SUPPLEMENTARY GAZETTE ON STAFF BENEFIT …scr.indianrailways.gov.in/cris//uploads/files/...SOUTH...

SOUTH CENTRAL RAILWAY

SUPPLEMENTARY GAZETTE ON

STAFF BENEFIT FUND

2013-14

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12.12.13

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SOUTH CENTRAL RAILWAY HEAD QUARERS STAFF BENEFIT FUND

Headquarters Office, Personnel Branch,

Secunderabad–500 071. STAFF BENEFIT FUND – SCHEMES ADOPTED FOR THE F Y 2013-14

No. SCR/P-HQ/456/17 – Subject to modification from time to time and availability of funds, the schemes approved by the South Central Railway HQ SBF Committee for the FY 2011-12 are enumerated in this booklet. The Staff Benefit Fund is managed by a Committee comprising the following:

S.No. Designation of the Officer Position in the HQ SBF Committee

01 Chief Personnel Officer Chairman

02

Dy. Chief Personnel Officer (W & Res.)

Secretary

03

Principal Chief Engineer (Open Line)

Member from the Official Side

04

Chief Medical Director Member from the Official Side

05 AO/XP, Representative from Accounts Dept.

Member from the Official Side

In addition to the above, the following members represent the recognized labour on the Committee:

S.No. Name & Official Designation of the representative

Organization represented

Mobile Number of the representative

01 M. Bharani Bhanu Prasad OS, PCE/OL/O/SC

S. C. R. E. S. 9848545044

02 Ch. Hari COS, GM/STT/O/SC

S. C. R. E. S. 9908694283

03 M. Uma Nagendramani Matron, Sr. MS/HU/CKL

S. C. R. E. S. 9848356711

04 G. N. Srinivasa Rao, BSR/EE

S. C. R. M. U

9440336301

05 S.Sreedhar Ch.OS, CCM/O/SC

S. C. R. M. U 9346666024

06 G.Udaya Bhaskar Rao OS, COS/O/SC

S. C. R. M. U 9866199714

The South Central Railway Central Staff Benefit Fund provides the following benefits to its Group ’C’ & ‘D’ employees: A. EDUCATION:

S. No

Scheme Eligibility Amount of

grant eligible

Application to be made In Proforma

EDUCATION

01 Advance for prosecuting Correspondence Courses

All Group ‘C’ & ‘D’ employees prosecuting a correspondence course offered by: B.I.E.T. Mumbai/ ICWA Kolkata/Institute of Rail Transport and Management/NDLS / Technical Education & Material Management in the evening colleges

Limited to the amount of Fee payable.

‘A’

02 Scholarship for Technical Education -Degree courses

Wards of Railway employees pursuing any of the following degree courses M.B.B.S/B.D.S/B.V.Sc/ BHMS/or MBS/BAMS/BUMS B.E., B. Tech., B.Arch., Bachelor in Environment Planning/ CA / ICWA MCA, BCA, MBA M.Sc- All Branches B. Pharmacy, BPT B.Sc - Agriculture, Home Science, Computers, Bio-Technology, IT, Horticulture, Nursing, Micro- Biology B. Com- (Computers) and Diploma courses exceeding one year duration.

`1200 per month/ `14400 per annum (or) the actual fee paid whichever is lower.*

‘B’ (Bank Account details of the scholar child to be furnished)

A

Girl Children of employees in GP 1800*

B

Boy Children of Railway employees in GP 1800*

`1000 per month/ `12000 per annum (or) the actual fee paid whichever is lower*

*See noted 1 below.

S. No

Scheme Eligibility Amount of grant eligible


C Children of employees in GP `1900/- and above.

Same as above except the diploma courses for which item 2 below applies.

`5000/-** per annum

‘C’

D

Technical Scholarship Diploma courses (for employees in GP `1900 and above).

Diploma in Engineering / Medicine/ Technology/ Architecture/ Environment /Planning

`1200/- per annum

‘D’

Scholarship amounts in regard to S. Nos. 1(c) and 1(d) would be made through the salary of the parent employee

Note: 1.*The schemes have been announced by the Railway Board in the SBF Grants for the FY 2010-11 and entail payment of scholarships into the Bank Account held by the scholar child. 2. **The scholarship would be payable @ `7500/- per annum or the fee paid, whichever is lower for courses in Engineering, Pure Medicine, MBA and MCA. In regard to all other courses, the scholarships would be `5000/- per annum or the fee paid, whichever is lower. The following are the conditions governing the grant of scholarship:

a) The applications should invariably be made in Proforma ‘B’, ‘C’ or ’D’ as the case may be.

b) The application should be made for the year of study the student is prosecuting during the academic year for which the notification has been issued.

c) The attested copy of mark list of the QUALIFYING EXAM should be enclosed to the application, for eg. The qualifying exam for Ist year Technical Degree courses would be INTERMEDIATE and for the subsequent years of study, the exam passed in the previous years and so on.

d) A ward should have successfully PASSED all the subjects in the qualifying exam to be considered for grant of scholarships.

e) The employees should mention their community viz. SC/ ST/OBC/Minority/UR etc.,.

f) The Rate of Pay, Pay Band, Grade Pay, and PF number should also be mentioned in the application.

g) Application with INCOMPLETE details shall stand rejected.

h) The scheme is open to all the Children/Dependents of a Railway employee who prosecute any of the courses mentioned in para 5 supra. In other words, the grant of benefit under the scheme is not limited to one child at a time.

i) Applications should be made to the Chairman of the HQrs. / Divisional /Workshop SBF Committee under whose jurisdiction the employee is working, once the notification in this regard is issued by the HQrs.,/Division/Workshops.

S. No



03

Cash award for meritorious students *see NOTE below

To all the children of Railway employees who come out in first to tenth ranks in the Common Entrance Examination and obtain 10% CGPA in SSC/CBSE/ICSE Exams.

`5,000/-

‘E’ To all the children of Railway employees who secure a GOLD MEDAL in the terminal exams at UG/PG level.

`20,000/-

NOTE: Applications for grant of Cash Awards for meritorious students should be made as and when the results are notified. Belated cases would not be considerecd.

(B) Grant to Railway Schools for Academic/Proficiency and Sports prizes:

With a view to inculcate a spirit of competition amongst the children of Railway employees studying in Railway Schools, the Chairman of Divisional SBF Committee shall sanction annual grants to each school on pro-rata basis of `10/- per child to award proficiency prizes and sports prizes from the fund provided as per budget allotment for Colleges at the rate of `25/- per child is provided to award proficiency prizes and sports prizes.

B. RECREATION & AMUSEMENT The SBF provides for the following towards recreation & amusement:

01 Children’s Camp Each Division/ Workshop/HQrs. shall conduct a camp once in a year, for children of Group’ C’ & ‘D’ employees who are aged between 12-15 years. The HQ SBF shall provide `2,00,000/- to each unit for conduct of the camp.

02 Employees Camp Each Division/ Workshop/HQrs shall conduct, once in a year a camp for its Group ’C’ &’D’ employees. . The HQ SBF shall provide ` `3,00,000/- to each unit for conduct of the camp. NOTE: The Camp for Differently Abled Employees would continue to be held on a Zonal Basis by the HQ Unit.

03. Grants from SBF to Cultural Activities: For promotion of Fine Arts and Cultural Activities, the SBF Committee considers and entertains the request for grants to cultural programmes. Applications for such grants should be submitted to the Chairman, HQrs. SBF Committee who will award grants judiciously for promoting cultural activities. 04. Handicraft Centres:

Handicraft centres function at the following places on S.C. Railway.

Sl.No. Name of the Division

Number of Centers

Located at

01 Secunderabad Division – 12

12 KZJ Diesel Colony, KZJ Station Colony, DKJ, VKB, BPA, Lalitha Nagar Colony, SC, R.K.Nagar,Colony, RDM, MFT, STPD, MLY, BDCR.

02 Hyderabad Division -09

09 Mahila Mandal/North Lallaguda, CKL, Rifle Range/SC, KCG, MBNR, KRNT, NZB, Bolarum, Mallikarjuna Nagar.

03 Vijayawada Division 09 Loco Shed Colony/BZA, UP Yard Colony/BZA, Traffic Colony/BZA, STPM, RJY, BVRM, BPP, OGL, Tuni.

Sl.No. Name of the Division

Number of Centers

Located at

04 Naned Division 04 PAU, J, AK, AWB, NED

05 Guntur Division. 03 Sanjeevanagar Colony/GNT, NDL, DKD

06 LGD Workshop 01 Lallaguda

07 Guntupalli Workshops

01 Guntupalli

08 CRS/TPTY 01 Tirupati

Total Centres

40

Each Handicraft centre is equipped with sewing machines and is manned by a qualified instructress.

The family members of the Railway employees who attend these centres are given training in the art of cutting, sewing, embroidery etc., in convenient batches. After they get sufficient training they are entrusted with the work of stitching garments received from the Stores Department, such as staff Uniform, school Children’s Uniforms, Hospital staff dresses, Banners Flags, Licensed Porter Uniforms, Pillow Covers, Mosquito Curtains are some of the items which are exclusively entrusted to the Handicraft Centres for Stitching. The stitching charges for these uniforms are distributed among the members of the centres according to the number of garment stitched by them. The family members of the Railwaymen have therefore, an opportunity in not only learning a useful trade during their spare time but also supplementing their family income by attending these centres.

The Staff Benefit Fund Committee sanctions funds for honorarium to the Instructress for the maintenance of the Handicraft Centres based on their membership. The rates w.e.f. 01.07.2006 are as under:-

(a) below 40 members `700/- p.m. (b) 40 members and above `1000/- p.m. per centre.

The honorarium to the Instructress shall be sanctioned by the Divisional/Workshop Staff Benefit Fund Committee under whose jurisdiction the HCCs’ function. The Chairman of the Division/WS SBF Committees should submit half yearly reports on the working of these centres to the Chairman, Headquarters SBF Committee during the first week of April and October every year without fail.

C. RELIEF OF DISTRESS AND SICKNESS The SBF provides for the following towards relief of distress and sickness:

S. No


Application to be made in Proforma

01 Maintenance Grant

All Gr.”C” & “D” employees irrespective of their pay and nature of disease, subject to the sickness in Govt./Rly Hospital exceeding 15 days on LWP

`3000/- per month

‘F’

02 Medical Assistance

All Gr.”C” & “D” employees who themselves/their family members suffer from major diseases and chronic diseases involving major operations, on recommendation by Rly medical authorities.

`2000/- per month for a maximum period of 3 months.

‘G’

03 Reimbursement towards cost of spectacles

All Gr.”C” & “D” employees who are required to wear spectacles for the better performance of their official duties. Periodicity (i) for employees below 45 yrs—once in 3 yrs ii) for employees above 45 yrs-once in 2 yrs

Actual cost or `800/- whichever is less.

‘H’

04 Reimbursement towards cost of Dentures

All Gr.”C” & “D” employees who have gone in for dentures for self, on the recommendation of the Railway Dental Surgeon.

Actual cost or `10,00/- whichever is less.

‘O’

05

Financial Assistance towards procurement of Artificial Limbs

All Group ‘C’ & ‘D’ employees suffering from disability of lower limbs of 50% and above.

Amount to be decided by the Chairman, HQ SBF Committee & CPO on a case by case basis. Application should be made in Proforma ‘P’

S. No



06

Promotion of Girl child and adoption of Small family norms (effective from 22.10.2004)

For employees who themselves/their spouses adopt small family norms after begetting i. One girl child

`10,000/-

‘M’

ii. One male child or two girl children

`5,000/-

07

Assistance towards funeral expenses for the families of those Employees who died in Rly / Referral Hospitals while undergoing treatment * see NOTE ‘d’ below

a) Families of deceased employees who are locally situated (within 100 KMs).

`5,000/-

‘L’

b) Families of deceased employees who are situated at Out stations (beyond 100 KMs)

`10,000/-

NOTE: a. Applications in regard to benefits under schemes at S.Nos. 01 to 03 should be made to the Chairman of the HQ/Divn/Workshop SBF Committee under whose jurisdiction the employee works.

b. Applications for grants under schemes under S.Nos. 04 and 05 should be made to the Chairman of the Divisional/Workshop SBF Committee who shall after a due scrutiny forward the ELIGIBLE CASES for obtaining the sanction of the Chairman, HQ SBF Committee & CPO.

c. The funds for grants to families of employees who die while undergoiung treatment at the Railway/Referral Hospital shall be placed at the disposal of the MD/CH/LGD, in regard to SC area and the CMS/BZA, GNT, GTL, NED, in regard to the Divisional Hospitals, who shall grant the amount to the family member of the deceased, after duly following the procedures.

d. Application for Maintenance Grant should be made within 03 Months from the date of resuming duty after the sickness. Maintenance Grant will be admissible for maximum period of 12 months. Individual cases requiring assistance for a longer period beyond 12 months should be referred to the Secretary, Headquarters SBF Committee, duly recommended by the medical authorities for consideration by the Chairman, Headquarters SBF Committee & CPO on the merits of each case.

NOTE: Employees suffering from T.B. and undergoing treatment as in patients in Sanatoria should be granted maintenance grant by the Headquarters/Divisional/Workshop SBF Committee even beyond 12 months on application by the employee duly recommended by concerned DMO’s certifying the nature of sickness as T.B. and recommending the cases even for period beyond 12 months subject to availability of funds.

D. Training for developing Occupational Skills of Physically/Mentally Challenged wards of Railway Employees and Financial Assistance to Differently Abled Sportsperson Employees to participate in National/Inter-National Tournaments The SBF provides for the following schemes under the above head:

S. No

Scheme ELIGIBILITY NORMS Amount of Grant Eligible


01

Financial assistance to children of Rly employees suffering from disabilities

A) Deaf, Dumb, Blind, Mentally challenged children of Rly employees attending special schools irrespective of the number of such children to cover tuition fee/transport.

`1000/- per month per child irrespective of the actual amount spent.

‘I’

B) Physically challenged children attending normal school-studying in Class I-X upto 3 such children for the expenditure incurred towards transport from residence to school and back.

`500/- per month per child irrespective of the actual amount spent.

‘J’

S. No

Scheme ELIGIBILITY NORMS Amount of Grant Eligible

02

Financial Assistance to Differently Abled Sportsperson Employees participating in Inter-National Tournaments

Available to Differently Abled Sportsperson Employees participating in Inter-National Tournaments.

To be decided by the Chairman on a case by case basis.

The Full Committee have also formulated the following guidelines for grant of assistance under the above scheme:

(a) The grant under the scheme for a differently abled sportsperson participating in International Tournaments would be granted, in advance, only in regard to the first instance.

(b) A subsequent grant would be available as “Re-imbursement” and limited to only such of those sportsperson who achieve a position/medal.

E. INDIGENOUS SYSTEM OF MEDICINE The SBF provides for the following under the head “Indigenous System of Medicine”:

S. No Scheme Eligibility

Amount of grant eligible

1

Treatment in Naturopathy from a Hospital/Institute recognised by the State Government for Re-imbursement of medical expenses

All Group ‘C’ & ‘D’ and their family members who are covered under Railway Servants (Pass) Rules (Once in a Life Time Affair)

50% of the cost incurred subject to a maximum of `5000/-

‘N’

The salient points of the scheme are be as under: [

The Scheme would be controlled by the Headquarters Staff Benefit Fund Committee.

The treatment would be available to the Railway employees and their family members covered under Railway Servants (Pass) Rules.

The treatment would be “Once in a Life Time affair”

The treatment can be had in any Hospital/Institute, recognized for Reimbursement by the State Government, which gives treatment in Naturopathy.

A re-imbursement to the extent of 50% of the cost incurred, subject to a maximum of ` 5000/-(Rupees Five Thousands only) shall be available

Applications for re-imbursement may be made to the Chairman, Divisional/Workshop SBF Committee & the Sr. DPO/WPO after availing the treatment, who shall after due scrutiny forward the eligible cases for obtaining the sanction of the Chairman/Vice-Chairman, HQ SBF Committee. The ORIGINAL BILL should invariably accompany the application.

02 Homeo clinics. Available at the following hospitals: CH/LGD; RH/KZJ; RH/GTL; RH/GY; RH/BZA.

03 Ayurvedic clinic Available at CH/LGD.

In regard to the functioning of the Clinics under S.Nos.02 & 03 above, the SBF provides for payment of Honorarium to the Physician and the Helper as also re-imburses the cost incurred towards medicine. The Honorarium payable to the Physician of Homeo as well as the Ayuredic clinics / Helper of the Ayurvedic Clinic are fixed by the Railway Board from time to time while the aspect of cost towards medicines and the Honorarium payable to the Helper of the Homeopathic Clinics are decided by the HQ SBF Committee. (04) Homeo Clinics at Railway Concentrations

On the recommendations of DRMs Headquarters SBF Committee provides grant for opening Homemo Dispensaries where there is a large concentration of Railway employees. A grant of `3000/- (Rupees one thousand five hundred only) per annum for purchase of medicines and `2000/- (Rupees eight hundred only) per month towards honorarium for the doctor of each dispensary is provided. GENERAL: The Headquarters SBF Committee shall have the RIGHT to consider Financial Assistance to cases of employees not covered under any of the above schemes. They shall also have the power to alter/modify/include/delete any aspect of the existing schemes as also introduce any new scheme at any time, without assigning any reasons therefor. The decision of the HQ SBF Committee shall be FINAL and BINDING and no correspondence in this regard would be entertained.

For further details and application forms, the Welfare Section of HQrs., Divisions and Workshops may be contacted. Their Railway phone numbers are given below;

Sl. No. Division/ Workshops Phone No. Railway

1 Headquarters Office 86603

2 Secunderabad Division 86649

3 Hyderabad Division 85207

4 Vijayawada Division 68293

5 Guntakal Division 27078

6 Guntur Division

32625

7 Nanded Division

52266

8 Carriage Workshops, Lallaguda

89413

9 Wagon Workshops, Guntupalli

63636

10 Carriage Repair Shop, Tirupathi

25452, 25454

11 S & T Workshops, Mettuguda

89262, 84114

Chairman, Headquarters SBF Committee & Chief Personnel Officer

PROFORMA – ‘A'

Application for an Advance for Correspondence Course offered by B.I.E.T.Mumbai/ICWA Kolkata/Institute of Rail Transport and

Management/NDLS / Technical Education & Material Management in the evening colleges from the SBF

PHONE NUMBER The Secretary, Railway : South Central Railway, Mobile : HQrs. / Divisional / Workshop SBF Committee,

Sir, I hereby apply for an advanced from Staff Benefit Fund to pay the fees in lump sum for the correspondence course in ……………..offered by the BIET, Mumbai/ICWA, Kolkata, Institute of Rail Transport and Management, NDLS / Technical Education / Material Management in the EVENING COLLEGE. (Strike out which ever is not applicable)

1 Name of the employee in full (in Block letters)

1(a) Son of / Wife of (In case of female employee)

2 Date of Appointment Bill Unit Number

3 Community (Tick Mark)

SC ST OBC Muslim Christian

UR

4 Designation

Office/Station

5 Department/Division

P. F. Number

6 Pay in Pay Band

Running Allowance

7 Grade Pay Substantive Grade Pay Officiating / MACP

8 Particulars of course and amount of fees. a) course studying d)Duration of course d) Amount of fees paid during the year 9 Whether certificate from the B.I.E.T.Mumbai,

KCWA, Kolkata, IRTM/NDLS/ College of study is enclosed.

10 Amount of advance applied for

I authorize the Administration to recover the amount from my salary in 10 equal monthly installments. Place……….. Date………… Signature of the Applicant.

Memo No………………….. Office:……….. Date:……..

Forwarded for necessary action. The above particulars furnished by the employee are correct.

Controlling Officer. (Designation) (Office Stamp)

PROFORMA – ‘B'

Application for Special Scholarship for Technical Education (Scheme is open only to such of those employees who SUBSTANTIVELY hold

the Grade Pay 1800 & below) To TELEPHONE NUMBER The Secretary, Railway : South Central Railway, Mobile : HQrs. / Divisional / Workshop SBF Committee,



1(b) If spouse is a Railway/Government employee, details thereof

2 Date of Appointment Bill Unit Number 3 Community

(Tick Mark) SC ST OBC Muslim Christian

UR

4 Designation Office/Station 5 Department/Division P. F. Number 6 Pay in Pay Band

Running Allowance

7 Grade Pay Substantive

Grade Pay Officiating / MACP

8 Name of the student in whose favour the scholarship is sought for

Relationship with the employee

9 Course Studying

10 Year of Study in during the Academic Year for which notification issued viz., 1st Yr, 2nd Yr, 3rd yr, 4th Yr etc.,

11 Name of the Institution where studying

12 Whether the child is in receipt of any other scholarship and it so, the value.

`

13 Whether the child is exempted from payment of term/tuition fee and if so, the value.

`

14 Whether the student is employed and is having his/her own resources.

15 In case, where the student is a dependent of the employee:-

I hereby declare that all the particulars furnished above are true and I am liable for disciplinary action, if they are proved to be incorrect at a later date. I also declare that the student Master/Kumari………………. Is related to me as ………………… My father is not alive and the student is entirely dependent on me and the particulars as furnished by me are correct. Date: Place: Signature of the employee

- 2 - Witnesses: We hereby declare that the particulars furnished by Shri./Smt. __________________________ Designation _____________ are correct to the best of my knowledge: S. No.

Name (in BLOCK LETTERS)

Designation/Office/ Station

Signature

01

02

Memo No. Office Date Station: Forwarded, It is certified that the particulars furnished against item 1 to 7 have been verified and found correct. Signature & Stamp of the Controlling Officer The details mentioned in Col. No.15 is hereby certified. The said scholar ward has been included as a dependant in the pass declaration submitted by the employee. Signature & Designation of the Pass Issuing Officer.

Documents to be enclosed to the application: 1. Community Certificate, in case of SC/ST/OBC employees.

2. Attested copy of the Mark Lists of the Qualifying Examination, viz.,

the exam passed in the Academic Year previous to the one for which notification is issued.

3. Certificate from the College of study on Fee Payment.

Please note that no coloumn should be left blank. The telephone number should be furnished

Name of the college with seal. Affiliated to :

CERTIFICATE

This is to certify that Kum./Master_____________________ Son/Daughter of Shri_____________________, is/was a student of this college studying in _________________( course)____________ (Year of study –1st Yr, 2nd Yr, 3rd Yr, 4th Yr etc.,) during ___________ (the Academic year for which notification is issued). 2. The student has remitted an amount of ` ____________ (Rupees ____________________________________________________ only) towards college fee during the said Academic Year. It is also certified that the student is NOT EXEMPT from payment of FEE and is also not in receipt of any SCHOLARSHIP from any other sources. 3. This certificate is issued to the student to enable her to obtain SCHOLARSHIP from the Staff Benefit Fund of the Railways. PLACE: DATE:

Signature of the Authorized Signatory with College Seal

_____________________________________________________________________

Details of the Bank Account held by the Scholar Child

1. Name of the Account Holder : 2. Account Number : 3. Bank and Branch : 4. IFSC Number : 5. MICR Number :

Signature of the Authorized Signatory with seal

PROFORMA – ‘C'

Application for Special Scholarship for Technical Education (Scheme is open only to such of those employees who SUBSTANTIVELY hold

the Grade Pay 1900 & above) To TELEPHONE NUMBER The Secretary, Railway : South Central Railway, Mobile : HQrs. / Divisional / Workshop SBF Committee,






UR


Running Allowance





9 Course Studying




`


`




- 2 - Witnesses: We hereby declare that the particulars furnished by Shri./Smt. __________________________ Designation _____________ are correct to the best of my knowledge: S.No. Name (in BLOCK

LETTERS) Designation/Office/ Station

Signature

01

02








CERTIFICATE



PROFORMA’D’

Application for Scholarship for Technical Education (3rd Year DIPLOMA COURSES*)

To TELEPHONE NUMBER The Secretary, Railway : South Central Railway, Mobile : HQrs. / Divisional / Workshop SBF Committee,






UR


Running Allowance





9 Course Studying




`


`




- 2 - Witnesses: We hereby declare that the particulars furnished by Shri./Smt. __________________________ Designation _____________ are correct to the best of my knowledge: S.No. Name (in BLOCK

LETTERS) Designation/Office/ Station

Signature

01

02








CERTIFICATE



PROFORMA – ‘E’

GRANT OF CASH AWARDS FOR MERITORIOUS WARDS OF RAILWAY EMPLOYEES FOR ACHIEVING ACADEMIC EXCELLENCE

To TELEPHONE NUMBER The Secretary, Railway : South Central Railway, Mobile : HQrs. / Divisional / Workshop SBF Committee,



1(b) If spouse is a Railway/Government employee, details thereof.




UR

4 Designation

Office/Station


P. F. Number

6 Pay in Pay Band

Running Allowance



8 Name of the student in whose favour the Cash Award is sought for


9 Course Completed

10 Year of Completion

11 Name of the Institution where studied

12 Nature of Academic Excellence achieved

I hereby declare that all the particulars furnished above are true and correct and I have enclosed copies of relevant certificates issued by the University in this regard. I also understand that the submission of the application does not automatically entitle my son for the award. Date: Place: Signature of the employee

Forwarded to the Chairman, HQ SBF Committee & CPO for a consideration.

Signature of the Controlling Officer with Stamp

PROFORMA ‘F’

Application for Maintenance Grant To TELEPHONE NUMBER The Secretary, Railway : South Central Railway, Mobile : HQrs. / Divisional / Workshop SBF Committee, Sir, I have been sick from……………………..and without pay from …………Please therefore sanction maintenance grant in my favour. Particulars required are furnished below. Period of sickness as in patient……………….. Period of sickness as out patient ……………… Date: ………………. Yours faithfully, Signature of the Applicant

(to be filled in by the office where the applicant i.e. working) 1 Name of the employee in full (in

Block letters)





UR

4 Designation

Office/Station


P. F. Number

6 Pay in Pay Band

Running Allowance



8 Period of Sickness From To A With Pay B With Half Pay C Without Pay 9 Sick Certificate Number &

Date

10 Sick Certificate issued by (Designation of the Railway / Govt. Medical Officer

Forwarded to DMO/………….. It is certified that the particulars given above are correct. He has already been paid maintenance grant for the period from ……….. to ………vide sanction letter No. …….. dated ……………. Office/station Controlling Officer Designation Stamp to be affixed

Memo No. Date Office/Stn Recommended. The employee is on Sick List from _____________ to _______________ vide M 8 B Certificate No. ______________ Dated _________ Period of Sickness as in patient: From: To: Period of Sickness as out patient: From: To: Nature of illness: (Common name as can be understood by Non-Medical Staff Should be given) Divisional Medical Officer

(Signature with Stamp)

ANNEXURE – ‘G’ Application for Grant of Medical Assistance for Major Diseases and Chronic

Cases involving Major Operation. To TELEPHONE NUMBER The Secretary, Railway : South Central Railway, Mobile : HQrs. / Divisional / Workshop SBF Committee, 1 Name of the employee in full (in

Block letters)





UR

4 Designation Office/Station 5 Department/Division

P. F. Number

6 Pay in Pay Band

Running Allowance



8. For whom the assistance is applied for

9. Name of the dependent & Relationship, If the assistance is for dependent

Date: Signature of the employee.

Memo No. Office Date: Station: Forwarded, it is certified that the particulars given above are correct. Controlling Officer. (Designation Stamp)

Memo No. Date: Office:______________ Station:___________ Recommended. Certified that the employee/dependent family member named has undergone major operation for on and is suffering from which is major disease/chronic case. She / He is/was under treatment from . to (Strike off whichever is not applicable) Divisional Medical Officer, (Designation Stamp to be affixed)

PRFORMA ’H’ Application for Reimbursement of the Cost of Spectacles

TELEPHONE NUMBER The Secretary, Railway : South Central Railway, Mobile : HQrs. / Divisional / Workshop SBF Committee,

I hereby apply for the reimbursement of the cost of spectacles purchased by me. 1 Name of the employee in full (in

Block letters) (a) DATE OF BIRTH

(b) S/o / W/o (In case of female employee)




UR

4 Designation

Office/Station


P. F. Number

6 Pay in Pay Band

Running Allowance



8 Whether applied previously, if so, when & what is the result

9 Receipt Number & Date (ORIGINAL RECEIPT to be enclosed)

10

Cost incurred in the purchase

I declare that I have not claimed reimbursement of cost of spectacles during the last 02 / 03 Financial Years. The particulars furnished by me above are true and I am liable for disciplinary action if proved untrue. Encl: Yours faithfully Date: Station: Signature of the Applicant

Memo Office: Date: Forwarded to DMO/………………. It is certified that the particulars given against 1 to 10 are correct.

Controlling Officer. (with Office Stamp)

Memo No.

Office Date:

Forwarded The spectacles/change of spectacles are necessary for proper vision. This employee is required to keep a pair of spectacles on duty (Strike off whichever is not applicable) Divisional Medical Officer. (Designation Stamp)

PROFORMA ’I’ Application for grant of financial assistance from SBF for the children of

Railway employees attending Schools for Deaf, Dumb, Blind and Mentally retarded.

To TELEPHONE NUMBER The Secretary, Railway : South Central Railway, Mobile : HQrs. / Divisional / Workshop SBF Committee, 1 Name of the employee in full (in

Block letters)






UR


Running Allowance



8 Name of the Deaf, Dumb, Blind or mentally retarded child

9 Relationship 10 Date of Birth & Age of child 11 Name of the School for Deaf, Dumb, Blind

or Mentally retarded and place where the student is studying and residing in without fail.

12

a)Amount of tuition fees paid per month b) Amount of Transport charges paid per month.

c) Amount of residential fees paid per month.

13 Grant of SBF received upto

14

Amount now claimed: a) Period of claim (From – To) b) Tuition fees c) Residential fees d) Conveyance charges incurred

15 Whether Vouchers/stamped receipts enclosed.

16 Whether the students is in receipt of any financial aid from any other source for this purpose, if so, full particulars

The particulars mentioned above are true and the amounts received in this respect will be refunded, if the same are found incorrect. I also declare that the child for whom the FA is sought from SBF is not in receipt of the Children Education Allowance (Re-imbursement of Tuition Fee). Date Signature of the applicant Certified that the particulars furnished against columns 6 to 11 are correct and that the child (name)…………………………………………………..is a bonafide student of this Institution studying in …………………class. The duration of his/her course of studies extends upto _______________. He/She is not in receipt of any scholarship/Stipend/Reimbursement from any other source. His/her conduct and progress is satisfactory. The tuition fees/residential fees referred to above are recommended as these are essential for the prosecution of studies in the Institution. Seal of the Institution Signature of the Principal Place:____________ Name of the Institution Date: ___________

Memo No. Date: Office of the Forwarded to DMO _____________________ The particulars furnished against columns 1 to 5 are correct. Signature of the Controlling Officer Designation

Memo No. Office:_________________ Station: _________________ Division: _______________ Forwarded to the Secretary, Headquarters SBF Committee, CPO’s Office, SC for necessary action. The above particulars furnished by the employee are correct and the case is recommended for sanction. Divisional Medical Officer.

PROFORMA ‘J’

Application for sanction of financial assistance in favour of Physically Handicapped and School going Children of Railway Employees.

To TELEPHONE NUMBER The Secretary, Railway : South Central Railway, Mobile : HQrs. / Divisional / Workshop SBF Committee, I hereby apply for financial assistance for my Physically Challenged School going son/daughter to cover the cost of transport from residence to school & back. Necessary particulars are furnished below: 1 Name of the employee in full (in

Block letters)






UR

4 Designation

Office/Station


P. F. Number

6 Pay in Pay Band

Running Allowance



8 Name of the Physically Challenged student ward in whose favour the scholarship is sought for


9 Date of Birth of the School going Child

Class studying

10 Name of the School in which studying at present.

11 Nature of physical disability

12 Financial assistance from SBF received upto

13 Period for which Financial assistance is now claimed (From – To)

The particulars furnished above are true and the amount received in this respect will be refunded if the same are found incorrect. Date: Signature of the applicant.

PROFORMA ’J’ No. Date: Certified that the particulars furnished against columns 8 TO 11 are correct and the child Master/Kumari. Is/was bonafide student of this institution studied last year in Class and at present studying in class academic year 20 . It is also certified that the student is a physically handicapped person. Signature of the Headmaster Name of the Institution (Stamp)

Memo No. Date Office Forwarded to DMO ………………………………………… The particulars furnished against columns 1 to 8 are correct. Office seal:

Signature of the Controlling Officer. With Designation Stamp.

Memo No. Date Office Forwarded to the Secretary, HQrs. SBF Committee, CPO’s Office/SC for necessary action. It is certified that ……………………………son/daughter of Shri ………………….. is a physically handicapped person. The nature disability…………………………. Divisional Medical Officer with stamp

PROFORMA ‘K’ Application for Grant of financial assistance for loss of property on Account

of Fire, Flood and Cyclone To TELEPHONE NUMBER The Secretary, Railway : South Central Railway, Mobile : HQrs. / Divisional / Workshop SBF Committee, 1 Name of the employee in full (in

Block letters)





UR

4 Designation

Office/Station


P. F. Number

6 Pay in Pay Band

Running Allowance



8 Nature of loss sustained 9 Date of occurrence 10 Financial loss sustained in detail 11 Certificate from the Police or Civil

authorities

12 Whether any financial assistance is received from State Govt. & if so the amount received.

DA: Certificate Date: Signature of the employee.

Memo No. Office:___________ Station:___________ Date: ____________ Forwarded, it is certified that the particulars given above are correct and correct and I recommend/do not recommend this case for financial assistance for sanction.. Controlling Officer. (Designation Stamp to be affixed)

ANNEXURE- L

Application for grant of Financial Assistance to the families of employees who die while undergoing treatment at RAILWAY/ REFERRAL Hospitals.

*** My husband/wife/father/mother, who is a serving Railway employee has died while under treatment at Central Hospital, Lallaguda / Referral Hospital, RH/BZA; GTL; GNT; NED; Poly clinic/ KZJ; . His/ Her details are as under: Name of the

deceased employee (in Block letter)

Designation & Station

Division/ Unit

P.F Number

Date of

Death

Address where the last rites

are to be performed

I request that Financial Assistance, as due and admissible may be paid to me from HQ SBF. Signature/LTI of the Applicant Name : (in BLOCK LETTER) Relationship with The deceased : No. Office: The family of the deceased employee is entitled for a FA of ` 10,000/ ` 5,000 from HQ SBF. The same may please be sanctioned.

OS/Railway Hospitals Sr. MS/Admn./In charge Physician Received an amount of ` 10,000/ ` 5,000 from MD/CH/LGD/CWS (BZA; GTL;GNT;NED) Sr. MS/KZJ. The payment has been made in on Signature of the receiver Presence:

Sl. No

Signature Name & Designation

1

2

PROFORMA ‘M’ APPLICATION FOR GRANT OF CASH INCENTIVE FOR ADOPTING SMALL FAMILY NORMS AFTER ONE GIRL CHILD OR ONE MALE/TWO FEMALE

CHILDREN. To TELEPHONE NUMBER The Secretary, Railway : South Central Railway, Mobile : HQrs. / Divisional / Workshop SBF Committee,

I hereby apply for grant of cash incentive for adopting small family norms after one girl child or one male/two female children. Necessary particulars are furnished below: 1 Name of the employee in full (in

Block letters)



1(b) Date of Birth




UR

4 Designation

Office/Station


P. F. Number

6 Pay in Pay Band

Running Allowance



8 Family composition S. No.

Name of the dependent Relationship Age/DOB Remarks

9

Number of living children (on the date operation)

MALE FEMALE TOTAL

10

Sterilization operation particulars.

Date of operation

Hospital/Clinic where the sterilization operation was

performed

(Note: In case the operation was done in a private Hospital, the certificate should be got countersigned by the Railway Doctor. In other cases, the copy of the certificate should attested by a Railway Officer).

Signature of the employee

DECLARATION I hereby declare that the particulars furnished above are true complete and correct to the best of my knowledge and belief and that no fact has been concealed to derive the incentive from SBF. I also declare that the above incentive has not been claimed by my spouse (in case the spouse of the employee is also a Railway employee) / my spouse is not employed on Railways.

I fully understand that should the information provided by me is found to be incorrect at a later date, the amount granted to me is fully recoverable from my salary and I shall not take legal recourse to avoid such recovery. I am also aware that I am liable to be taken up under D&A Rules in case the information provided by me is found to be false/incorrect. Place: Date: Signature of the employee We, the co-employees of Shri………………………………………………………………… Design……………………Station…………………. Hereby certify that the information furnished by Shri …………………………. Is true complete and correct to the best of our knowledge. We also certify that the declaration has been signed by Shri …………….. in our presence. S.No. Name Designation Office/Stn. Signature

No. Office Station Date: Forwarded to Chairman/HQrs. SBF Committee & CPO/SC for necessary action. The particulars furnished by the employee have been verified with the Service Register / Pass Declaration of the employee and found to be IN ORDER. Signature Design. & Stn. (with office seal)

PROFORMA ‘N’

APPLICATION FOR RE-IMBURSEMENT OF 50% EXPENSES INCURRED ON TREATMENT IN NATUROPATHY

To TELEPHONE NUMBER The Secretary, Railway : South Central Railway, Mobile : HQrs. / Divisional / Workshop SBF Committee, I hereby apply for re-imbursement of 50% expenses incurred on treatment in naturopathy, in favour of myself/my family member covered under RS(Pass)Rules. . Necessary particulars are furnished below: 1 Name of the employee in full (in

Block letters)


1(b) Date of Birth




UR

4 Designation

Office/Station


P. F. Number

6 Pay in Pay Band

Running Allowance



8 Details of the family member who underwent the treatment in Naturopathy

S. No.

Name Relationship Age/DOB Remarks

9

Name & Address of the Hospital/Institution where the treatment was taken

10

Whether the Hospital/Institute is recognized by the Government, if so the details of the Govt. G.O (a copy of the G.O. should be enclosed in support

11 Amount incurred towards treatment (ORIGINAL BILLS in support should be enclosed)

Signature of the employee

DECLARATION I hereby declare that the particulars furnished above are true complete and correct to the best of my knowledge and belief and that no fact has been concealed to derive the incentive from SBF. I also declare that I have not claimed the above grant in my favour/in favour of the family member for whom this is claimed. I also declare that the family member for whom the claim has been made is fully dependant on me and is also included in my PASS DECLARATION. I am fully aware that I would not be eligible to claim the grant in favour of myself/my dependant in whose favour the claim is made.

I fully understand that should the information provided by me is found to be incorrect at a later date, the amount granted to me is fully recoverable from my salary and I shall not take legal recourse to avoid such recovery. I am also aware that I am liable to be taken up under D&A Rules in case the information provided by me is found to be false/incorrect. Place: Date: Signature of the employee We, the co-employees of Shri………………………………………………………………… Design……………………Station…………………. Hereby certify that the information furnished by Shri …………………………. Is true complete and correct to the best of our knowledge. We also certify that the declaration has been signed by Shri …………….. in our present. S.No. Name Designation Office/Stn. Signature

No. Office Station Date: Forwarded to Chairman/HQrs. SBF Committee & CPO/SC for necessary action. The particulars furnished by the employee have been verified with the Service Register / Pass Declaration of the employee and found to be IN ORDER. Signature Design. & Stn. (with office seal)

- PRFORMA ’O’

Application for Reimbursement of the Cost of Dentures

TELEPHONE NUMBER

The Secretary, Railway : South Central Railway, Mobile : HQrs.SBF Committee,

I hereby apply for the reimbursement of the cost of Dentures . 1 Name of the employee in full (in






UR

4 Designation

Office/Station


P. F. Number

6 Pay in Pay Band

Running Allowance



8 Whether the dentures have been recommended by the Railway Medical Authorities?

9 Receipt Number & Date (ORIGINAL RECEIPT to be enclosed)

10

Cost incurred in the purchase

I declare that I have not claimed reimbursement of cost of dentures earlier and the particulars furnished by me above are true and I am liable for disciplinary action if proved untrue. Encl: Yours faithfully Date: Station: Signature of the Applicant

Memo Office: Date: Forwarded to DMO/………………. It is certified that the particulars given against 1 to 7 are correct.


Memo No.

Office Date:

Forwarded The employee requires replacement of his tooth/Dentures. The employee has got the tooth/dentures fixed and the replacement is satisfactory. Divisional Medical Officer. (Designation Stamp)

PRFORMA ’P’ Application for grant of Financial Assistance for procurement of Wheel

Chair/Prosthesis/Artificial Limbss TELEPHONE NUMBER

The Secretary, Railway : South Central Railway, Mobile : HQrs. / Divisional / Workshop SBF Committee,

I hereby apply for financial assistance from SBF for procurement of Wheel Chair/Prosthesis/Artificial Limbs. 1 Name of the employee in full (in






UR

4 Designation

Office/Station


P. F. Number

6 Pay in Pay Band

Running Allowance



8 Nature of Disability and the % thereof (Attested copy of the Certificate issued by the Govt. Civil Surgeon to be enclosed)

9 Whether the said implement is provided by agencies recognized by the Government (List of agencies given overleaf). If so, the rate quoted by them (Quotation obtained should be enclosed in ORIGINAL).

10

Cost of the Wheel Chair/Prosthesis/Artificial Limbs as indicated in the quotation.

11 In case the Agencies mentioned do not manufacture the said implement, the name of the Agency from whom the implement is likely to be purchased.

12 Rate quoted by the outside agency (Quotation to be enclosed in ORIGINAL).

I declare that the details as above are true, complete and correct and I am fully aware I am liable for disciplinary action if proved untrue. Encl: Yours faithfully Date: Station: Signature of the Applicant

-2-

PRFORMA ’P’

Memo Office: Date: Forwarded to Sr. DMO/Ortho, CH/LGD. The employee is hereby directed. It may please be certified as to whether the implement sought by the employee would be helpful to him. The Sr. DMO/Ortho may record his recommendations underneath.


Memo No. Office Date:

Verbatim recommendations/observations of the Sr. DMO/Ortho, CH/LGD Sr. Divisional Medical Officer/Ortho. Central Hospital/Divisional Hospital (Designation Stamp)

Forwarded to the Chairman, HQ SBF Committee & CPO. The recommendations of the Sr. DMO/Ortho are hereby accepted. The Differently abled employee may be provided financial assistance as sought for from the SBF for procurement of Wheel Chair/Prosthesis/Artificial Limbs. Member, HQ SBF Committee & CMD/SC

List of Government / Approved agencies manufacturing Artificial Implements:

(a) Sweekar Multi Speciality Rehabiliation Centre, Secunderabad (Opposite Jubilee Bus Station).

(b) Gandhi Hospital, Secunderabad.

(c) Artificial Limb Centre, PUNE.

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