Pension Related Information / Instructions for Retired Employee Employee having superannuated from the services of EIL on or after 1.1.2007 are required to submit duly filled in pension forms alongwith nomination form, prescribed ECS mandate form with photocopy of crossed cheque-leaf and pre-discharge receipt (amount not to be indicated). The formats for the same are available on the retired-employees portal. Fields pertaining to Account number/pension number/annuity number in the formats can be left blank. In order to locate nearest LIC Divisional Office please visit website of LIC. Before filling up the claim form, please ascertain the balance standing to your credit in the Pension fund. Pension amount You can ascertain your pension amount(indicative) by inserting the accumulations* standing to your credit in one of the annuity tables depending upon the quantum of corpus amount and accordingly indicate your option in the claim form. The four categories of annuity tables are as under : Table No. Corpus Amount ------------ -------------------- 1 Less than 1.51 lacs 2 1.51 lacs to < 3.0 lacs 3 3.0 lacs to < 5.0 lacs 4 5.0 lacs and above. Important 1. Employees having corpus amount of less than Rs.68,670/- to their credit shall have to compulsorily choose annual mode of payment only without commutation. 2. * Denotes accumulations standing to your credit after commutation. 3. Click to view Annuity Tables for Pension amount calculation
APPLICATION FOR PENSION ON RETIREMENT Page 1 of 2 EIL EMPLOYEES DCS PENSION TRUST 1. Name & Emp. No. of Member : 2. Pension No. : 3. Address at which pension payment is to be made: 4. Date of Appointment: 5. Date of entry into the Scheme: 6. Date of exit (Leaving): 7. Mode of exit (Specify): 8. Date of Birth: 9. Name, relation & DOB of beneficiary 10. Option to choose pension (i) (ii) (iii) Life pension ceasing at death, No purchase price shall be paid on death to beneficiary. No guaranteed payments. Life pension with guaranteed payments for 5 / 10 / 15 / 20 years. No. purchase price shall be paid on death or at end of 5 / l0 / l5 / 20 years guarantee. On survival to guaranteed payments pension shall be continued to be payable till life. (Please specify period) Life pension ceasing at death of member with return of capital (purchase price) to beneficiary along with group pension terminal bonus declared by LIC. 11. Mode of payment of pension (specify ): MLY / QLY / HLY / YLY. 12. State whether member wants commutation of pension as per prevalent Income Tax Rules: (Member can commute maximum 1/3 rd (33.33%). ( yes / no ) 13. If you wish to transfer your annuity servicing to your nearest LIC Divisional Office please specify the area 14. Bank A/c details for transfer of annuity (Please submit filled up ECS Mandate form duly certified by the bank) PTO Format No. 3-3041-0004 Rev.0 Copyright EIL All rights reserved
APPLICATION FOR PENSION ON RETIREMENT Page 2 of 2 15. Remittance particulars after last schedule (to be furnished by payroll to trust). (Signature of witness) (Signature of the member) Forwarded to Trustees, EIL Employees DCS Pension Trust. The particulars at SL NO. 1 to 9 have been verified at our end and we certify that these are correct. Head (Establishment)/Head Field Personnel Cell Dear Sir, Re: Master Policy No. GS/CA/332436 Favouring Mr. We are forwarding the claim papers containing ECS mandate, nomination form, form C, form N and two discharge receipts duly signed by member and one of our existing trustees affixed with revenue stamp. Yours faithfully, (Signature of Trustee) The Manager(P&GS) LIC of India Delhi Divisional Oflice 1 Jeevan Prakash, 6th, 7th Floor, 25, K. G. Marg, New Delhi I l0001 Format No. 3-3041-0004 Rev.0 Copyright EIL All rights reserved
Divisional Office I, P& GS Unit, Jeevan Prakash, 7 th Floor, 25, K. G. Marg, New Delhi 110 001 Phone No.: (011) 23350678, Fax : (011) 23350832 ECS /NEFT MANDATE FORM Annuitant s desire to receive payment through Credit clearing mechanism 1. ANNUITANT S NAME : 2. AMOUNT OF ANNUITY 3. ANNUITY NO. : 4. PARTICULARS OF BANK ACCOUNT : A B BANK NAME BRANCH NAME & ADDRESS C D E F 9 DIGIT CODE NO. OF BANK & BRANCH APPEARING ON THE MICR CHEQUE OR IFSC CODE ACCOUNT TYPE ( S B ACCOUNT / CURRENT ACCOUNT OR CASH CREDIT) WITH CODE 10/11/13 ACCOUNT NO (AS APPEARING ON THE CHEQUE BOOK) ENCLOSE A CANCELLED CHEQUE LEAF I hereby declare, that the particulars given below are correct and complete. If the transaction is delayed or not effected at all for reasons of incomplete or incorrect information, I would not hold LIC responsible. Date : ( ) Signature of Annuitant Above mandate will be acceptable for following stations only: 1. DELHI 2. CHANDIGARH 3. JAIPUR 4. AHMEDABAD 5. MUMBAI 6. NAGPUR 7. HYDERABAD 8. BANGALORE 9. CHENNAI 10.PUNE 11. TRIVENDRUM 12. KOLKATA 13.BHUBHNESHWAR 14.GUWAHATI 15. PATNA 16. KANPUR 17.SOLAPUR 18. VADODRA 19. COIMBATORE
इ ज नयस इ डय ल मट ड ENGINEERS INDIA LIMITED न म कन और घ षण पऽ NOMINATION AND DECLARATION FORM इ ज नयस इ डय ल मट ड कम च र प रभ षत अ शद न अ धव ष त य जन क अ तग त घ षण एव न म कन फ म DECLARATION AND NOMINATION FORM UNDER THE ENGINEERS INDIA LIMITED EMPLOYEES DEFINED CONTRIBUTION SUPERANNUATION SCHEME. 1. न म व कम. स./Name & Empl.No. ( प अ र म /In Block Letters) 6. ख त स./Account No. 2. पत /प त क न म 7. थ य पत Fathers/Husbands Name Permanent Address 3. ज म त थ 8. अ थ य पत Date of Birth Temporary Address 4. ल ग/Sex 5. व व हक थ त/Marital Status भ ग-क PART-A म एत र न न कत य ) य (क न मत करत /करत ह पहल स न मत य ) य (क न म कन क र करत / करत ह और अपन म य ह ज न क दश म न च उ ल खत य ) य (क अपन ख त म जम इ ज नयस इ डय ल मट ड कम च र प रभ षत अ शद न अ धव ष त य जन र श करन क लए न मत करत /करत ह I hereby nominate the person(s)/cancel the nomination made by the previously and nominate the person(s) mentioned below to receive the amount standing to my credit in the ENGINEERS INDIA LIMITED EMPLOYEES DEFINED CONTRIBUTION SUPERANNUATION SCHEME in the event of my death. न मत/ न मत क न म एव अ श(%) Name & Share (%) of the nominee/ nominees पत Address सद य क स थ न मत क स ब ध Nominees relationship with the member ज म त थ Date of Birth य द न मत न ब लग ह त उसक अ भभ वक क न म और स ब ध एव पत ज न मत क न ब लक रहत प स कर ग If the Nominee is a minor, name & relationship & address of the guardian who may receive the amount during the minority of nominee. 1 2 3 4 5 गव ह क ह त र (न म व पत स हत) Signature of Witness (With name and address) अ भद त क ह त र अथव अ ग ठ क नश न Signature or thumb impression of the subscriber
भ ग-ख (PART-B) इ ज नयस इ डय ल मट ड कम च र प रभ षत अ शद न अ धव ष त य जन (THE ENGINEERS INDIA LIMITED EMPLOYEES DEFINED CONTRIBUTION SUPERANNUATION SCHEME नय र म णपऽ /CERTIFIED BY EMPLOYER म णत कय ज त ह क उपर घ षण अथव न म कन क / मत /क म र न, ज म र थ पन म क य रत ह म र सम ह त र /अ ग ठ क नश न लग य ह उसन व य क पढ़ ह व य उसक सम म र र पढ़ गई और उसन उनक प क ह Certified that the above declaration and nomination has been signed/thumb impressed before me by Shri/Smt./Kum employed in my establishment after he/she has read the entries/entries have been read over to him/her by me and got confirmed by him/her. नय अथव थ पन क अ य धक त अ धक रय क ह त र थ न/Place: दन क/Date: Signature of the employer or other officers authorised of the establishment पद/Designation फ श / थ पन क न म और पत अथव उनक रबड़ क म हर Name & Address of the Factory/ Establishment or Rubber Stamp thereof.
DISCHARGE RECEIPT Received a sum of Rupees ( Rupees ) from the in full and final Settlement of my claims and demands under Master Policy No. on my resignation/retirement from the services on Dated at on this day of 20 Name of the member : across Rs. 1/- Revenue stamp Signature of the Member WITNESS: SIGNATURE NAME ADDRESS