For Pension/Gratuity Claim

DECLARATION / UNDERTAKING

I,___________________________ /o ________________________ Designation ___________________________ (BPS-______) Office of ____________________________ Department _____________________ ________________________________________  do hereby declare that I have neither applied for nor received any pension or gratuity in respect of any portion of the services of my deceased _________________ included in the application and in respect of which pension/ gratuity is claimed here nor I shah submit any application and the order may kindly be passed thereon and that no government dues are outstanding against me and if there will be any recovery of the government, it should be deducted from my pension.

SIGNATURE: ______________________

Download PDF File: Undertaking for pension gratuity claim

This Undertaking Format is Valid per Pension / Gratuity Claim from Government Department.