OIL AND NATURAL GAS CORPORATION LIMITED Office of Chief-ER Corporate Policy Section II Floor, B. S. Negi Bhavan Tel Bhavan, Dehradun

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1 OIL AND NATURAL GAS CORPORATION LIMITED Office of Chief-ER Corporate Policy Section II Floor, B. S. Negi Bhavan Tel Bhavan, Dehradun O.O. No. ONGC/ER/CP/WEL/004 Dated: 28 th July 2006 OFFICE ORDER (WEL-004) Sub: REVISED SCHEME OF EX-GRATIA FOR PRE EMPLOYEES AND POST EMPLOYEES I. SCHEME: The Management of Oil and Natural Gas Corporation Limited had introduced the Agrani Samman Ex-gratia Benefit Scheme in recognition of valuable contribution made by the pioneers to the cause of ONGC to mitigate their post-separation hardships. 2. The Scheme is available to eligible pre employees as well as to those eligible post employees who superannuated/died while in service prior to (in case of executives) and (in case of non-executives) and those post employees who voluntarily retired prior to as executives as mentioned hereinafter. 3. Eligibility Conditions: 3.1. Payment under the Agrani Samman Scheme is purely and entirely ex-gratia and not because of any right or entitlement Ex-employees who had joined ONGC prior to and superannuated/voluntarily retired from the services of ONGC or died after rendering a minimum of 10 years service before such separation Ex-employees who had joined ONGC after and superannuated/voluntary retired from the services of ONGC or died before (in case of executives) and (in case of non-executives), after rendering a minimum of 10 years service before such separation Such of those ex-employees/spouses will not be eligible under this scheme where the spouse or any dependent son/daughter of ex-employee has been provided employment in ONGC on compassionate grounds The eligible ex-employee will continue to get Agrani Samman so long he/she is alive after Thereafter, his/her surviving spouse shall be eligible for 50% of ex-gratia as mentioned under para 5.1(e) & 5.2(d) of this scheme. 3.6 In case of break-in-service, net service rendered in ONGC will be taken into account for the purpose of eligibility, provided the break-in-service was not more than the net service rendered in ONGC. 1

2 3.7 For the purpose of eligibility with regard to service in ONGC, only regular service in ONGC will be considered and the period of engagement on contractual/ daily/ ad-hoc etc. shall not be reckoned at all. 3.8 For the purpose of eligibility, the ex-employee must not have been dismissed/removed/terminated or resigned/deemed to have resigned from the services of ONGC. 3.9 All those ex-employees who separated from the service of ONGC on account of Pre-mature retirement shall not be eligible for ex-gratia under the scheme For the purpose of reckoning service in ONGC as eligibility criteria for Agrani Samman, qualifying service in respect of Deputationists, will be taken from the date of absorption in ONGC, 3.11 Full time Members/Directors of ONG Commission shall also be eligible subject to fulfillment of above conditions The ex-employees/surviving spouses, who are, eligible for Agrani Samman, shall have to execute undertaking in the prescribed form to the effect that this "Agrani Samman is being given not because of any right or entitlement, but entirely in the nature of ex-gratia. Further, he/she will not enter into any litigation in this and other related matters before any Court of Law/Forum/Authority. If any case pertaining to ex-gratia and/or in relation to PRBS is pending before any Court of Law/Forum/Authority, he/she shall withdraw the same forthwith (Proforma at Annexure I). The eligibility of the applicants shall be considered and application processed only after withdrawal of such case/petition before any Court/Forum/Authority where the applicant is a petitioner either singly or jointly. Note: All those employees who have rendered a net service of 9 years and 6 months or more but less than 10 years prior to their superannuation/voluntary retirement/death and fulfill all other terms and conditions of the scheme are also eligible for benefit under the Agrani Samman Ex-gratia Benefit Scheme. 4. General Conditions 4.1 Agrani Samman will be taken into account as income for the purpose of determining dependency for availing LFA The spouse of deceased eligible ex-employee, who is getting the benefit of Family Pension under FPF scheme, shall be eligible to receive ex-gratia benefit without any adjustment on this account For calculating the length of service, fraction of a year equal to six months and above shall be treated as full year and period less than 6 months of a year shall be ignored. 2

3 5. Amount of ex-gratia payment: 5.1 Pre employees: 5.1(a) The Pre employees who have rendered 20 or more years of service and not receiving/eligible for PRBS and /or Govt. Pension shall now be eligible to revised ex-gratia at the following rates per month w.e.f : Level of employees Ex-gratia amount Dearness Allowance (DA) Class III & IV Rs Plus DA E-0-E-3 Rs admissible from E-4 E-6 Rs time to time E-7 & above Rs (b) The ex-gratia amount for those, who have rendered 10 or more years of service but less than 20 years of service, and not receiving/eligible for PRBS and/or Govt. Pension shall receive ex-gratia amount on pro-rata basis i.e. ex-gratia rate multiplied by No. of years of service divided by 20 plus applicable DA from time to time. See illustrations A & B at Annexure-II. 5.1(c) Those eligible pre employees who separated and receiving/eligible for PRBS and/ or Govt. Pension shall be eligible for ex-gratia at the rates mentioned in para 5.1(a) & (b) above plus applicable DA from time to time minus PRBS benefit, or Govt. Pension or both as the case may be. The PRBS amount to be deducted shall be the full monthly amount that the PRBS beneficiary would have received without any commutation of PRBS corpus. For pensioners, only pension amount will be reduced from ex-gratia rate and admissible DA will be added to the amount so arrived (as DA rates in Govt. and PSU differ). See illustrations E & F at Annexure-II. 5.1(d) In those cases where pre beneficiaries of ex-gratia had withdrawn their full PRBS Corpus on their separation and hence not receiving monthly PRBS benefit, the notional amount of PRBS as admissible shall be deducted from the ex-gratia amount payable to them. 5.1(e) The eligible surviving spouse of a deceased ex-employee, shall get 50% benefit of ex-gratia that was/would have been admissible to the ex-employee plus applicable DA from time to time minus PRBS and / or Govt. Pension. 5.2 Post employees: 5.2(a) Those eligible post employees who separated from the services of ONGC after rendering 20 or more years of service on or before (executive) / (non-executive) and not receiving Govt. Pension, shall be eligible to exgratia every month at the following rates w.e.f

4 Level of employees Ex-gratia amount Dearness Allowance (DA) Class III & IV Rs. 750 Plus DA as admissible E-0-E-3 Rs from time to time E-4 - E-6 Rs E-7 & above Rs (b) The ex-gratia amount for those who have rendered 10 or more years of service but less than 20 years of service and not receiving Govt. Pension shall be on pro-rata basis i.e. admissible ex-gratia amount multiplied by No. of years of service divided by 20 plus admissible DA from time to time. (See illustrations C & D at Annexure-II). 5.2(c) In case of post employees who are in receipt of any Govt. Pension, the same shall be reduced from the admissible ex-gratia amount. Reduction of pension amount shall be as described at para 5.1(c) 5.2(d) The eligible surviving spouse of a deceased ex-employee shall get 50% benefit of ex-gratia that was/would have been admissible to the ex-employee plus applicable DA from time to time minus Govt. Pension, if any. 6. General Instructions: 6.1 Those Pre employees/spouses who are already receiving Rs. 1000/ Rs.500 p.m. plus applicable DA under existing Ex-gratia Scheme dated are allowed to either opt for this "Agrani Samman" scheme of exgratia payment if otherwise eligible or continue with the existing ex-gratia scheme. 6.2 All eligible beneficiaries under the Agrani Samman shall submit application form in the Proforma prescribed separately for each category as given in Annexure III, IV, V & VI alongwith all relevant documents as indicated in the application form, to the Heads of P&A of concerned work centre/regional Office/Office/Institute of ONGC from where the ex-employee retired. Advance Copy of application in the prescribed format for Agrani Samman is to be sent to the Agrani Samman Cell, Corporate Administration, ONGC, Tel Bhavan, Dehradun, (Pin Code ). The last date for receipt of all suchapplications was 30 th June, Any application received thereafter was to be considered on exceptional grounds. 6.3 It will be for the applicant to satisfy the Head of P&A/Establishment of concerned work centre/office/institute/ of ONGC that he / she is eligible to receive ex-gratia payment under these instructions and establish identity by producing relevant documents which may be available in his / her possession. 4

5 6.4 In case, the eligible beneficiary does not have all relevant documents as a proof of having rendered the requisite service in ONGC or documents mentioned in the application form, the claimant shall produce an affidavit sworn before a First Class Magistrate or Oath Commissioner or Notary Public in the prescribed proforma stating all relevant details and also that applicant had not been removed or dismissed/terminated or had not resigned or was not deemed to have resigned from the services of ONGC etc. (Proforma at Annexure VII & VIII respectively). 6.5 The beneficiary has to indicate the name of a established Private/Public Sector bank where he/she holds bank account for making remittance of ex-gratia amount. 6.6 The periodical certificate such as Life Certificate prescribed for drawal of exgratia shall be required to be produced by the recipient of the ex-gratia to the concerned disbursing authority every year in the month of November.(Proforma at Annexure - IX ). 6.7 The procedure for payment of ex-gratia is same as was being followed under other ex-gratia scheme. 6.8 In case, any difficulty is faced in receiving the Agrani Samman Ex-gratia by any eligible Ex-employee fulfilling all the conditions of the Scheme and who has also submitted all the requisite documents to the concerned authority, the applicant may make a reference with full particulars to the ED-Chief Employee Relations, ONGC, Tel Bhavan, Dehradun (Pin ) for redressal of his grievance. In case his grievance is not redressed in 30 days, he may write to CEA to C&MD, ONGC, Jeevan Bharti Building, Tower-II, `128 Indira Chowk, New Delhi for follow-up. CLARIFICATIONS Sl. No. (1) Issue (2) Clarification (3) 1 Whether post employees (upgraded to E.0 scale) who superannuated / died while in service after or voluntarily retired after , shall be eligible for Agrani Samman ex-gratia if they fulfil all requisite eligibility conditions of Agrani Samman Ex-gratia Benefit Scheme? No, such post employees (upgraded to E.0 and above scale) who superannuated / died while in service after or voluntarily retired after , shall not be eligible for Agrani Samman ex-gratia since they were eligible for PRBS. 5

6 2 In respect of an eligible ex-employee who was upgraded from class III to E-0 / E-0 to E-I scale, whether the Agrani Samman ex-gratia amount shall be regulated based on the rate specified for non-executive level or the rate specified for executives (E-0 to E-3) level? In respect of eligible ex-employees who were upgraded from class III to E.0 / E.0 to E.I scale and fulfil all requisite eligibility conditions of Agrani Samman Ex-gratia Benefit Scheme, the amount shall be regulated corresponding the executive level to which they were last upgraded before superannuation / voluntary retirement / death. 3 Whether an employee who joined ONGC prior to but subsequently resigned and again re-joined ONGC after and retired / voluntarily retired or died after rendering minimum 10 years net service in ONGC, should be treated as pre employee or post employee? In case the initial joining of an ex-employee in regular service in ONGC was prior to , he/she shall be treated as pre employee. However, payment of Agrani Samman exgratia shall be subject to all requisite eligibility conditions of Agrani Samman Ex-gratia Benefit Scheme. Note:- In respect of a Deputationist, the crucial date for determining whether he is pre employee or post employee, shall be his date of absorption in ONGC. 4 Whether notional amount of PRBS is to be deducted from the Agrani Samman ex-gratia payable to those pre employees who had not opted for PRBS and either superannuated or died after as executives / deemed promoted retrospectively from class III to executive cadre after retirement or voluntarily retired after ? Yes, in such cases, the notional amount of PRBS benefit which would have been admissible to the eligible executive, had he opted and contributed towards PRBS upto the date of superannuation / VR / death, shall be deducted from Agrani Samman ex-gratia amount. 5 There are a number of eligible pre employees who retired / voluntarily retired on or after but could not avail themselves of PRBS benefits as they did not contribute towards PRBS. Whether notional amount of PRBS is to be deducted from the Agrani Samman ex-gratia payable to such employees? Yes, in such cases, the notional amount of PRBS which would have been admissible to the eligible employees, had he contributed towards PRBS, shall be deducted from Agrani Samman ex-gratia amount. 6

7 Note :- Employees expiring on or after but before actual recovery of contribution towards PRBS were all extended the benefit of PRBS vide Circular No.PRBS-43 dated ( for executives ) and Circular No. PRBS-U-2 dated (for unionised category of employees); and are all in receipt of PRBS benefits. ( Amarendra Sahu ) Chief Manager (P&A) 7

8 (To be executed on non-judicial stamp paper of appropriate value) Annexure-I UNDERTAKING I Son/Wife of aged years, retired from ONGC's service on as (Designation) having my CPF No., now residing at, hereby declare and undertake the following:* OR I spouse and legal heir of late who expired on and retired from ONGC's service on as (Designation)/CPF No., residing at, hereby declare and undertake the following:* 1. That I recognise and unconditionally admit and accept that my request for grant of 'Agrani Samman' is not based on any right or entitlement whatsoever, but entirely an ex-gratia benefit; 2. That I expressly understand and acknowledge that the grant of such an ex-gratia benefit will not create any right, privilege or claim whatsoever, to me individually or collectively qua ONGC entitling for claiming any cause before any Court of Law and I further expressly waive any such right, privilege or claim. 3. That, I had entered into litigation(s) against ONGC Ltd. on the matter(s) related to my service and/or service conditions including PRBS Scheme, and I have since withdrawn such litigation(s) for which relevant legal affidavit/documentation is enclosed* And/or 4. That I had, along with others, entered into litigation(s) against ONGC Ltd. on matter(s) related to our service and/or service conditions including the PRBS Scheme, and I have since, along with all others concerned, withdrawn such litigation(s) for which relevant legal affidavit/documentation is enclosed.* 8

9 5. That I have not entered into any litigation either singly or jointly against ONGC relating to my service and/or service conditions including PRBS Scheme, before any Court/Forum/Authority. 6. That, I am executing this undertaking on my free will. Encl: As above. Place: Date: (SIGNATURE) and NAME OF THE EXECUTANT To be attested by Notary * NB: Strike out whichever is not applicable. 9

10 ILLUSTRATION - A: Annexure-II Mr.X joined ONGC on and retired on as Sr.Dy.Director(P&A) (E- 3) after rendering 14 years of service. The ex-gratia payable to him shall be: Rs.3000 X ( 14/20 ) = Rs.2100 plus applicable DA from time to time. ILLUSTRATION - B: Mr.Y joined ONGC on and retired on as Addl.Director(P&A) (E-5) after rendering 17 years and 4 months of service. The ex-gratia payable to him shall be : Rs.4500 X (17/20) = Rs.3825 plus applicable DA from time to time. ILLUSTRATION - C: Mr.X joined ONGC on and retired on as Sr.Dy.Director(P&A) (E- 3) after rendering 14 years of service. The ex-gratia payable to him shall be : Rs.1500 X (14/20) = Rs.1050 plus applicable DA from time to time. ILLUSTRATION - D: Mr.Y joined ONGC on and retired on as Addl.Director(P&A) (E- 5) after rendering 17 years and 10 months of service. The ex-gratia payable to him shall be: Rs.2250 X (18/ 20) = ILLUSTRATION - E: Rs.2025 plus applicable DA from time to time. Mr.X joined ONGC on on deputation and was absorbed in ONGC on He retired on as General Manager (E-7) after rendering 15 years of post absorption service. He is receiving Govt. Pension Rs plus DA Rs per month. The ex-gratia payable to him shall be: (Ex-gratia minus Govt. Pension plus DA) Rs minus Rs = Rs X (15/20) = Rs plus applicable DA from time to time. 10

11 ILLUSTRATION - F: Mr.Y joined ONGC on on deputation and was absorbed in ONGC on He retired on as General Manager (E-7) after rendering 20 years of service. He is receiving Govt. Pension Rs plus DA Rs per month. The ex-gratia payable to him shall be: (Ex-gratia minus Govt. Pension plus DA) Rs minus Rs = Rs plus applicable DA from time to time. N.B. The date of joining, retirement and Govt. Pension amount are hypothetical figures. 11

12 Annexure-III OIL AND NATURAL GAS CORPORATION LIMITED DEPARTMENT OF EMPLOYEE RELATIONS TEL BHAVAN: DEHRADUN Application form A (For use of pre employee) *Affix Photograph Of spouse *Affix Photograph Of ex-employee Sir, I joined ONGC on (i.e. prior to ) and had rendered minimum of years of net service till my normal date of superannuation/voluntary retirement. I am (a)** receiving/eligible for PRBS and / or Govt. Pension (b)** not receiving/eligible for benefit under ONGC Post Retirement and Death in Service Benefit Scheme and / or Govt. Pension Scheme (** Strike off whichever is not applicable). Therefore, I hereby apply for grant of Agrani Samman ex-gratia. 1. Name of the applicant ( in block letters) 2. Designation on appointment 3. Date of joining ONGC 4. Date of birth 5. CPF No. 6. Designation on superannuation/vr 7. Whether superannuated/voluntarily retired 8. Date of superannuation/vr 9. Present residential address ( in block letters) Tel. No. 10. Name of the office from where superannuated/voluntarily retired 11. Whether receiving/eligible for benefit Yes / No under ONGC Post Retirement and Death in Service Benefit Scheme (write yes or no) 12

13 11(i). If yes, the amount of monthly PRBS benefit being received by him/her 12. Whether withdrawn/commuted his/her PRBS Withdrawn / commuted / No corpus 12(i) If yes, the proportion of corpus withdrawn/ full/ % commuted (indicate exact percentage of commutation) 12(ii) The amount of PRBS withdrawal/ commutation Rs. 13. Whether receiving/eligible for pension Yes / No under Govt. Pension Scheme (Write yes or no) 14. If yes, the amount of monthly Govt. Pension being received (Basic Pension only) 15. Whether receiving Post Retirement Medical benefit from ONGC, if so, from where receiving 16. Whether rendered continuous service Yes / No in ONGC for more than 20 years (write yes or no) a) If no, Net years of service rendered in ONGC b) Total years of break-in-service, if any, give details. 17. Name of the spouse, if alive Specimen signatures (1) (2) (3) (Write the name of the Bank Branch where ex-employee desires to receive ex-gratia amount) Bank Name and Address: 1. A/C No. Date: Signature of the applicant Place: Note: Please enclose photocopies of: a) Appointment letter. b) Superannuation/voluntary retirement letter. c) Medical booklet (relevant portion) d) Or any documentary evidence to show about eligibility for ex-gratia. * Photographs should be attested by a Gazetted Officer or serving E-5 level or above ONGC Officer. 13

14 OIL AND NATURAL GAS CORPORATION LIMITED DEPARTMENT OF EMPLOYEE RELATIONS TEL BHAVAN: DEHRADUN Application form- B Annexure-IV (For use of spouse of deceased ex-employee Pre ) Sir, *Affix Photograph of self (spouse) *Affix Photograph of ex-employee Sh./Smt. who was my husband/wife joined ONGC on (i.e. prior to ) and had rendered minimum of years of net service till his/her normal date of superannuation/voluntary retirement/death while in service and he/she was (a)** receiving/eligible for PRBS and / or Govt. Pension (b)** not receiving/eligible for benefit under ONGC Post Retirement and Death in Service Benefit Scheme and / or Govt. Pension Scheme (** Strike off whichever is not applicable). Therefore, I hereby apply for grant of Agrani Samman ex-gratia. 1. Name of the applicant ( in block letters) 2. Name of the ex-employee( in block letters) 3. Designation of ex-employee on the date of superannuation/vr/death 4. CPF No. of ex-employee 5. Date of birth of ex-employee 6. Date of joining ONGC of ex-employee 7. Whether the ex-employee superannuated/ Voluntarily retired/died in service 8. Date of superannuation/vr of ex-employee 9. Date of death (enclose Death Certificate of ex-employee or other documentary evidence) 10. Present Residential address of applicant ( in block letters) Tel. No. 14

15 11. Name of the office from where ex-employee superannuated/voluntarily retired 12. Whether ex-employee received/eligible for Yes / No benefit under ONGC Post Retirement and Death in Service Benefit Scheme (write yes or no) 12(i) If yes, the amount of monthly PRBS benefit being received by him/her 13. Whether withdrawn/commuted his/her Withdrawn / Commuted / No PRBS corpus 13(i) If yes, the proportion of corpus full / ( %) portion withdrawn/commuted (indicate exact percentage commutation) 13(ii) The amount of PRBS withdrawal/ commutation Rs. 14. Whether ex-employee was receiving/ Yes/No eligible for pension under Govt. Pension Scheme (write yes or no) 14(i) If yes, the amount of monthly Govt. Pension being received (Basic Pension only) 15. Whether applicant is receiving post Retirement Medical benefit from ONGC, if so, from where receiving 16. Whether ex-employee had rendered Yes/No continuous service in ONGC for more than 20 years (write yes or no) a) If no, net years of service rendered in ONGC b) Total years of break-in-service, if any, give details. Specimen signatures (1) (2) (3) 15

16 (Write the name of the Bank Branch where the spouse of deceased ex-employee desires to receive ex-gratia amount). Bank Name and Address: A/C No Date : Signature of the applicant Place : Note : Please enclose photocopies of : a) Appointment letter. b) Superannuation/voluntary retirement/name struck off (in case of death) letter. c) Medical booklet (relevant portion) d) Or any documentary evidence to show about eligibility for ex-gratia. * Photographs should be attested by a Gazetted Officer or serving E-5 level or above ONGC Officer. 16

17 Annexure-V OIL AND NATURAL GAS CORPORATION LIMITED DEPARTMENT OF EMPLOYEE RELATIONS TEL BHAVAN: DEHRADUN Sir, Application form C (For use of post employee) *Affix Photograph of spouse *Affix Photograph of ex-employee I joined ONGC on (i.e. after ) and had rendered minimum of ---- years of net service till my normal date of superannuation/voluntary retirement. I superannuated/voluntarily retired on or before (executive) / (non-executive). I am (a)** receiving/eligible for Govt. Pension (b)** not receiving/eligible for Govt. Pension ( ** Strike off whichever is not applicable). Therefore, I hereby apply for grant of Agrani Samman ex-gratia. 1. Name of the applicant ( in block letters) 2. Designation on appointment 3. Date of joining ONGC 4. Date of birth 5. CPF No. 6. Whether superannuated/ voluntary retired 7. Designation on superannuation/vr 8. Date of superannuation/vr 9. Present residential address & Tel. No. ( in block letters) Tel. No. 10. Name of the office from where superannuated/voluntarily retired 11. Whether receiving/eligible for benefit Yes / No under ONGC Post Retirement and Death in Service Benefit Scheme (write yes or no) 12. Whether receiving/eligible for pension Yes/No under Govt. Pension Scheme (write yes or no) 17

18 12(i) If yes, the amount of monthly Govt. Pension being received (Basic Pension only) 13. Whether receiving Post Retirement Medical benefit from ONGC, if so, from where receiving 14. Whether rendered continuous service Yes / No in ONGC for more than 20 years (write yes or no) a) If no, Net years of service rendered in ONGC b) Total years of break-in-service, if any, give details. 15. Name of the spouse, if alive Specimen signatures (1) (2) (3) (Write the name of the Bank Branch where ex-employee desires to receive ex-gratia amount) Bank Name and Address: A/C No Date : Place: Signature of the applicant Note : Please enclose photocopies of : a) Appointment letter. b) Superannuation/Voluntary Retirement letter. c) Medical booklet (relevant portion) a) Or any documentary evidence to show about eligibility for ex-gratia. * Photographs should be attested by a Gazetted Officer or serving E-5 level or above ONGC Officer. 18

19 Annexure-VI OIL AND NATURAL GAS CORPORATION LIMITED DEPARTMENT OF EMPLOYEE RELATIONS TEL BHAVAN: DEHRADUN Application form- D (For use of spouse of deceased post employee) *Affix Photograph of self (spouse) *Affix Photograph of ex-employee Sir, Sh./Smt. who was my husband/wife joined ONGC on (i.e. after ) and had rendered minimum of ---years of net service till his/her normal date of superannuation/voluntary retirement/death while in service. He/she superannuated/voluntarily retired/died while in service on or before (executive)/ (non-executive). He was (a)** receiving/eligible for Govt. Pension (b)** not receiving/eligible for Govt. Pension Scheme (** Strike off whichever is not applicable). Therefore, I hereby apply for grant of Agrani Samman ex-gratia. 1. Name of the applicant ( in block letters) 2. Name of the ex-employee( in block letter 3. Designation of ex-employee on the date of superannuation / VR / death 4. Date of birth of ex-employee 5. CPF No of ex-employee 6. Date of death of ex-employee (enclose Certificate of ex-employee or other documentary evidence) 7. Date of joining ONGC of ex-employee 8. Whether ex-employee superannuated/ voluntarily retired/died in service. 9. Date of superannuation/vr of ex-employee 19

20 10. Present Residential address and Tel.No. ( in block letters) Tel. No. 11. Name of the office from where ex-employee superannuated/ voluntarily retired/ died in service. 12. Whether ex-employee received/eligible for _ Yes / No benefit under ONGC Post Retirement and Death in Service Benefit Scheme (write yes or no) 13. Whether ex-employee was receiving/eligible for Yes / No pension under Govt. Pension Scheme (write yes or no) 13(i) If yes, the amount of monthly Govt. Pension being received (Basic Pension only) 14. Whether applicant is receiving Post Retirement Medical benefit from ONGC, if so, from where receiving. 15. Whether ex-employee had rendered _ Yes / No continuous service in ONGC for more than 20 years (write yes or no) (a)if no, Net years of service rendered in ONGC (b)total years of break-in-service, if any, give details. Specimen signatures (1) (2) (3) (Write the name of the Bank Branch where the spouse of deceased ex-employee desires to receive ex-gratia amount). Bank Name and Address: A/C No Date: Place: Signature of the applicant 20

21 Note : Please enclose photocopies of : a) Appointment letter. b) Superannuation/Voluntary Retirement/Name struck off (in case of death) letter. c) Medical booklet (relevant portion) d) Or any documentary evidence to show about eligibility for ex-gratia. * Photographs should be attested by a Gazetted Officer or serving E-5 level or above ONGC Officer. 21

22 Annexure-VII AFFIDAVIT For use of ex-employee Before the First Class Magistrate/Oath Commissioner/ Notary Public I,.. aged. Years, son/wife of., resident of... do hereby solemnly affirm and state as under: 1. That I joined ONGC in regular service on.on my appointment to the post of.at (Name of the Project and place). 2. I served ONGC for net years and superannuated/voluntarily retired from services of ONGC on from the post of..while serving at.. 3. My break in service in ONGC is from to..i.e.. years which is not more than the total service rendered in ONGC. 4. I am receiving an amount of Rs...as monthly benefit under ONGC PRBS and Rs. as Govt. Pension. 5. I am not covered under any pensionary benefit/scheme either under ONGC Post Retirement & Death in Service Benefit Scheme (PRBS) and / or Govt. Pension Scheme. 6. I was not dismissed/removed/terminated or had not resigned/deemed to have resigned from the services of ONGC. VERIFICATION (DEPONENT) I, above named deponent hereby declare and verify that the aforementioned facts from para 1 to 6 above are true to the best of my knowledge, belief and information. Signed and verified this day of Identified by (DEPONENT) 22

23 AFFIDAVIT Annexure-VIII For use of spouse of deceased ex-employee Before the First Class Magistrate/Oath Commissioner/ Notary Public I,..aged years, wife/ husband of., resident of... do hereby solemnly affirm and state as under: 1. That my spouse Shri/Smt joined ONGC in regular service on at..(place and Project) as (Designation). 2. My above-named spouse served ONGC for years net service and superannuated/voluntarily retired/expired on.. as (Designation) from...(name of Project/place). 3. His/her break in service in ONGC is from. to i.e. years which was not more than the total service rendered in ONGC. 4. He/she was receiving an amount of Rs.. as monthly benefit under ONGC PRBS and Rs... as Govt. Pension. 5. My above-named spouse was not covered under any pensionary benefit / Scheme either under ONGC Post Retirement & Death in Service Benefit Scheme (PRBS) and / or Govt. Pension Scheme. 6. My above-named spouse was not dismissed/removed/terminated or had not resigned/deemed to have resigned from the services of ONGC. 7. Neither me, nor my son or daughter had been provided employment in ONGC on compassionate grounds. VERIFICATION (DEPONENT) I, above named deponent hereby declare and verify that the aforementioned facts from para 1 to 7 above are true to the best of my knowledge, belief and information. Signed and verified this day of Identified by (DEPONENT) 23

24 Annexure-IX Life Certificate (In support of ex-gratia payment under 'Agrani Samman' ex-gratia dated ) Certified that I have seen the Ex-employee/spouse of ex-employee Sh./Smt holder of Ex-gratia Payment Order No and that he/she is alive on this date. Place Name Date Designation (Gazetted Officer/serving E-5 level officer or above of ONGC/ Branch Manager of Drawee Bank Branch) Office Address Seal 24