Fillable LIFE CERTIFICATE (To be submitted by Pensioner once

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LIFE CERTIFICATE (To be submitted by Pensioner once

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LIFE CERTIFICATE
(To be submitted by Pensioner once a year in November)
Certified that I have seen the pensioner Shri/Smt./Ms. holder
of Pension Payment Order No. and that he/she is alive on this date.
Name:
Date:
Place:
Designation of Authorised Officer
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LIFE CERTIFICATE (To be submitted by Pensioner once

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Completed 2 October 2020

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