Get Annexure 4 Form For Pensioners 2020-2025

The Annexure 4 Form for Pensioners is essential for those who wish to provide details necessary for the Health Insurance Scheme for Pensioners. This guide will walk you through each section of the form, ensuring that you complete it accurately and efficiently.

Follow the steps to fill out the Annexure 4 Form For Pensioners online.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Begin filling out the section entitled ‘Pensioner / Family Pensioner Details’. Start with entering your Pension Payment Order number (PPO No.), the name of the Pension Disbursing Office, and select your scheme type.
3. Fill in your name in block letters as the Pensioner or Family Pensioner. If applicable, include your spouse's name along with a joint photograph.
4. Provide the bank and branch details from where your pension is disbursed, including the account number.
5. Complete your permanent address and current address in block letters, including district and PIN code.
6. Enter your contact details including phone number, mobile number, and email ID (if available).
7. If you possess a Permanent Account Number (PAN), input it in the designated section of the form.
8. Specify the post you held at the time of retirement, including details of the office or department from which you retired.
9. Include your pension details, which may consist of original pension, commuted amount, provisional pension, and family pension.
10. Provide your date of birth and the date of retirement along with proof where required.
11. Input details of any legal heir, including their name, relationship to you, and their contact information.
12. Sign or provide a thumb impression to certify that all information provided is accurate.
13. Finally, review the form for accuracy before saving changes. You can then download, print, or share the completed form as necessary.

Complete your Annexure 4 Form For Pensioners online for a smoother processing experience.