FORM No. 13

[Ad. G. From no. A.T.C.4]

(See paragraph (35) Section II of the Appendix ‘A’ at the end of Part III and Subsidiary Rule 135)



Sri / Srimati/Kumari...................................




(Please note them carefully)

(1) Entries regarding promotions etc. as and when they occur must be made and attested.

(2) See that in the case of government servants appointed in permanent pensionable establishment before April 1, 1965, their latest option in respect of the applicable pension/family pension rules is invariably posted in the service book. In addition to posting such declarations in service book all important events including options should also be recorded therein under proper attestation.

(3) See that the exact nature of officiating post (i.e., whether the Government servant was in a clear vacancy), is entered and the copies of orders showing the chain of arrangements are pasted in the Service Book (for the last three years of service).

(4) If the Government servant was on probation before confirmation, the Service Book should say so (Article 375. C. S. R.)

(5) In the case of officiating and temporary Government servants the certificate required to the effect that the Government servant concerned would actually have continued to officiate in the post but for his proceeding on leave should always be recorded in service book.

(6) See that the nature of service in the last three years is clearly indicated.

(7) See that the service is verified and recorded every year.

(8) At the time of sending pension papers to the Accountant General, U.P., see if the pay fixed in 1947/1965 scales has been checked by the audit party of Accountant General’s office, if not a statement showing the details of how the pay was fixed should be sent.

(9) In case of invalid pension, the certificate regarding acceptance of medical certificate may be given.

(10) If an official remains absent at the end of his sanctioned leave, it is open to the leave sanctioning authority either to extend the leave as may be admissible or to order regularisation of the period of overstayal in the manner prescribed in Fundamental Rule 73 read with the ‘Note’ thereunder.

If, however an official remains absent without leave, it is open to the leave sanctioning authority to commute retrospectively such period of absence into extraordinary leave, vide Fundamental Rule 85 (b) read with the orders of the Governor thereunder.

(11) All entries in the Service Book should be recorded in ink under proper attestation.

(12) Over-writings should be avoided scrupulously. Fresh entries may be made by cancelling the old entries in ink. These should invariably be attested by the competent authority.

(13) If a Government servant is unable to state his exact date of birth, but can state the year, or year and month of birth, the 1st July or the 16th of the month, respectively shall be treated as the date of his birth.


1. Name (In Block letters)...................................................

2. Nationality (if not a citizen of India, number and date of the certificate of eligibility granted by the Government of India).

3. If a member of a Scheduled caste or Scheduled Tribe, particulars of Caste/Tribe.

4. Address.

5. Father’s name (and also husband’s name in the case of married female Government servant) and address:

6. Date of birth by Christian era as nearly as can be ascertained.

7. Educational Qualifications

8. Exact height by measurement

9. Personal marks of identification

10. Signature of the Government servant

11. Signature and designation of the Head of Office or other attesting officer.



NOTE—The entries in this page should be renewed or re-attested at least every five years and signature in cols. 10 and 11 should be dated.






Provided Fund Account No. G.P.F.

State Insurance Policy No.


1. Name of appointment and scale of pay.

2. Whether substantive or officiating and whether permanent or temporary.

3. If officiating, here state the substantive appointment.

4. If officiating appointment was in a clear vacancy, state the chain of arrangement (Copies to be attached—see instruction 3).

5. The pay in permanent or temporary post held substantively, if any.

6. Pay for officiating appointment.

Other emoluments falling under the term ‘Pay’ such as special pay, etc.

7. Amount.

8. Rule under which granted and no. and date of G. O. (copy to be attached at the end in respect of last three years of service).

9. Date of appointment.

10. Signature of Government servant should be obtained whenever a change in appointment takes place and annually in every case.

11. Date of termination of appointment.

12. Reasons of termination (such as promotion, transfer, dismissal, increment etc.). In case of suspension, state the period of suspension and whether it will count for pension(copy of orders of competent authority under Articles 416-417, C. S. Rs. to be attached at the end).

13. Signature of the Head of the Office or other attesting officer verifying the entries in cols. 2 to 12.


14. Nature of leave taken.

Duration of leave:

15. From

16. To

17. Number and date of sanctioning order.

18. Signature of Head of the office or other attesting officer verifying the entries in cols. 14 to 16.

19. Remarks.

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