Stipend Form

 

Form No. B:

Basic Pay Scale. 5-16

Price Rs.10/-

 

GOVERNMENT OF PAKISTAN

 CABINET SECRETARIAT

ESTABLISHMENT DIVISION

                                    (STAFF WELFARE ORGANIZATION)

                                                                                                    *********

_______________________________________________________________________________________________

     Instruction     (i) Use Capital Letters      (ii)  Mark “√” only in the relevant answer in col. 9,13,14 & 15

_______________________________________________________________________________________

 

PART I- (PARTICULARS OF GOVERNMENT SERVANT)

 

1.         Name of the Govt. Servant ___________________________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.         C.N.I.C. No.      3. Pay Scale

                                                                                                                (Photocopy must be attached)

 

 

 

 

 

 

 

 

 

4.         Designation __________________________ 5.  Department Vender No.

 

 

 

 

 

 

 

 

I

D

 

 

 

 

 

 

6.         Pay Slip Personal No. 7. DDO Code No.

 

8.         Office Name where Employed (Complete postal address):___________________________________

 

 

 

 

 

 

            _______________________________________________________ Office Code:

1

2

3

9.         Service status              In-service   Retired   Deceased 

 

10.       Residential Address_________________________________________________________________

_______________________________________________________________________________________

 

11.       Telephone No.             Office _______________________    Residence ________________________

_______________________________________________________________________________________

PART II – (PARTICULARS OF STUDENT)

12.       Name of the Student ________________________________________________________________

1

2

 

13.       Sex                                                         Male Female 

 

1

2

3

 

14.       Relationship with the Govt. Servant   Father Mother Self (upto BPS-15 only)  

1

2

 

15.       Day-Scholar/Boarder                Day-Scholar Boarder 

 

 

 

16.       Class/Course in which studying at present ________________________________________

 

 

 

17.       (i) Duration of Course ___________________  (ii) Subject Group/Year of study __________   

18.       Marks Sheet of last year of examination must be attached.

 

 

Signature of the Student                                                                    Signature of Federal Government Servant.

 

 

 
 

 

- 2 -

 

PART III – (FOR DRAWING & DISBURSING OFFICER OF THE OFFICE)

_______________________________________________________________________________________

 

19.       (1)  Certified that: Mr./Mrs.___________________________________________________________

                   S/O, W/O______________________________________________________________________

                   is working in this office as ________________________________________________________

                   scale ____________________________________________________________________ in pay

                   and drawing basic pay (including special pay) Rs__________________________________ P.M.

                   from the Civil Estimates.

 

            (2)  D.D.O. Code No I.D.        

   

 

 

 

 

 

 

 

 

 

 

            (3)  Department vender No.      

   

 

 

 

 

 

 

 

 

                  

 

       (Must be filled by D.D.O.)

                                                                                                Signature and seal of the D.D.O._____________

                                                                                                Telephone No.___________________________

Note:-  In case of Retired and Deceased Government Servant, an attested copy of the Pension Payment Order is to be attached instead of the getting the application forwarded through the D.D.O.

_______________________________________________________________________________________________

PART IV – (FOR HEAD OF EDUCATIONAL INSTITUTION)

 

20.       (1)  Certified that: Mr./Miss. __________________________________________________________

                   S/O, D/O_____________________________________________________ is a bona fide student 

                   of this Institution, studying in Class _________________________________________________

                   with Subjects___________________________________________________________________

(2)    His/Her conduct is satisfactory and he/she did not receive stipend for the same class last year.

(3)    He/She is in receipt of the following educational assistance from this Institution or             

From______________________________________________________________.

Scholarship and Other Concessions Rs._______________________________ P.M.

(4)    The Present Institution is recognized              

Full Postal Address of the Institution.

_____________________________

_____________________________                                                             Signature & Seal of the

                                                                                                                       Head of the Institution.

_______________________________________________________________________________________

PART V- (FOR BOARDER STUDENTS ONLY)

21.       Certified that Mr./Miss. ______________________________________________________________

            S/O, D/O_________________________________________is residing in the hostel of this Institution

            Room No.___________ Since____________ and paying Rs.___________ P.M. as boarding charges.

 

 

                                                                                                                     Signature & Seal of the

                                                                                                                     Superintendent /Warden.

----------------------------------------------------------------------------------------------------------------------

PART VI – (FOR OFFICE USE ONLY)

Class________________________                                                    Amount Rs.______________________

Checked by___________________                                                   Approved by_____________________

 

____________________________                                                    _______________________________

 (Signature, Name & Designation)                                                            (Signature, Name & Designation)



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