F O R M. O.A.P.-1
APPLICATION FORM FOR NATIONAL OLD AGE PENSION
Village/ Panchayat/ Mohalla/ Ward/ House No.
P.S ..District ..
4. Categories:- SC/ST/Woman/Landless/Handicapped/General .
(i) I do not have any family income of Rs. 5,000.00/- per annum or more
(ii) I have/have not applied previously for grant of old age pension under National Old Age Pension.
(iii) I am a resident of ..(District/State) where I have been residing during the three years immediately preceding the date of this application.
(iv) I declare that the information furnished in this application is true and correct to the best of my knowledge and belief.
Signature or Thumb impression
of the applicant.
(TO BE FILLED UP BY THE ENQUIRY TEAM)
Results of Preliminary Enquiry by the Village Panchayat level team.
Date .. Signature of verifying persons
at the village level panchayat
F U L L A D D R E S S
Note:- This application should be sent with full particulars to the B.D.O./ Panchayat Samity concerned.
RECOMMENDATION OF THE B.D.O. /MUNICIPAL COMMISSIONER.
Dated Signature of B.D.O./ Municipal
F O R M O.A.P.-II
Urban Local Body/ Gram Panchayatwise list of Application for National Old Age Pension.
F O R M O.A.P.-III
Urban/Local Bodies/Panchayat Samitiwise Register of sanctioned pensions.