ਪੰਜਾਬ ਸਰਕਾਰ ਵਲੋਂ ਤਰਸ ਅਧਾਰਿਤ ਨਿਯੁਕਤੀਆਂ ਅਧੀਨ ਸਰਕਾਰੀ ਸੇਵਾਵਾਂ 'ਚ ਰੋਜਗਾਰ ਦੇਣ ਸਬੰਧੀ ਪੱਤਰ 2002 ਦੀ ਸਕੀਮ ਸੋਧਾਂ ਸਮੇਤ
PROFORMA REGARDING EMPLOYMENT OF DEPENDENTS OF GOVERNMENT SERVANTS WHO DIE WHILE IN SERVICE/ RETIRED ON INVALID PENSION
PART-A
(b) Designation of the Govt. Servant ....................
(c) Whether is Group 'D' or not............................
(d) Date of birth of the Govt. Servant ..................
(e) Date of death ................................................
(f) Total length of service rendered ......................
(g) Whether permanent or temporary ...................
(h) Whether belonging to SC/ST/OBC .................
II. (a) Name of the candidate for appointment
(b) His/Her relationship with the Govt. Servant .....
(c) Date of birth .................................................
(d) Edu. Qualifications ........................................
(e) Whether any other dependent family member has been appointed on compassionate grounds. .....................................................
(b) D.C.R. Gratuity ...........................................
(c) G.P.F. Balance ...........................................
(e) Moveable and Immoveable properties and- annual income earned therefrom
by the family .................................
(h) Any other assets ......................................
TOTAL ..................................... .............
V Particulars of all dependent family members of Govt, servant (if some are employed, their income and whether they are living together or separately)..................................................
| Sr. No. | Names(s) | Relationship with the Govt. Servant | Age | Address | Employed or not (if employed particulars fo employment & emoluments) |
| 1 | |||||
| 2 | |||||
| 3 | |||||
| 4 | |||||
| 5 |
VI.
1. I, hereby declare that the facts given by me above are to the best of my knowledge, correct. If any of the facts herein mentioned are found to be incorrect or false at a future date, my services may be terminated.
I hereby also deciare that I shall maintain properly the other family members, who were dependent on the government servant/ member of the, Armed Forces mentioned against (a) of this form and in case it is proved at any time that the said family, members are being neglected or not being properly maintained by" me, my appointment may be terminated.
| Date:............... | Signature of the candidate |
| Name............................... | |
| Address............................. |
| Date:............... | Signature of permanent Government servant |
| Name............................... | |
| Address............................. |
| Date:............... | Signature of the Officer Incharge |
| Name............................... | |
| Address............................. |
Information/documents to be supplied by the candidate seeking employment on compassionate grounds.
| Sr. No. | Category required | Information/documents |
| 1 | A dependent member of family of bread winner killed or 100% physically disabled in terrorists violence/ by security forces acting in aid of Civil Power in the State. | i) A certificate of death/100% physical disability with the death or 100% physical disability occured certifying thatit was as a result of terrorists Bettor security forces acting In aid of Civil Power to be issued by the Deputy Commissioner –in whose territorial limits as the death or 100% physical disability occured (to be supported by a certificate of the Chief Medical Officer concerned.) ii) An affidavit duly attested by 1st Class Magistrate to corroborate the fact that the person being employed is in fact a dependent member of the family of the breadwinner killed or 100% physically disabled,iii) Name of all dependents, their occupation and reasons in support of the claim of the person being appointed viz-a-viz other dependents should be brought on the record, |
| 2 | A dependent member of deceased govt, employee. | i) Name of the deceased Govt. employee full particulars of rank, pay nature of post pensionable or not held by the deceased Govt, employee from the . department concerned, ii) Certificate of death and in case of death due to terrorist violence, certificate of death giving full details of circumstances under which, the death occured and also certifying that it was as a result of terrorist action to be obtained from the Deputy Commissioner of the Distt. wihtin territorial limits of which the death occured. iii)An affidavit duly attested to corroborate the fact that the person being employed is a member of the family of the deceased Govt, employee/officer and,, was dependent upon him/her. iv) Names of all dependents, their occupation reasons in support of claim viz-a-viz other dependent should be brought on record.v) An, affidavit from the applicant and other dependents that none of them has already obtained appointment under this priority scheme. |
| 3 | Disabled Ex- servicemen | Proof from military authorities of being disabled and not being unfit from civil service. |
| 4 | A dependent member the family of the defence Services Personnel:a) Killed in service while performing duties.b) Who are severely disabled and are totally unfit for re-employment. | i) A certificate from the Military Authorities about the fact that the Defence Services Professional concerned was killed in service while performing duties or was serverly disabled and is totally unfit for reemployment. ii) An affidavit duly attested to corroborate . the fact of being widow or dependent of a Defence Service Personnel concerned. iii) If a candidate is a dependent of a Defence Service personnel killed in service while 'performing duties or severely disabled in -the Army then the " following details may also be furnished, iv) Names of all dependents, their age, their occupation, reasons in support of claim viz-a-viz other' depdendents.v) An affidavit from the applicant and the other dependents that none of them have already obtained appointment under the priority scheme. |
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