GOVERNMENT OF INDIA (BHARAT SARKAR)
MINISTRY OF RAILWAYS/RAIL MANTRALAYA
(RAILWAY BOARD)

RAILWAY SERVICES (PENSION) RULES, 1993 - FORMS  

Subject :- STATEMENT SHOWING THE DETAILS OF THE MEMBERS OF THE FAMILY FOR PURPOSE OF FAMILY PENSION

"FORM 6

[See rule 75(15)(a)]

Details of Family

  1. Name of railway servant
  2. Designation
  3. Date of birth
  4. Details of the members of family as on......................................
  Names of the members of family Date of birth Relationship with the officer Marital status Remarks Dated signature of Head of office
(1) (2) (3) (4) (5) (6) (7)
1.            
2.            
3.            
4.            
5.            
6.            
7.            
8.            
9.            
10.            

I hereby undertake to keep the above particulars up-to-date by notifying to the Head of the Office any addition or alteration.

Place;    
    Signature of railway servant;
    Date:

Note 1. -The original Form submitted by the railway servant is to be retained. All additions/ alterations are to be recorded in this Form under the signature of Head of Office in Col 7. No new Form will substitute the original Form. However, the retiring railway servant should submit the details of family afresh along with Form 8.

Note 2. -The details of spouse, all children and parents (whether eligible for family Pension or not) and disabled siblings (brothers and sisters) may be given.

Note 3. -The Head of Office shall indicate the date of receipt of communication regarding addition or alteration in the family in the 'Remarks' column. The fact regarding disability or change of marital status of a family member should also be indicated in the 'Remarks'

Note 4. -Wife and Husband shall include judicially separated wife and husband."

Form 6 substituted vide Railway Board's letter No. 2015/F(E)III/1(1)/4 dated 17.06.2016 (RBE 70/2016)

FORM 6

[See Rule 75 (15)(a) ]

STATEMENT SHOWING THE DETAILS OF THE MEMBERS OF THE FAMILY FOR PURPOSE OF FAMILY PENSION

1. Name (Block letters)   ..................
2. Designation   ....... Branch ........
3. Office   ..................
4. Date of birth   ..................
5. Date of appointment   ..................
6. Details of family as on   ..................

 

Sr. No. Name of members of family Relationship with the railway servant Date of birth (By Christian era) Whether the child is physically handicapped Remarks
1.          
2.          
3.          
4.          
5.          
and so on        

I declare that the information given above is correct. I hereby undertake to keep the above particulars upto date by notifying to the Head of Office by addition or alteration.

 

Station ...........   ............
Dated .............   Signature of Railway Servant
  Witness  
Signature .........
Date ...........
Name (Block Letters)  ......
..............
Designation .........
Office ........

 

Countersigned      
  Head of Office/Accounts Officer
Station ...................    
Dated .............  Designation ........
Detail of the Letter / Codal / Manual Provisions