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    Canteen Id Card Form

    Uploaded by

    Er Arul Prakash
    This document is an application form for a canteen identity card. It requests information such as name, rank, department, address, family members, and ceiling slab based on salary. The instructions explain how to fill out the form correctly, including attaching photos and payment. The form and instructions provide the necessary information for employees to apply for a canteen identity card to receive discounts at canteens.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Canteen Id Card Form

    Uploaded by

    Er Arul Prakash
    697 views2 pages
    This document is an application form for a canteen identity card. It requests information such as name, rank, department, address, family members, and ceiling slab based on salary. The instructions explain how to fill out the form correctly, including attaching photos and payment. The form and instructions provide the necessary information for employees to apply for a canteen identity card to receive discounts at canteens.

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    Original Title

    CANTEEN ID CARD FORM

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    This document is an application form for a canteen identity card. It requests information such as name, rank, department, address, family members, and ceiling slab based on salary. The instructions explain how to fill out the form correctly, including attaching photos and payment. The form and instructions provide the necessary information for employees to apply for a canteen identity card to receive discounts at canteens.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    697 views2 pages

    Canteen Id Card Form

    Uploaded by

    Er Arul Prakash
    This document is an application form for a canteen identity card. It requests information such as name, rank, department, address, family members, and ceiling slab based on salary. The instructions explain how to fill out the form correctly, including attaching photos and payment. The form and instructions provide the necessary information for employees to apply for a canteen identity card to receive discounts at canteens.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    APPLICATION FOR THE CANTEEN IDENTITY CARD

    1 UNIT CANTEEN CODE NO & NAME


    (To be filled by the Canteen Manager)
    2 NAME OF THE EMPLOYEE ( IN BLOCK LETTERS)
    3 WHETHER SERVING/RETIRED/
    FAMILY/PENSIONER
    4 *GPF *CPS *PPO
    (* Please tick whichever is applicable and write your no)
    5 RANK &NO/DESIGNATION
    6 DEPARTMENT

    7 UNIT NAME
    8 CITY / DISTRICT/ BN., /SPECTAL UNIT
    9 DATE OF BIRTH (DD/MM/YY)
    10 DATE OF ENLISTMENT (DD/MM/YY)
    11 * DATE OF RETIREMENT (DD/MM/YY)
    12 DATE OF DEATH (DD/MM/YY)
    * In Case of family pensioner
    13 BASIC PAY GRADE PAY
    14 CELING SLAB * (Please tick whichever is applicable) SLAB-I SLAB-II SLAB-III SLAB-IV
    15 GENDER
    16 MARITAL STATUS MARRIED UNMARRIED WIDOW WIDOWER
    17 CUG MOBILE NO.
    18 E-MAIL I.D
    19 OFFICE ADDRESS

    20 PRESENT ADDRESS

    21 PERMANENT ADDRESS

    22 IF ON DEPUTATION, FURNISH THE PARENT


    UNIT & EXPIRY OF DEPUTATION
    23 NAME OF THE FAMILY MEMBER WITH RLATION
    SHIP

    I Certify that the information furnished above is correct and myself or any other member of my family has not been
    issued with Canteen identity card. I have read and understood the instructions relating to Canteen Identity Card. I am aware
    that I am liable for disciplinary action including cancellation of card without prior notice at any point of time, if the
    information furnished above is found incorrect.

    Signature of Applicant
    Certified that the information furnished above are correct as per records.

    Counter Signature of the Controlling Officer.


    In case of Retired / Deceased Employee, the unit canteen Manager may countersign the application where the Pensioner /
    Family Pensioner resides after verifying his identity and other particulars.
    Date:

    Place: Unit Canteen Manager’s signature & Seal


    INSTRUCTIONS:

     Fill up the application form in CAPITAL LETTERS

     Attach a copy of the Official ldentity Card / ppo with the application

     Passport size photograph of Govt Servant and Post card size photograph of the family should be attached
    in an envelope with the application. The photographs should not be pasted or stapled or attested. Please
    write the Name, Rank & No, place of serving and GPS/CPS/ PPO No. on the reverse-side of the photographs
    with marker pen.

     * Please indicate the category as per Rank :

    Slab – I - Ceiling PC to
    Monthly Annual HC/Havildars and Grade Pay below Rs.4800/-
    equivalent Rank
    Rs. 15,000/- Rs. 1,50,000/-

    Slab-ll - Ceiling SI/SSl to ADSP Grade Pay Rs.4801/- to Rs.6600/-


    Monthly Annual and equivalent
    Rs. 20,000/- Rs.2,50,000/- Rank

    Slab-lll - Ceiling
    Monthly Annual SP and Above and
    Grade Pay Rs.6601/- and above
    equivalent Rank
    Rs.30,000/- Rs.3,50,000/-

    Slab-lV - Ceiling DIG and Above Grade Pay Rs.6601/- and above
    Monthly Annual and equivalent
    Rank
    Rs.30,000/- Rs.4,50,000/-

     Filled up applications duly countersigned submitted to the Canteen Officer along with Rs. 125/- (One
    Hundred and twenty five only) per application.

     Canteen ldentity Card will be delivered to the applicant through the Canteen Managers from whom the
    application for l.D Card was received.

     Only one Canteen ldentity Card will be issued to the beneficiaries.

     Only the BENEFICIARY / Family member mentioned in the canteen Identity card is authorized to use the
    Card.

     The quantum of purchase is subject to the admissible purchase limits.

     Only the canteen ldentity Card holder or his/her family member is entitled to purchase the items at Tamil
    Nadu Police Canteens.

     Loss of the canteen ldentity card should be intimated to the respective canteen staff immediately and new
    Card will be issued only on payment.

     For any queries or clarifications regarding Canteen ldentity Card please contact 9884051976 /
    9884818074
    E-Mail : [email protected] or [email protected]

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