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| His/Her GPF/NPS Account No _________________ is maintained by CCA, A&T. |
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| 3. a) His/Her bank Account Number is : |
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b) Name of Bank:
IFSC Code:
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| c) Contact No. : |
| d) Date of Increment : |
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| 1. He/She made over charge of the Office / post of _________________________________ |
| on the forenoon/afternoon of ___________________________________ |
| 2. Recoveries are to be made the pay of the Government Servant detailed on the reverse. |
| 3. He/She is also entitled to joining time for ________________ days. |
| 4. He/She has been sanctioned leave proceeding joining time for ___________ days. |
| 5. Details for P.L.I. recovery through Pay Bill. |
| 6. Details of Income tax recovered up to the date from, the beginning of the current financial year are noted on the reverse. |
| 7. Service from the period from __________ to ____________ (during his stay in this Office) has been verified. A copy of L.P.C. has been given to the Government Servant. |
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| PAY HEAD: |
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Signature: _________________
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