FORM “C”

APPLICATION FOR THE GRANTS FROM WAPDA WELFARE FUND

I TO BE FILLED IN BY THE APPICANT

1. Name of Wapda employee ___________________________

2. Date of death, invalidation or retirement, in ___________________________

case of deceased employee (Not applicable in
case of serving employees)
3. (a) Details of dependent family members, ___________________________
such as the names, ages, whether
married or unmarried, school or college
where being educated, relationship of
each with the Wapda employee
(applicable in all cases)
(b) Details of earnings family members not ___________________________
included in item (a) above and their
monthly income
4. Details of property left by the Wapda ___________________________
employee for his dependents (applicable in
the case of deceased employees only)
(I) Movable, including each ___________________________

(II) Immovable ___________________________

5. If the Wapda employee was insured, the ___________________________

amount for which insured (applicable in the
case of deceased employees only)
6. Reasons for the application with proof, if any. ___________________________

7. In the case of application by a widow, a ___________________________

statement to the effect that she has not
remarried.
I do hereby solemnly affirm and verify that the contents of the above application are true to the
best of my knowledge and belief and that I have concealed nothing.
I know that in the event of marking a willful misrepresentation or suppression of facts, I shall be
liable to criminal prosecution.
Signature and name of the employee
___________________________
___________________________

or
Signature of applicant alongwith name and relationship ___________________________
with deceased employee.

Address:- Office of ___________________________

II. TO BE FILLED IN BY THE OFFICE IN WHICH THE WAPDA EMPLOYEE LAST
SERVED/PRESENTLY SERVING

1. Date of entry into Wapda service ___________________________

2. Date of birth as per service record ___________________________

3. Total length of service at the time of death, ___________________________

invalidation or retirement and in the case of
serving employees total service till the date of
filling the application.
4. a) Post held at the time of retirement or at ___________________________
the time of death or invalidation before
retirement.
b) Post held at present in case of serving ___________________________
employee.
5. I) Last pay drawn ___________________________

II) Scale of Pay ___________________________

6. Amount and date from which pension/ ___________________________

gratuity/compensation has been granted by
Wapda in the case of deceased/ retired/
Invalided employee.
7. Date from which contributing to the Wapda ___________________________
Welfare Fund.

I certify and attest the details furnished above from the record available in the office and,
I) Recommended

II) Do not recommended the case for

reasons.

8. The deceased was a Wapda employee at the

___________________________
time of his death

9. The deceased was a regular Wapda employee ___________________________

Dated: Signature and name of Head of Office/Division

with Official Seal