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FORM B ANNEXURE - XVIII NON-EMPLOYMENT / RE-EMPLOYMENT CERTIFICATE To be given by pensioner once a year in November A Existed Deleted I declare that I have been employed / re-employed in the Offices which is a part of / financed by and was in receipt of the following monthly rates of emoluments during the year ended November 20 or during the month of within the said year a Pay b Special Pay c Other Allowances / Fees / Honorarium it includes D.A. A.D.A. these to be shown clearly Further that the orders of my re-employment do / do not stipulate my pension being held in abeyance during the re-employment period. Or sanction of the Central Government and none of the conditions if any attached thereto by Government has been violated* sanction of Central Govt* NOTE This declaration is required to be given for a period of two years from the date of retirement. International Organisation of which Govt* of India is not a member. Organisation of which Govt* of India is not a member after obtaining the previous Govt* has been deviated from* Place Signature Date Name of the Pensioner P. P. O. No* Certificates at B and C are to be furnished only by retired Group A Officers in May and November each year. these to be shown clearly Further that the orders of my re-employment do / do not stipulate my pension being held in abeyance during the re-employment period. Or sanction of the Central Government and none of the conditions if any attached thereto by Government has been violated* sanction of Central Govt* NOTE This declaration is required to be given for a period of two years from the date of retirement. Or sanction of the Central Government and none of the conditions if any attached thereto by Government has been violated* sanction of Central Govt* NOTE This declaration is required to be given for a period of two years from the date of retirement. International Organisation of which Govt* of India is not a member. Organisation of which Govt* of India is not a member after obtaining the previous Govt* has been deviated from* Place Signature Date Name of the Pensioner P. International Organisation of which Govt* of India is not a member. Organisation of which Govt* of India is not a member after obtaining the previous Govt* has been deviated from* Place Signature Date Name of the Pensioner P. P. O. No* Certificates at B and C are to be furnished only by retired Group A Officers in May and November each year. these to be shown clearly Further that the orders of my re-employment do / do not stipulate my pension being held in abeyance during the re-employment period. Or sanction of the Central Government and none of the conditions if any attached thereto by Government has been violated* sanction of Central Govt* NOTE This declaration is required to be given for a period of two years from the date of retirement. International Organisation of which Govt* of India is not a member. Organisation of which Govt* of India is not a member after obtaining the previous Govt* has been deviated from* Place Signature Date Name of the Pensioner P.

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