GROUP INSURANCE SCHEME FORM GIS – E (Vide Rule 12)

Register for Watching the Recovery of Subscriptions towards Group Insurance Scheme from Employees on Leave Without Allowances, Suspension, Deputation, Foreign Service, etc. Name of the Employee with Sl. No. Designation and Account Number (1)

(2)

Group and Rate of Subscription

Month upto which Recovery has been Effected

(3)

(4)

Details of Remittance Details of Leave If transferred, Without Allowances, Details of T.R.5 Amount whether noted Deputation, Foreign Receipt/Chalan/ in the LPC Remitted (` ) Service, Suspension etc. Cheque with date (5) (6) (7) (8)

Remarks

Note: 1. Each member on L.W.A/Foreign Service/Deputation/or under suspension should be assigned a separate page. 2. In respect of Chalans, the number, date, head of account and name of the treasury should be noted. The chalans should be got verified with reference to the receipt schedule of the treasury.

(9)

GROUP INSURANCE SCHEME

Register for Watching the Recovery of Subscriptions towards Group Insurance Scheme from Employees on Leave Without Allowances,. Suspension, Deputation ...

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