FORM 3 [See rule 54 (12)] Details of Family 1. 2. 3. 4. Name of the Government servant Designation Date of birth Details of the members of family as on-----------------------: S. No Names of the members of family Date of birth Relationship with the officer Marital status Remarks (1) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. (2) (3) (4) (5) (6) Dated signature of Head of Office (7) I hereby undertake to keep the above particulars up-to-date by notifying to the Head of the Office any addition or alteration. Signature of Government servant Place : Date : Note 1. – The original Form submitted by the Government. 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 Government. servant should submit the details of family afresh along with Form 5. 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’ column. Note 4. - Wife and husband shall include judicially separated wife and husband.
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