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Application For GPF Part Final Withdrawel: Station: Dated: Signature of The Applicant

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APPLICATION FOR GPF PART FINAL WITHDRAWEL

1. Name of the Applicant

2. Designation & Office

3. (a) Date of Birth

(b) Date of Entry into Govt. Service

4. Subscribers Probable date of retirement

5. Subscribers Pay

6. Name of the GPF or PF

7. Account No.

8. Balance of Credit of the Subscriber


of the on the Date of application

9. Objections of the withdrawal

10. Amount of withdrawals sanctioned

11. G.O under which the advance is sanctioned

12. No and date of the letter if any of the A.G.


Intimating the eligibility(This is to be quoted
in the case of Gazetted subscribers)

13. Whether all condition prescribed by Govt.


For the sanction of such withdrawals have
Satisfied by the subscribers

14. Designation of the authority competent to


sanction on advance to be subscribers from
his A.E accounts for special reasons.

15. D.D to be issued in favour of


( DDO Designation & Adress)

Station:
Dated :

|| Attested by the DDO||

Signature of the Applicant

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