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Application For Issue of Family Identity Card

The document is an application form for the issuance of a Family Identity Card (FIC) for retiring employees or widows of deceased employees to obtain Post Retirement Complimentary Passes (PCRP). It requires personal details of the employee and dependent family members, including photographs and verification of dependency criteria based on income. The applicant must certify the accuracy of the information provided and submit the form for processing by the appropriate authority.

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16 views1 page

Application For Issue of Family Identity Card

The document is an application form for the issuance of a Family Identity Card (FIC) for retiring employees or widows of deceased employees to obtain Post Retirement Complimentary Passes (PCRP). It requires personal details of the employee and dependent family members, including photographs and verification of dependency criteria based on income. The applicant must certify the accuracy of the information provided and submit the form for processing by the appropriate authority.

Uploaded by

ranjith270696
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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APPLICATION FOR ISSUE OF FAMILY IDENTITY CARD

Notes: 1. The Family Identity Card (FIC) is issued to retiring employees/widow of the deceased to
facilitate issue of Post Retirement Complimentary Passes (PCRP).
2. Two copies of stamp-size photograph of each member of Family (including self), entitled
for pass, must be submitted alongwith the application form for issue of F.I.C.

1. Name of employee as per service book Mr./Mrs./Ms....................................................


2. Name of Father/Spouse Mr./Mrs...........................................................
3. Date of Birth of the employee ………………………………………………
4. Designation (at the time of retirement) ………………………………………………
5. Date of Appointment in Railway Service ………………………………………………
6. Date of Retirement from Railway Service ………………………………………………
7. Name of Office/Railway where pass account is maintained ………………………………………………
8. Class of Pass entitled ………………………………………………
9. (a) RUID No ………………………………………………
(b) Blood Group ………………………………………………
( c) Aadhaar No ………………………………………………
10. Residential address ………………………………………………
11. Mob. No. ………………………………………………

12. Details of dependent Family Member(s)*, if any, as defined in Pass Rules:

S. Name of dependent family Relation Date of Mob. No. Aadhaar No. Blood
No. member(s) Birth Group
1
2
3
4
5
6
13. I undertake that the particulars mentioned above are true to the best of my knowledge and belief and
certify that the dependent family member(s)/widowed mother whose name(s) is/are indicated in Table No.12
fulfill(s) the dependency criterion, mentioned below.

*Income criterion stipulated in the extant pass rules for inclusion of dependent family member(s)/widowed
mother: “A person shall not be considered to be a dependent if his/her monthly income from all sources
including pension, dearness relief, etc., exceeds 15% of the basic pay of the Railway servant or the amount
arrived at by adding minimum pension/family pension of Rs. 9,000/- (excluding the element of additional
pension to old pensioners) and the dearness relief admissible to the pensioner/family pensioner thereon, rounded
off to the nearest ten rupee figure, whichever is more.”

……………………………………….
(Signature of applicant & date)

Verified and forwarded to G(Pass) Branch


. ……………………………………
(Signature of Section Officer)
RBE-I/ERB-II/ERB-V

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