1998 1.11.1998 to 31.5.2013

Subscription Amount 20 30 60

ACS 1388 6032 5311 3166

Units 2 2 2 2

Calculation 1388 X 2 6032 X 2 5311 X 2 3166 X 2

Total 2776 12064 10622 6332

TOTAL
CALCULATION OF SAVING FUND

31794

Period
1. 11.1984 to 31.10.1994 1.11.1994 to 31.10.1998 1.11.1998 to 31.5.2013

Subscription Amount
20 30 60

Units
2 2 2

Subscription Time in Months

120 48 175

Calculation
6.875 X 120 X 2 10.5 X 48 X 2 10.5 X 175 X 2

Total
1650.00 1008.00 3675.00

TOTAL Saving Fund 25461.00 Interest 6333.00 Total 31794.00

6333.00

Mandal Educational Officer Mandal Parishad Tekmal

As Per G.O Ms.No 293

Date:08-10-1984

FORM NO.1
Government of Andhrapradesh. Department/Office Date:

MEMORANDUM
Sri N.RUBEN a Group D Employees has been enrolled as a member of the Andhra Pradesh State Government Employees Group Insurance Scheme,with effect from November1984 his monthly subscription of Rs.20 Rupees,(Twenty rupees only) (shall be deducted from his salary/wages commecing from the month of November 1984 and he will be eligible to the benefits of the scheme appropriate to group D with effect from November1984

To, Sri N.RUBEN ,PG.HM.Gr-II, Retired ZPHS . As Per G.O Ms.No 293

HEAD OF OFFICE

Date:08-10-1984

FORM NO.2
Department/Office Government of Andhrapradesh. Date:

MEMORANDUM
Sri . N.RUBEN has been promoted on a regular basis from Group "D" to Group "C" with effect from November 1994 His monthly subscription for the Andhra Pradesh State Employees Group Insurance Scheme,shall be raised from Rs 20 to 30 to (Rupess(Thirty rupees only) from the month of November 1994 and he will be eligible to the benefits of the scheme appropriate to Group"C"with effect from November 1994

To, Sri N.RUBEN ,PG.HM.Gr-II ,ZPHS ..

R.Ramesh,Tekmal,9989663755

As Per G.O.Ms No 293

Date: 8-10-1994

FINANCE & PLANNING (Fin.Wing Accts.II) Dept. FORM - 3

To, The Sub Treasury Officer, Jogipet

Sub:- Application for Payment of accumulation under Andhrapradesh State Employees Group Insurance Scheme. Sir, I have been a member of the Andhra Pradesh State Employees Group Insurance Scheme since November 1984 I have retired from service after attaining the age of 58 years .I have ceased to be in employement (with the Andhra Pradesh Government in Secondary Education,ZPHS ..with effect from I was holding the post of PG.HM.Gr-IIbefore retirement (with the State Government ZPHS .) I request that the amount due to me under the Andhra Pradesh State Employees Group Insurance Schme may be paid to me.

Yours Faithfully
N.RUBEN Rtd .PG.HM.Gr-II.

Mandal Educational Officer,Mandal Parishad Tekmal November 1984

R.Ramesh,Tekmal,9989663755

CERTIFICATE
This is to certify that Sri/Smt. is only widow of Late Sri/Smt. deceased(Office).

Mandal Educational Officer Mandal Parishad Tekmal

RECEIPT
I Sri N.RUBEN S/O Venkatesham , PG.HM.Gr-II(Retired) do here by declare that I have received Rs.towards payment of lumpsum benefit under GroupI nsurance Scheme.

" Attested " Attesting Officer

Signature of the Receiver.

NON- DRAWAL CERIFICATE

This is to cerify that the claim under Group Insurance Scheme of Rs. To Sri N.RUBEN,PG.HM.Gr-II S/O Venkatesham ,PG.HM.Gr-II (Retired) is for the first time and not claimed previously as per the Office records.

CERTIFICATE
Certified that the Late Sri/Smt was in service on the date of his death. He was holding the post of in the office / Department.

R.Ramesh,Tekmal,9989663755

Mandal Educational Officer Mandal Parishad Tekmal

APTC FORM - 40
BILL FOR WITHDRWAL FROM GPF/GIS/FBF/EWF/LOANS AND ADVANCES
For the Month & Year
Bill For Date:

Dist

Trans ID D.D.O's T.T.B.R No

TREASURY/PAO CODE

Major Head

8 -1 0 -0 0

0 -0 2 -0 0

1 1

Insurance and Pension Fund

DDO CODE DDO Desigination DDO Office Name

18022202149 MEO
Mandal Parishad Tekmal

Sub Major Head Minor Head Goup Sub Head

State Govt.Employees GIS Insurance Fund (Disbursement)

Bank Brach Code Bank Branch Name

Sub Head Detailed Head

2 3

Saving Fund (Disbursement) Interest fund (Disbursement)

Sub Detailed Head

Non Paln = N/Plan=P

Charged=C/Voted=V

Contigency Fund MH/ Service Major Head

Bill total amount Rs.

31794.00

Rupees

(Thirty one Thousand Seven Hundred and Ninety four rupees only)

Payable with adjustment Received amount Drwaing Oficer /Authority

FOR USE IN TREASURY / PAY & ACCOUNTS OFFICE ONLY

Pay Rs..( Rupees . .only) by cash/Cheque/Draft/Account Credit /Adjustment.

NBST/ Bank
Treasury Officer Pay & Accounts Officer

(P.T.O)

CES

Sl.No Name & Designation /Subsciber Employee or Nominee 1 2

Pay Rs.

Account No No & Date of Sanction of the 4 5 Mandal Educational Officer Mandal Parishad Tekmal Proc.No A2/15/2011 Date 25.06.2011

Natute & Amount of withdrawal Final/Part final Payment Rs. 6

N.RUBEN PG.HM.Gr-II

e and Pension Fund

yees GIS

sbursement)

ursement)

sbursement)

2
TOTAL

ees only)

Designation of the Sanctioning Authority-----------------------------------------------------------------------------------------------------------Note : Original Sanction order Should be enclosed

DETAILS OF BUDJET
1. Yearlt Budget allotment 2.Contains this Bill with expenditure of incumbent 3.Balance. Rs.. Rs.. Rs..

31794.00
Drawing Authority

(P.T.O)

For Use Accountant General Office

Amount of withdrawal Advances 7 Claimed as perMandal Educational Officer Mandal Parishad Tekmal Proc.No A2/15/2011 Date 25.06.2011

Remarks 8

--------------------------------------

..

..

..

Drawing Authority