12 From The Chief Secretary to Govt. Haryana, Defence Branch ...

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17Sanction No.ANNEXURE ‘C’DatedApplication performa for sanction of One time Monetary grant in lieu of land to Pre-1.7.1985awardees/family of awardees.( To be submitted in Duplicate )1. (1) Ex. No. ___________________ Rank ________________________Name ___________________ S/o Sh.________________________Name of Regiment/Battalion ______________________________Date of enrollment in Defence Service____________ Date of Discharge ___________2. Name of the claimant __________________ Relation with the awardee____________Date of Marriage with awardee (for awaradee’s widow only) _____________Date of death of the awardee _____________ (attach proof)3. (1) Home address of the awardee at the time of award /citation (Attach proof)__________________________ _________________________________________________ _______________________(2) Present Home address of the awardee/claimant (Attach copy of Ration Card andDomicile certificate issued by competency authority_________________________ ________________________________________________ _______________________4. (i) Name of Award/ Medal _______________________Date of Notification / Award_______________________(Attach copy of Notification with original citation)
18-2-(ii)Names of other gallantry awards earned _______ Date of Notification/Award ________Dated ____________Signature of applicant5. Whether any monetary grant in lieu of land has earlier been sanctioned/paid by theRSB/ZSB in any case of the awardee for any other award _____________6. Certified that above contents have been checked by me personally and verified as perrecordsDated ____________Signature of Welfare OrganizorName of Welfare Organizor7. I have checked the contents of the application to my personal satisfaction and thecase is recommended for monetary grant to the applicant.8.Date _____________ Secretary Zila Sainik Board_________Despatch No. _____________ Dated ______________ToSecretary,Rajya Sainik Board, Haryana,Panchkula.
Page 3 and 4: 14ANNEXURE-A(refer to para 4 of let
Page 5: 16ANNEXURE ‘B’Check List for ca

12 From The Chief Secretary to Govt. Haryana, Defence Branch ...

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