Part – I General Information
1. Name and present designation ……………………
2. Post held including name of establishment:
(i) Substantive ………..…
(ii) Officiating ……………
3. Any post, other than the present appointment, held during 6 months prior to the month in which
resignation is tendered ……………
4. Permanent residential address …………
Part-II Points to be checked up before accepting resignation
5. The date on which the Government servant wants to be relieved from service …………
6. (i) Whether any inquiry or investigation or disciplinary case is pending or contemplated ………….
(ii) Whether under suspension ……..…….
7. Whether the Government servant concerned has executed any Bond for serving the Government for a specified number of years on account of his being given specialized training, fellowship/scholarship
for studies or deputed for training whether in India or abroad, and if so, the Bond period is over …
8. Time required for filling up the post and/or making alternative arrangements
9. Authority competent to accept resignation, i.e., Appointing Authority ……
Part-III If the resignation is accepted, points to be checked up before relieving the Government servant
10. Whether alternative arrangements have been made for discharge of the duties of the post including arrangements for taking over charge of cash/stores in the custody of Government servant (wherever applicable) ……
Controlling Officer:
11. Whether the Government servant has surrendered and obtained ‘No Demand Certificates’ in respect of
(i) MHA/Departmental Identity Card ……
(ii) Library cards/Tokens of the Central Sectt. Library and/or Departmental Library, etc. ……
(iii) CGHS Identity card ……
(iv) Typewriters, brief-cases, cycles, Liveries, etc. (wherever applicable) ……
(v) Headgear set and locker in case of To and other tools in case of other cadres …...
12. Arrangement made for recovery of outstanding advances/loans, if any taken or any other category of
dues, viz., -
(i) Training allowance paid to the official ………
(ii) House Building Advance …… …… .…….
(iii) Advance for purchase of Motor Car/Motor Cycle/Scooter/Cycle …….
(iv) Festival Advance/Flood Advance …… …….
(v) Any other dues such as –
(a) Amounts due to be recovered from or settled by the employee in respect of money
/material entrusted to him in the course of his official duties in this or earlier post ……
(b) Recoveries ordered to be made as a result of disciplinary proceedings ……
13. whether the Government servant is in occupation of Government accommodation. If so, whether the
dues in respect of such accommodation (including electrical appliances, etc.) have been settled and a
No Demand Certificate obtained. ……
14. Whether accounts in respect of water and electricity charges in respect of Government accommodation held by the Government servant have been settled with the concerned Municipality/Corporation ……
15. In case where the Government servant has not been in occupation of any Government residential
accommodation during the service, whether ‘No Demand Certificate’ has been issued by the Ministry/ Department as required in Ministry of W.H. & R. Memo. No. 15-362-ACC. I, dated the 19th October, 1963 ……
16. Whether any cash deposit/security of sufficient value has been taken where it is not found possible to make a correct assessment of the dues immediately ……
17. Leave sanctioned to the official from previous half-year and any leave sanctioned extra, if so leave
salary paid. The Personal File and Service Book may also be forwarded
18. Any other section concerned ……
[Reference O.M. No. 24011/11/1/76-Estt. (B), dated the 17th May, 1976 G.I., M.H.A. (D.P. & A.R.)]
Source:www.pensionersportal.
1. Name and present designation ……………………
2. Post held including name of establishment:
(i) Substantive ………..…
(ii) Officiating ……………
3. Any post, other than the present appointment, held during 6 months prior to the month in which
resignation is tendered ……………
4. Permanent residential address …………
Part-II Points to be checked up before accepting resignation
5. The date on which the Government servant wants to be relieved from service …………
6. (i) Whether any inquiry or investigation or disciplinary case is pending or contemplated ………….
(ii) Whether under suspension ……..…….
7. Whether the Government servant concerned has executed any Bond for serving the Government for a specified number of years on account of his being given specialized training, fellowship/scholarship
for studies or deputed for training whether in India or abroad, and if so, the Bond period is over …
8. Time required for filling up the post and/or making alternative arrangements
9. Authority competent to accept resignation, i.e., Appointing Authority ……
Part-III If the resignation is accepted, points to be checked up before relieving the Government servant
10. Whether alternative arrangements have been made for discharge of the duties of the post including arrangements for taking over charge of cash/stores in the custody of Government servant (wherever applicable) ……
Controlling Officer:
11. Whether the Government servant has surrendered and obtained ‘No Demand Certificates’ in respect of
(i) MHA/Departmental Identity Card ……
(ii) Library cards/Tokens of the Central Sectt. Library and/or Departmental Library, etc. ……
(iii) CGHS Identity card ……
(iv) Typewriters, brief-cases, cycles, Liveries, etc. (wherever applicable) ……
(v) Headgear set and locker in case of To and other tools in case of other cadres …...
12. Arrangement made for recovery of outstanding advances/loans, if any taken or any other category of
dues, viz., -
(i) Training allowance paid to the official ………
(ii) House Building Advance …… …… .…….
(iii) Advance for purchase of Motor Car/Motor Cycle/Scooter/Cycle …….
(iv) Festival Advance/Flood Advance …… …….
(v) Any other dues such as –
(a) Amounts due to be recovered from or settled by the employee in respect of money
/material entrusted to him in the course of his official duties in this or earlier post ……
(b) Recoveries ordered to be made as a result of disciplinary proceedings ……
13. whether the Government servant is in occupation of Government accommodation. If so, whether the
dues in respect of such accommodation (including electrical appliances, etc.) have been settled and a
No Demand Certificate obtained. ……
14. Whether accounts in respect of water and electricity charges in respect of Government accommodation held by the Government servant have been settled with the concerned Municipality/Corporation ……
15. In case where the Government servant has not been in occupation of any Government residential
accommodation during the service, whether ‘No Demand Certificate’ has been issued by the Ministry/ Department as required in Ministry of W.H. & R. Memo. No. 15-362-ACC. I, dated the 19th October, 1963 ……
16. Whether any cash deposit/security of sufficient value has been taken where it is not found possible to make a correct assessment of the dues immediately ……
17. Leave sanctioned to the official from previous half-year and any leave sanctioned extra, if so leave
salary paid. The Personal File and Service Book may also be forwarded
18. Any other section concerned ……
[Reference O.M. No. 24011/11/1/76-Estt. (B), dated the 17th May, 1976 G.I., M.H.A. (D.P. & A.R.)]
Source:www.pensionersportal.
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