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1 (a) Salary received in Arrears or Advance in accordance with the provisions of Sub Rule (2) of Rule 21A
(b) Payment in the nature of Gratuity in respect of Past Services, extending over a period not less than 5 years
in accordance with the provisions of Sub Rule (3) of Rule 21A
(c) Payment in the nature of compensation from the Employer or Former Employer at or in connection with
termination of Employment after continuous Service of not less than 3 years or where the unexpired
portion of the Term of Employment is also not less than 3 years in accordance with the provisions of Sub
Rule (4) of Rule 21A
(d) Payment in Commutation of Pension in accordance with the provisions of Sub Rule (5) of Rule 21A

2 etails particulars of Payments referred to above may be given in the Annexure - I, II, III or IV as the case
may be
Signature

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