Application for funeral charges

APPLICATION FOR FUNERALCHARGES (SERVICE / PENSIONER)

To

The Sub Treasury Officer

Sir,

Ref :

i) G.O.Ms.No.504 dated 10-12-1998 and G.O.(P)No.250 Fin. dated 4-10-2005.

ii) G.O.Ms.No.102 Fin. (Pen-1) Dept., dated 6-4-2010.

I invite attention to the G.O.'s cited. My Wife / Husband/Father Smt./ Sri ..................retired on.............. drawing his/her through........ .branch under S.B. (Death Certificate / Proforma of Certificate of death in Form-ll enclosed).

Hence I request you to pay the death relief as ordered in G.O. and holder of PPO No........ pension from Sub Treasury...... ..bank...... A/c. ........expired on........ cited.

Yours faithfully

Address :