FORM 7

[See rules 59, 60, 63, 80]

Form for Assessing Pension/Family Pension and Gratuity

[To be sent to the PAO four months before the date of retirement]

PART-I (To be filed by Head of Office)

Nationality
1. Name of the retiring Government
servant Mother
Father
Name of Mother/Father

*Aadhaar No. (if PAN no. Date of Birth

available) (DD/MM/YYYY)
2. Post held at the time of retirement: -
(a) Name of the office (b) Post held
(c) Level of pay in the pay matrix (d) Basic pay
(e) Whether the appointment mentioned above was under Government or
outside the Government on foreign service terms
(f) Level of pay /basic pay in the pay matrix of the post in the parent department
Whether declared substantive in any post under the Central Government
3. Date of beginning of 4. Date of ending of service
service (DD/MM/YYYY) (DD/MM/YYYY)
5. Cause of ending of service (please tick one)
(a) Superannuation (Rule 33) (b) Voluntary retirement on being declared surplus (Rule 34)
(c) Voluntary retirement [under Rules 43 or FR 56 (k)]
(d) Premature retirement at the initiative of the Government [ Rule 42 or FR 56 (j) ]
(e) Permanent absorption in State Government/ public sector undertaking/autonomous body (Rules
35, 36, 37 or 38)
(f) Invalidation on medical grounds (Rule 39)
(g) Compulsory retirement (Rule 40) (h) Dismissal/Removal from service (Rules 24 and 41)
5.A. In the case of compulsory retirement, the orders of the competent authority whether pension may be allowed at full rates or
at reduced rates and in case of reduced rates, the percentage at which it is to be allowed (Please see Rule 40)
5.B.In case of removal/dismissal from service, whether orders of competent authority have been obtained for grant of
compassionate allowance and if so, at what rate (Please see Rule 41)
6. Military service, if any :-
(a) Period of military service (b) Terminal benefits drawn/being drawn for military service
(c) Whether opted for counting of military service towards civil pension (Rule 20)
(d) If answer to (c) above is in the affirmative, whether the terminal benefits have been
refunded
7. Service in Autonomous body/State Government, if any :-
(a) Details of service : Name of organisation Post held
Period of service From To
(DD/MM/YYYY) (DD/MM/YYYY)
(b) Whether the above service is to be counted for pension in the Government
(c) Whether the Autonomous Organisation has discharged its pensionary liability to the Central Government

8. Whether any departmental or judicial proceedings are pending against the retiring Government servant. If yes, particulars of
Memorandum of charges/suspension order/criminal case may be indicated.( In terms of Rule 8, provisional pension will be
admissible and gratuity will be withheld till the conclusion of departmental or judicial proceedings and issue of final orders
thereon.)

9. Details of Service
(a)Period of service From To Total duration of service
(b)Details of omission, imperfection or deficiencies in the Service Book which have been ignored [under Rule 57(1) (b)(ii)]
(c) Period not counted as qualifying service :-
(i) Boy service (2nd proviso to Rule 11)
(ii) Extraordinary leave not counted as qualifying service (Rule 21)
(iii) Periods of suspension not treated as qualifying service (Rule 23)
(iv) Interruptions in service [Rule 27 (1) (b) and Rule 28 (c)]
(v) Periods of foreign service with United Nation Bodies for which no pension contributions are payable/paid (Rule 29)
(vi) Any other period not treated as qualifying service (give
details)

(d) Additions to qualifying service :-

(i) Civil service (Rule 19) (ii) Military service (Rule
20)
(iii) Benefit of service in a State Temporary Status service
Government or Autonomous Body (Rule 15)
(Rule 13/Rule 14)
(e)Net qualifying service(a – b – c + d)
(f) Qualifying service expressed in terms of completed six monthly periods (Period of three months and above is to be treated as
completed six monthly period (Rule 44 and Rule 45)

10. Emoluments :-
(a) Emoluments in terms of Rule 31
(b) Emoluments during ten months From To
preceding retirement- (DD/MM/YYYY) (DD/MM/YYYY)
From Date To Date Basic Rate NPA Other pay Basic pay for the purpose of Average
Emoluments (including NPA)

Note : If the officer was on foreign service immediately before retirement, the emoluments which he would have drawn under
Government but for being on foreign service may be mentioned in items (a) and (b) above (Rule 31)
.
(c) Average emoluments (Rule
32)
(d) Emoluments or average emoluments (whichever is higher) to be reckoned for pension (Rule 44)
(e) Emoluments reckoned for retirement gratuity [(a) or (c), whichever is higher] (Rule 45)
(f) Pay reckoned for family pension [(a) or (c), whichever is higher] (Rule 50)
11. Proposed Pension Details:-
(a) Proposed pension / service gratuity (Rule 44)
(b) Proposed dearness relief on pension (as on the date of
retirement)
(c) Date from which pension is to commence (Rule 81)
(d) Date from which Date upto which Amount of
provisional pension under provisional provisional
Rule 62 being paid, if any. pension is pension being
sanctioned by paid (per
HOO month)
12. (a) Amount of retirement gratuity (Rule 45)
(b) Amount of Provisional gratuity paid under Rule 62, if
any
13. Details of Government dues recoverable out of gratuity
(a) Licence fee for Government accommodation [see sub-rules (2), (3) & (4) of Rule 68]
(b) Dues referred to in Rule 69
(c) Amount indicated by Directorate of Estates to be withheld under sub-Rule (5) of Rule 68
14. Amount and Period of family pension : Amount
(a) Enhanced rate [Rule 50(2)(a)(iii)]
(b) Ordinary rate [Rule 50(2)(a)(i)]
Note: In the event of death of pensioner, the family pension at enhanced rate shall be payable for a period of seven years, or for
a period up to the date on which the retired deceased Government servant would have attained the age of 67 years had he
survived, whichever is less.
15. Name of the family member(s) to whom family pension is to be authorized in Pension Payment Order
a. Name of the Spouse
b. Percentage of family pension to be
paid to spouse, if the family pension
is to be shared with other members
of the family (e.g. children from a
wife who is not alive or children from
a divorced wife)
c. Names and relationship of other 1.
family members, referred to in (b) 2.
 above.
3.
d. Name of family member to be co-
authorised (i.e. disabled
child/dependant parent/disabled
sibling)
16. Whether Fixed Medical Allowance is Yes No Amount(₹ )
admissible
17. Commutation of pension :-
(a) Percentage of pension commuted
(b) Amount of monthly pension commuted
(c) Commuted value of pension
(d) Amount of residuary pension after deducting commuted portion
Post-retirement address of the retiree
e-mail ID, if any Mobile number
*Providing Aadhaar No. is voluntary. However, if it is provided consent to link it to Bank Account for authentication of identity
from UIDAI for pension related purpose only, is presumed.

Note: Commuted part of pension will be restored after 15 years from the date of retirement or payment of commuted value of
pension, whichever is later.
FORM 7- CHECK LIST FOR HEAD OF OFFICE FOR TIMELY PROCESSING OF RETIREMENT DUES

1. Whether retiring Government servant is an allottee of Government

accommodation
2. The date on which action initiated to obtain the 'No demand certificate from the
Directorate of Estates as provided in Rule 55.
3. Date of receipt of 'No Demand Certificate' from Directorate of Estates
4. Date on which intimation regarding any recovery/withholding of amount from gratuity
received from Directorate of Estates
5. If retiring Government servant is not an allottee of Government accommodation, date
on which ‘No Demand Certificate' issued by the office(DD/MM/YYYY)
6. Date on which a certificate regarding the length of qualifying service and the
emoluments/average emoluments proposed to be reckoned for retirement gratuity and
pension was provided to the Government servant. (DD/MM/YYYY)
7. Whether any objection received from the Government servant on the above
certificate
8. Whether the objection has been resolved to the satisfaction of Government
servant
9. Whether nominations made in common nomination forms for
(i) Death gratuity/retirement gratuity (ii)Payment under Central
Government Employees' Group
Insurance Scheme
(iii) Amount of General Provident (iv)Arrears of pension
Fund, if applicable
(v)Commuted value of pension (if applicable)
10.(i)Has the retiring Government servant worked in any of the organisations mentioned in sub-rule 4 of
Rule 7 of the Central Civil Services (Pension) Rules, 2021
(ii)If yes, whether an undertaking in Format 1 has been obtained along with Form 6 and placed on record
11. Whether name in ‘Pension Disbursing Authority’ i.e. Bank Account is tallying Yes No
with service records
12. Disbursement of commuted value of pension PAO Disbursing Authority
 PART-II
(Account Authorisation (by Accounts Officer)

Date of receipt of pension papers by the Accounts Officer from Head of Office(DD/MM/YYYY)
Entitlements admitted -
A. Length of qualifying service
B. Pension - (i) Class of pension (ii) Amount of monthly pension
(iii) Date from which provisional (iv)Amount of Provisional
pension under Rule 62 being paid Pension being paid
by Head of Office, if any.
(v) Date up to which (vi) Date from which regular pension
provisional pension to be is to commence
continued
Note 1 : The date from which the final pension shall be commenced by the Pension Disbursing Authority shall be at
least two months after the date of issue of the PPO, taking into consideration the time likely to be taken by CPAO and
CPPC to process the pension case. Pay & Accounts Office shall record a note in this regard in the PPO while authorizing
the final pension.
Note 2: The payment of provisional pension shall, accordingly, continue from the office till the date mentioned in the
PPO for commencement of final pension by the PDA.
Note 3: The HOO will draw and disburse the difference between the amount of pension finally assessed and the
amount of provisional pension. If the amount of pension finally assessed is less than the amount of provisional
pension, the difference will be adjusted from the amount of gratuity payable failing which, in instalments from pension
payable in future.
C. Commutation of pension -
(i) Portion of pension commuted, if any
(ii) Commuted value of portion of pension commuted, if any
(iii) Residuary pension after commutation
(iv) Date from which reduced pension is payable(DD/MM/YYYY)
(v) Date of restoration of commuted portion of pension (subject to the pensioner continuing to
live) (DD/MM/YYYY)
D. Retirement Gratuity -
(i) Total amount of gratuity
(ii) Provisional gratuity paid by Head of Office under Rule 62
(iii) Amount to be adjusted towards arrears of licence fee for Government accommodation and
licence fee for retention of Government accommodation beyond retirement [Rule 68(1) and
68(4)]
(iv) Amount intimated by Directorate of Estates for being withheld on account of unassessed
licence fee (Rule 68(5))
(v) Amount to be adjusted towards Government dues other than those pertaining to Government
accommodation (Rule 69)
(vi) Net amount to be released immediately
E. Amount and period of Family pension – Amount Period
(i) At enhanced rate
(ii)At normal rate
F. Name of the family member(s) to whom family pension is to be authorized in Pension Payment Order
(a) Name of the Spouse
(b)Percentage of family pension to be paid to spouse, if the family
pension is to be shared with other members of the family (e.g.
children from a wife who is not alive or children from a divorced wife)
(c) Names and relationship of other family members, referred to in (b)
above.

(d) Name of family member to be co-authorised (i.e. disabled

child/dependant parent/disabled sibling)

G. Head of account to which the amount of pension,

retirement/death gratuity and family pension are to be debited

Signature of Accounts Officer

 PENSION CALCULATION SHEET

1. Name 2. Designation
3. Date of birth 4. Level of pay in the pay
5. Basic pay
matrix
6 Date of entry in the Government 7.Date of retirement
service(DD/MM/YYYY) (DD/MM/YYYY)
8. Length of qualifying service reckoned for pension/gratuity(as indicated in
PPO)
9(a). Emoluments for pension
9(b). Emoluments drawn during the last ten months
9(c). Average emoluments
10. Emoluments or average emoluments, whichever is more beneficial for pension (as indicated in
PPO)
11. Pension admissible (if qualifying service is ten years or more) calculations to be shown as
follows :-
Emoluments or average emoluments/2
12. Emoluments for gratuity (as indicated in
PPO)
13. Retirement gratuity admissible: calculation to be shown as follows :-
Emoluments/4 x Qualifying Service (In completed six monthly periods, not exceeding 66.)
14. Pay for family pension (as indicated in Pension Payment Order)
15. Family pension admissible (calculation to be shown as follows) :-
(a) Ordinary family pension :
Pay x 30% (subject to prescribed minimum and maximum)
(b) Enhanced family pension:
Pay /2 (Subject to prescribed minimum and maximum)
16. Details of Commutation of Pension, If any
(a) The percentage of pension commuted
(b) Amount of monthly pension commuted
(c) Commuted value of pension
(d) Amount of residuary pension after deducting commuted portion
17. Amount of Fixed Medical Allowance, if admissible

Signature of the Head of Office

Countersigned by PAO
Copy to:- Shri/Smt./Kumari

……………………………………………………………… (Retired/retiring Govt.

servant)