FORM No. 42-D

(See Chapter XVIII, paragraph 385)
 

Family Pension Fund

  

Schedule of deduction on account of the		  

realized

 

Widows and Orphans Fund

  

during the month of* 19 , through the

Ledger folio†

Office through which paid‡

Subscribers

Wife

Son

Daughters

Unmarried subscription

Payment on account of insurance or passage money

Interest on passage money premia

Total

Remarks.

Name

Designation

Period of pay bill

Promotion donation

Marriage donation

Excess age donation

Disparity donation

Subscription

Donation

Subscription

Donation

Subscription

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

Rs p

Rs p

Rs p

Rs p

Rs p

Rs p

Rs p

Rs p

Rs p

Rs p

Rs p

Rs p

Rs p

*Month of realization.

†For use in the Fund section.

‡Accountant General will use this column for entering the names of the Treasuries.

Station———

Signature———

Date———19 .

Designation———

NOTE—Separate lists should be rendered for deduction on account of Indian Military Service Family Pensions of the old Presidencies.