CERTIFICATE OF NON-RE-MARRIAGE

CERTIFICATE OF NON-RE-MARRIAGE

I hereby declare that I have not been re-married and I undertake to report such an event promptly to the Pension Disbursing Authority / Bank.

Place:  _________

Date:   _________

      Signature:

Name of the Pensioner:

I certify to the best of my knowledge and belief that the above declaration is correct.

Place: _________

Date: _________

 

Signature of a responsible Officer or a well – known Person

Name: _________    
 Designation: _______

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