VIJAYA BANK
Branch :
APPLICATION FOR DRAWAL OF PENSION THROUGH PUBLIC SECTOR BANKS

To,
 
Dear Sir,
I opt to draw my pension through a Public Sector Bank and give below necessary particulars to enable you to make arrangements in this regard.

Sl. No Particulars Information
1.
Particulars of pensioner
Name :
Pension Payment Order No :
Treasury Serial No :
Personal Serial No :
Present Address :
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
2.
Particulars of Public Sector Bank
Name :
Branch, where payment is desired :
Pensioner's Savings Bank / Current Account No (Not joint account) :
__________________________________________
__________________________________________
__________________________________________
__________________________________________
3.
Specimen Signature :
1.
2.  
3.  
 
I am aware that the pension sanctioned to me is subject to review by the President and that it is liable for cancellation or modification without notice, if it is found that it was sanctioned on mistaken grounds or on false information.
 

Yours faithfully,

 
(SIGNATURE)

Place:
Date: