E-SR CERIFICATES

SR Declaration Forms (A4 Portrait) - Designed by K.S.Naidu Type in Form 1 to auto-fill all 4 forms. 100% Full-Width Vector PDF Download!

MARRIAGE DECLARATION

I, Sri/Smt. working as at School, Village/Town of Mandal, hereby declare that I was married to Sri/Smt. S/o / D/o on at .

I further declare that the above information is true and correct to the best of my knowledge and belief. I request that my marriage particulars may kindly be entered in my Service Register (SR).

Place:
Date:

Signature of the Teacher:
Name:
Designation:
Employee ID / CFMS ID:
School:

DESIGNED BY K.S.NAIDU

HOME TOWN DECLARATION FORM

I, , working as at School, Village/Town of Mandal hereby declare that my home town is at the place as shown below for the purpose of availing Leave Travel Concession for self and family as noted in the Govt. of India, Ministry of Home Affairs, New Delhi vide O.M. No. 43/1/55/Estts-(A) Part-II dated 11.01.1956. And I hereby request my HOO to enter these details in my Service Register.

Home Town / Village	Mandal	Division	District & State	Nearest Railway Station	Nearest Airport	Instance / Distance

Place:
Date:

Signature of the Employee:
Name:
Designation:
Employee ID / CFMS ID:
School:

DESIGNED BY K.S.NAIDU

LIST OF FAMILY MEMBERS / DEPENDENTS DECLARATION

I, Smt./Sri Working as at School, Village/Town of Mandal hereby declare that I have married on: to and I am having the following legitimate family members/dependents who actually live with me and depend upon my earning.

ANNEXURE

Sl. No.	Name of the Family Member	Gender	Relationship	D.O.B	Blood Group	Employment Status	ID / Ref No.	Marital Status
1								Married
2
3
4
5
6
7

Place:
Date:

Signature of the Employee:
Name:
Designation:
Employee ID / CFMS ID:
School:

DESIGNED BY K.S.NAIDU

NOMINEE ASSIGNING FORM FOR DCRG AND OTHER BENEFITS

I, Smt./Sri Working as at School, Village/Town of Mandal hereby declare that I have married on: to and I am having the following legitimate family members/dependents who actually live with me and depend upon my earning. I nominate the following family member(s) of my family to receive the Death-cum-Retirement Gratuity, G.I.S Final claims, APGLI final claims, GPF/ZPGPF Final claims and other pensionary benefits from the Govt. in case of death while in service. I hereby request my HOO to record these details in my Service Register. In support of my nomination I have taken witness of two Govt. employees/others as shown below.

ANNEXURE

Sl. No.	Name of the Fund	Name of the Nominee	Relationship	D.O.B	ID / Ref No.	Share	Remarks
1	Death Cum Retirement Gratuity					100%
2	GPF/ZPGPF/CPS Final claim					100%
3	G.I.S Insurance and Savings Fund					100%
4	APGLI Final settlement					100%
5	EWF Fund benefits					100%

Name of the Witness:
1.
    CFMS ID:
2.
    CFMS ID:

Signature of the Employee:
Name:
Designation:
Employee ID / CFMS ID:
School:

DESIGNED BY K.S.NAIDU