Forms all

MLR REQUEST FORM

Tele No. (Dept) ……………….. Present Ration ………… Date of Birth ……………………

Name ………………………….. Rank ………………………. No ……………………………

Dept …………………………… Div Officer …………………………………………………….

Request to see the Commanding Officer/Executive Officer through proper channel regarding: -

(i) To draw MLR w.e.f. AM/PM ……………………………………..

(ii) Permission to stay ashore on off duty days at MLR address (IN CAPITAL LETTERS)

…………………………………………………………………….

…………………………………………………………………….

…………………………………………………………………….

Tele No. (R)/ C/o ………………………………………………………..

Certificate: -

(i) Reported on board on Pmt Duty/Ty Duty/Ex Leave vide Gx No. __________________ dated _______________

(ii) I am married/unmarried

(iii) I am staying with family at duty station

(iv) I am with parents (if applicable)

(v) I am liable for disciplinary action of making false declaration

(vi) I will intimate Regulating Office in case of change of MLR address

(vii) I am staying within the Municipal limited of Delhi Area (Delete / tick as applicable)

Dated : …………………………… Sailor’s Signature

The sailor has been warned for making any false declaration.

Div Officer’s Remarks Rec / Not Rec

Dated ………………………………..

Genform No. ……………………………….. dated ……………………………..

(Enclosed a copy of Reporting Gx)

I

DEPARTMENT ___________________

RATION ______________________

INS INDIA OUT GOING ROUTINE

NAME ___________________ RANK________________ NO. __________________

TRANSFERRED TO INS ___________________ FOR _____________________

ON/TY/PMT/DUTY/ON COMPLETION OF TY DUTY VIDE INDIA GX NUMBER

_________________ DATED ____________ W.E.F. ______________ EXO FOR S/COY

& MCPO ADDL ___________________________________________________ DIV

OFFICER ____________________ DEPT OFFICER _______________________

BLOCK IN CHARGE _____________________MESS SECY ____________________

ACCOM OFFICE __________________ MAINTENANCE OFFICE ________________

CDR OFFICE _________________ PAY OFFICE ____________________ CLOTHING

OFFICE ________________ SICK BAY __________________________ SD SECTION

_____________ ARMOURY _________ GUNEERY OFFICE _________ LIBRARY

____________________ LIQUOR CANTEEN _______________________ DIV

MCPO/CPO________________ RPO (VICT) _____________________________ NO

OF DEP I-CARDS HOLDING __________________ MCAA (SECY) ____________

MC-AT-ARMS (D) ________________ REGULATING OFFICER __________________

NOTE:- To be returned to Regulating Office duly completed before the date of transfer.

NOMINATION FOR INSURANCE BENEFITS FROM NAVAL GROUP INSURANCE FUND

As per instruction contained in NHQ letter BA/GIS/39(PC)

dated 06 Mar 97.

1. No ____________ Rank ___________ Name ________________________ hereby nominate the person/persons below and confer him/her/them the right to receive any amount that may be sanctioned from Naval Group Insurance Fund in the event of my death whilst in service. _________________________________________________________________________

For Married Personnel (a) Parents 25% of insurance benefits (Parents/dependant Brother/Sister)

Name(s) & Address of Nominee/ Age & Relationship Amt Payable % or Nominee

(i)(ii)(iii)

(b) Nucleus Family For balance 75% of insurance benefits payable (wife/son/daughter/adopted children)

Name(s) & Address of Nominee/ Age & Relationship Amt Payable % or Nominee

(i)(ii)(iii)

OR

(c) 100% to Nucleus Family Name(s) & Address of Nominee Age & Relationship Amt Payable %

(i)(ii)(iii)

_________________________________________________________________________

(d) For Unmarried personnel100% for parents/dependents Brother/Sister

(a)(b)(c)

This nomination super cades the nomination made by me earlier which stands cancelled.

_____________________ Signature of individual

COUNTERSIGNED

REQUISITION FORM

Date of Journey

Time Type of Vehicle

Required

Purpose and authority for Movements

Signature and Name,

Rank & Unit

1. Vehicle Report at: _______________________________________________

2. Vehicle Report on: ______________________________________________

3. Contact Number: _______________________________________________

4. Train No/Flight No: ______________________________________________

MARRIAGE DECLARATION FORM

1. Particulars of the Sailor: -

Name: _______________________ Rank : ________________ P.No. ___________

Religion : _______________________ Native Place : ________________________

2. Particulars of Sailor’s Father: -

(a) Name in full ___________________________ (b) Religion __________________

(c) Address :

(i) House No. Name _________________________ (ii) Vill ____________________

(iii) Post _________________________________ (iv) Teh _____________________

(v) Nearest P.S. __________________________ (vi) Distt ____________________

(vii) State ______________________________ (viii) PIN _____________________

3. Particulars of Marriage: -

(a) Date of marriage and under what rites performed __________________________

(b) Performed at residence ____________________________________________

(c) Vill/Town ________________________ (d) Nearest P.S. ___________________

(e) Post ___________________________ (f) Teh ____________________________

(g) Distt __________________________ (h) State ___________________________

4. Particulars of Wife: -

Affix a recent passport size

colour photograph with

spouse

(a) Maiden Name _______________________ Present Name __________________

(b) D.O.B. ___________________________ (c) Religion _____________________

(d) Native Place _____________________ (e) Vill/Town _____________________

(f) Post ___________________________ (g) Teh __________________________

(h) Distt __________________________ (j) State __________________________

-2-5. Particulars of Wife’s Present: -

(a) Father’s Name ______________________ (b) Mother’s Name ___________________

(c) Residential address :

(i) House No. Name _________________________ (ii) Vill ____________________

(iii) Post _________________________________ (iv) Teh _____________________

(v) Nearest P.S. __________________________ (vi) Distt ____________________

6. Particulars of Children: -

(a) _________________________________ (b) _________________________________

7. Name & address of the important persons (living only): -

(a) Name _________________________ Age ______ Address ______________________

(b) Name _________________________ Age ______ Address ______________________

To be completed only by Hindu sailors who have contracted marriage in the state of Maharashtra or Gujrat.

(a) Whether the marriage is registered __________________________________________

(b) Date of registration of marriage _____________________________________________

(c) Marriage registration No. __________________________________________________

(d) Place of registration of marriage _______________________Distt

_________________ State __________________________ Pin

__________________________

Date _____________________

Witness

Certified that the informationDivisional Officer Sign Furnished above is correct

II

The above named sailor has been warned that making false declaration is serious offence. Certified that the sailor is not in receipt of CILQ.

INS India New Delhi

Date ________________ Commanding Officer

Issue date of Warrant ___________________________

REQUEST FOR WARRANT FOR SELF & FAMILY OF SAILORS

Name/Rank/No.______________________________ Dept______________Inliving/MLR______Div. Officer___________________________Dept. Officer ___________________________

Request regarding issue of Warrant for the family as follows: -

S.No. Name Age Relationship Dependent Pass No. (Mandatory)

1.2.3.4.5.6.

Warrant Required : under 184(i)/184(ii)/184(iii) TR (upto 1450 Kms)

From : _________________________ To ___________________________

(a) My home station is ________________ and nearest Rly Stn is _____________ home station as recorded in service documents is ____________________.

(b) I am/ my family is/are proceeding on ___________ days of AL/PAL/PBAL/BAL of 20____ w.e.f. _____________ vide INS India Gx No._______________ dated __________ (copy enclosed). 1st/2nd/3rd Sleeper/AC Rajdhani/Maill/Express.

OR(c) My family alone is proceeding on leave.

(d) Under 184(iii) TR distance from New Delhi to ______________ is _____________ Kms.

(e) My Father/Mother/Brother(s)/Unmarried Sister(s) is/are wholly dependent on me and residing with me at duty station and their income is not more than Rs. 1500.00 per month.

(f) The above particulars are true to the best of my knowledge.

(g) LTC/Warrant under Rule 184(ii) TR was availed by me for self & family during ________

(h) LTC/Warrant under Rule 184(iii) TR was availed by me for self & family during _______

(j) The above particulars are correct and recorded in service documents.

(k) I am ready to face any disciplinary action if any information furnished by me in this form is/are found false.

Date : __________________ _____________________ Signature of the Sailor

The Service Documents of the sailor has been verified by me and the family members mentioned above are correct. Dependents are residing with the sailor at the duty station.

Date : __________________ _____________________(Divisional Officer Signature)

Rank, Name &No. ______________

II

(Signature of Passage Section)

INSTRUCTION FOR PASSAGE SECTION

(i) Passage Section in-Charge to see dependent pass before signature. (PASSAGE SECTION SIGNATURE WILL BE DONE BY POWTR OF SAILOR’S SECTION)

(ii) Separate warrant not to be issued for self and family.

(iii) Original movement order to be attached along with form.

(iv) Warrant is parts will not be issued for family members. (i.e. warrant for family will be issued only once a year)

III

REMARKS BY SD SECTION

Certified that the dependent family members (Father/Mother/Brother(s)/Sister(s) and children for whom warrant is required has/have been declared by the sailor in his Service Documents. His/Her date of birth (Age) as per SD’s is/are given below: -

Relationship Date of Birth (Age)

Brother ________________

Unmarried Sister ________________

Railway Station as per Service Documents: ________________________

(Signature o SD Section)

_________ APS/-____

Stamp

Stamp

WARRANT ISSUED TO FAMILY OF SAILORS UNDER TR 70, 72, 73, 74 AND 200

Name_______________________ Rank___________________ P.No. _____________

Dept _________________ Div. Officer _______________________________

(a) ON PERMANENT TRANSFER (A) (II) – When borne in AME and in occupation of Govt. quarter or was in receipt of CILQ there of at the married scale was necessitated by transfer of head of family from INS India (New Delhi) to INS __________________ at ___________________ w.e.f. ___________________ vide INS India GX No. ____________________ dated ________________________.

(b) JOINING HEAD OF FAMILY FOR FIRST TIME AFTER MARRIAGE TR72. The sailor whose family has not been issued with Railway warrant for first time was married on____________________ and is borne in AME at his station with effect from ___________________ or in receipt of CILQ.

(c) CONVEYANCE TO FAMILY WHEN SEPARATED FROM HEAD OF FAMILY TR 73. The move of the family when borne on authorized Married establishment and was residing in Govt. Quarter of was in receipt of CILQ of the married scale in necessitated by transfer of head of family to afloat service from INS India to __________________ vide GX No. ________________________.

OR

Transfer of the head of family from afloat service/service overseas./field service/non family station to _______________________(family station) and allotment of marriage accommodation on _____________________ from ________________ date ________________________.

OR

Allotment of Marriage Accommodation at _______________________ (Station) on ____________________ dated ____________________ or in being paid period of Govt. Quarter last occupied and that the onward journey had been at Govt. experience.

(d) ON VACATION OF GOVT. ACCOMMODATION TR 74. The move of the family who was in AME was necessitation by the vacation under orders of married accommodation in the station and that a period of __________________ (station number of months) has elapsed from the date of re-joined the head of the family.

-2-

(e) ON RELEASE OF THE HEAD OF THE FAMILY UNDER TR200 When borne in AME and in occupation of Govt. Quarter or in receipt of CILQ. Family moving from old duty station to home station of selected place of residence.

(f) The married accommodation was vacated on _______________________13/74.

Signature of Divisional Officer Signature of Accommodation Officer (with office stamp) (with office stamp)

(Verification from the Accommodation officer whether the sailor is borne in AME or not)

Details of family members entitled for three warrants.

Wife ___________________ Mother ________________ Father _________________Children between 05 to 12 years __________ Children above 12 yrs of age _________Brother________________ DOB _______________ Age ___________ (below 18 yrs)Sister _____________ DOB ___________ Age _______ (unmarried or in divorce case)

Home Station ________________ Nearest Railway Station ____________________

I certify that mother/father/brother/sister are wholly dependent and residing with me his/her monthly income does not exceed Rs. 1500.00 per month from any sources and above particulars are recorded in Service Documents.

(SD Section Signature) (Sailor’s Signature)

Date : Date :

Issued warrant N. (IAFT) __________________ dated ____________ for the family of

the sailor from _______________ to ________________ in 1st A/C, 2nd A/C, 3rd A/C for

_________________ full and ________________ half with ______________________

Quintal baggage _________________________.

Date : (Signature of Issuing Officer)

GENERAL REQUEST FORM

Name _____________________ Rank ________________ No. __________________

Division ___________ Div/Dept Officer ____________________________

Request to see DO/RO/EXO through proper channel regarding ______________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Div/Dept Officer’s Remark Sailor’s Sign ___________

Date

---------------------------------------------------------------------------------------------------------------------

GENERAL REQUEST FORM

Name _____________________ Rank ________________ No. __________________

Division ___________ Div/Dept Officer ____________________________

Request to see DO/RO/EXO through proper channel regarding ______________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Div/Dept Officer’s Remark Sailor’s Sign ___________

Date

ACCOMMODATION OFFICE

CPO’S ROSTER

FROM – 21/01/04 TO 24/11/

LDG’S ROSTER

FROM – 12/01/04 TO 05/09/06


LDG’S ROSTER

FROM – 13/09/06 TO 05/07/10


LDG’S ROSTER

FROM – 14/07/10


CPO’S ROSTER

FROM – 30/11/10


PO’S ROSTER

FROM – 23/05/08


VENDOR’S REGISTER


SUBSCRIPTION BOOK

WEF: - 01/01/2008

Appendix ‘E’(Refer Para 5 (b))

CERTIFICATE FOR CLAIMING FAMILY ACCOMMODATION ALLOWANCE

1. I _________________________________________ (Name, Rank & No) hereby certify that : -

(a) I am not borne in Authorised Married Establishment. (b) I have not been provided with Govt. Married Accommodation . (c) I am not entitled for CILQ/HRA. (d) My family (*wife/children father/mother/dependent brother/sister) is/are residing at ______________________________________________________

______________________________________________________________

(e) I have reported to ______________________ (unit) at ____________ (Station) on ___________ (date) and am entitled to draw Family Accommodation Allowance with effect from ___________ at ‘Z’ class city/town rate (i.e. 10% of Pay in Pay Band, Grade Pay and MSP).

* Delete whichever not applicable

Station ____________________ __________________________(Signature of sailor)

Unit _________________ Name _______________________________

Date _________________ Rank______________ P.No. ______________

II

Certified that the above named sailor is not borne in AME and has not been allotted any type of Govt. Married Accommodation.

Date ____________________ (Signature of Station Cdr/Accommodation Officer )

III

Permitted to claim Family Accommodation Allowance (FAA) with effect from _______________.

Date ____________________ (Signature of Executive Officer)

IV

Genform No. _____________ dated ___________ for claiming Family Accommodation Allowance (FAA) issued and dispatched to Naval Pay Office, Mumbai for crediting the same through IPA.

Date ____________________ (Signature of RO)

VR O. _____________

DATE______________

MAINTENANCE / BDF / VENDORS / GUEST ROOM/ TRANSIT

Received a sum of Rs. ________________ (Rupees ______________________

_______________________) From ________________________ towards Maintenance /

BDF / Vendor / Guest Room/ Transit Charges from Receipt No. _______ to _______.

(Santosh Kumar)CommanderOfficer-in-charge

Date : / /2013

Fund :

---------------------------------------------------------------------------------------------------------------------

VR O. _____________

DATE______________

MAINTENANCE / BDF / VENDORS / GUEST ROOM TRANSIT


_______________________) From ________________________ towards Maintenance /

BDF / Vendor / Guest Room/Transit Charges from Receipt No. _______ to _______.

(Santosh Kumar)CommanderOfficer-in-charge

Date : / /2013

Fund :

APPLICATION FOR GUEST ROOM BOOKINGDear Sir, Kindly book the Guest Room of SS Complex for me as per details below. I am aware of rules, regulations and charges.

Name, Rank & Number ……………………………………………………………………

Unit/Dte and Tel No. ………………………………………………………………………

Name and address and Tele No. of the Guest ………………………………………….

…………………………………………………………………………………………………

…………………………………………………………………………………………………

Relation & Purpose of Visit …………………………………………………………………

Nationality ……………………………………………………………………………………..

Date and Duration of Booking ……………………………………………………………….

Receipt No. Amount Rs. Dated

Date : 2011 Div Officer Signature ……………With Stamp

(Santosh Kumar)CommanderAccommodation Officer

RULES GUEST ROOM – SS COMPLEX

1. Room No. 4/2 will be used as the Guest Room for the benefit of the in living sailors staying in SS Complex.

2. The guest room will function under the control of officer-in-charge NSB.

3. The room is available for sailors staying in SS Complex for his male guests only.

4. Sailors booking the Guest room is responsible for the conduct of his guest.

5. Guest room may be booked for not more than 02 days at a time. Booking charges will be Rs. 25/- per day, Civilian Bearer Rs. 10/- per day.

6. A sum of Rs. 250/-(Refundable) towards security deposit will require to be deposited at the time of booking.

7. Check in timings are 0900 hrs Food will be provided by Galley as per the menu of the day at the prevailing rates (Presently Rs, 54/- day).

8. Cooking of is strictly not permitted inside the room.

9. All damages to the property will be charged.

10. Guests are responsible for safety of their belongings / cash / valuables.

11. Guest Room should be booked minimum three working days in advance.

Date 2011 Sailor’s Signature

ALLOTMENT OF FAMILY ACCOMMODATION(INVENTORY)

NAME. --------------------------------------- RANK. ------------------------- NO. -----------------------

Meter reading No --------------

You have been allotted qtr. No. -------------------ON ----------------- you are to take over the quarter from the representative of accommodation office by -------------The furniture supplied in quarter is as given below: -

S No. Description Quantity

1. Charpoy Wooden/ GI Pipe Four2. MNF Sets Four3. Chair dining Caning/ wooden bottom Four4. Chair easy One5. Table dressing gents One6. Table 3/2 wooden without drawer One7. Table 3/2 with drawer One8. Receptacle with/without bucket One9. Fan with Regulator -----10. Kitchen Steel Rack One11. Steel Sink One12. Bed Side Table/ Teapoy One13. Meat & Milk sheaf with marble One14. Wooden sheaf 2/23 One15. Sheaf with glass slider 4/9 One

DEFICIENCIES

CERTIFICATE

Certified that I. -----------------------RANK. -------------------------- No. ----------------------------Taken over above accommodation along with furniture/ Deficiencies.

(Handed over by) (Taken over by)

ORDER AUTHORISE TO MAKE PRIVATE ARRANGEMENT FOR THE PURPOSE OF MLR/INLIVING CILQ

NAME................................................ RANK....................................... NO . .......................

AGE.................................................. DATE OF BIRTH.......................................................

Certified that the above mentioned sailor is MLR / inliving and he is staying with his family at the following address: -

.............................................................

.............................................................

.............................................................

Sailor’s Signature ____________

DO’s Signature _________________With stamp

II

CERTIFIED THAT: -

(a) The sailor is authorised to make private arrangement for the accommodation w.e.f..........................................................................(b) He is within the AME w.e.f.......................................................(c) He has not been provided with Govt. married accommodation.

( ) (GS Kalkat)Commander CommanderAccommodation Officer Executive OfficerFor Commanding Officer for Commanding Officer

His name has been placed on the roster w.e.f. ...................................With back seniority w.e.f. ....................................................................

403/1/3

INS IndiaDalhousie RoadNew Delhi-110011Date...............

DistributionOriginal : CDA (N) Mumbai (TRLA Section)Duplicate : Accommodation Office of the station Triplicate : Sailor’s CopyQuadruplicate : Office Copy

APPLICATION FOR PLACING THE NAME IN MARRIED ACCOMMODATION ROSTER

After Marriage / Joining New Duty Station / On Promotion(Strike off which ever is not applicable)

Name __________________________Rank ______________ No. _______________

Office Address ___________________________________________________________

_____________________________________ Date of Reporting _________________

Reporting Gx. No. ___________ dated _______________ date of promotion to

Present rank _______________________ Gx. No. ____________ dated ___________

Date of birth __________________ Date of Marriage ___________________________

No. of Children ______________________ Name of last duty station/Ship __________

Date of Name Struck OFF from last duty station __________________.

If retaining accommodation at last duty station _____________ Yes/No.

(a) On ground of children education up to ____________

(b) Any other ground (state) up to ___________________

Back Seniority: -

As ____________ for _____________ months (original seniority certificate attached).

As ____________ for _____________ months

As ____________ for _____________ months

Div Officer’s Remarks Sailor’s SignatureDate: _____________ Date: ___________

Bank’s Counterfull (To be forwarded to the CDA)(To be filled in by MRO issuing authority)

_______________________________________________________________________________________Dt: __________2010Received a sum of Rs.

0 0 0 0 0 0

Total (Rs in words) __________________

Crores Lakhs Thousands Hundreds Tens Numbers

From M/S (name of the individual/unit/office)

By cash/ cheques No ______________ date ____________ Bank________________ for credit to PCDA/CDA Western Command Chandigarh on account of Rent & Allied Charges as defence receipt.

CDA Western CommandChandigarhBudget Head-1/105/1Code Head-1/105/2 (Signature of Individual)Code No-4013000001

BSR Code DD MM YY Serial No

Bank Seal

____________________________________________________________________________________________________________

Depositors Counter foil-1 (To be retained by the Depositors)(To be filled up by Treasury/RBI/Bank)

Treasury/RBI/Bank ..............................................Received a sum of Rs....................................(Rs ....................................................................................................only)

From.................................... (individual/Unit/Office) on account of...................................................................................for credit to PCDA/CDA..........................as defence receipts.


Bank Seal

Depositors Counter foil –2 (To be forwarded to PCDA/CDA)(To be filled by Treasury/RBI/Bank)

Treasury/RBI/Bank..............................................Received a sum of Rs.................................... (Rs ................................................................................................ only)

From.................................... (individual/Unit/Office) on account of...................................................................................for credit to PCDA/CDA..........................as defence receipts.


Bank Seal

Tele 23011069INS IndiaDalhousie RoadNew Delhi – 110011

808/PRC Jul 10

The Principal/DirectorNational Industrial Training Centre

STATUS AND EMPLOYMENT OF CONSERVANCY OF MALIS

DATE

CONSERVANCY MALIS

BORNE STRENGTH - BORNE STRENGTH -PRESENT - PRESENT -LEAVE/ABSENT - LEAVE/ABSENT -

SERNO

AREA NO OF PERSONELDETAILED

REMARKS AREA NO OF PERSONEL DETAILED

(a) SS COMPLEX & SURROUNDING AREA

MAIN ENTRANCE GARDEN & NAUSHALA LAWN

(b) NAUSHALA & SURROUNDING

NAUSHALA SURROUNDINGS

(c) NWWA COMPLEX & TARSH

NWWA COMPLEX & SWIMMING POOL

(d) SWIMMING POOL & SURROUNDING AREA

COP/CPS

(e) ACC. OFFICE MAIN ENTRANCE GUARD ROOM & CANTEEN EXTN

TRIMMING AND TREE CUTTING

(f) BUILDING & ROADS & COMMON AREAS

AREA SURROUNDING FOOT BALL GROUND

(g) GARBAGE CLEARANCE

CHIDRENS PARK NEAR DE-BLOCK AND REAR GATE

MCPO I/C AO

INS IndiaDalhousie RoadNew Delhi – 110 011

103/2 Date ___________

ALLOTMENT OF ACCOMMODATION

Meter reading with allotment ----------------------------------------------------------------------Name______________________Rank____________________No._______________

1. You have been allotted Qtr No.___________________in _________________for ________________ years and you are to take over quarter form accommodation office INS India by ____________________

2. You will be personally responsible for taking over the furniture and fitting etc from CPWD/MES. You are to return this form along with sanction from CPWD/MES to accommodation office within 24 hrs, failing which rent on market rate will be charged from you.

3. The person authorized to live in your quarter are member of your family i.e. wife and children.

4. Sharing: You are to strictly adhered to NO 126/83. In case unauthorized sharing is detected you will be deprived of quarter. No sharing is to be entertained by you in the absence of your family being away from the station.

5. Out of Turn: - All Out of turn allotee are not permitted to share their accommodation except with those persons/ sailors specified by the accommodation office.

6. In case if it is found that your family has not occupied the qtr within one month from taking over or is away from quarter for more than two months except when you are on leave will be ordered to vacate the quarter.

7. You are to take/furnish the particulars of your family in the enclosure and hand over the same to the accommodation officer immediately after take over.

8. Your premises is liable to be inspect by a person deputed by the accommodation officer/Commanding officer as such time is deemed necessary.

9. You are requested to pay the subscription in accommodation office NSBI/II/III before 10th of every month, failing which a fine will be charged from you as per existing rules.

10. You will be required to make good damages at the time of handing over.

11. You are responsible for keeping the surrounding of the building allotted to you in neat and clean shape. For this you will be required to participate in the Shramdan as and when organized.

-2-

12. You are not to leave your boxes/stores in the common areas like stair cases, lobbies and in the surrounding.

13. Your family members are not to climb in the terrace of the buildings at any time as all terrace top are out of bonds.

14. You are not to extend any fitting out side the balcony, which gives shabby appearance to the building. 15. You are to ensure that your families do not spread clothes for drying in park and along the roads.

16. Your family members should be in possession of family passes issued by DNPM (DA), failing which the entry inside the NSB I, II and III will be prohibited.

17. You will be charged for violating any of the above orders and may be ordered to vacate the accommodation immediately.

(Santosh Kumar)CommanderAccommodation Officer for Commanding Officer

II

I have read and understood above instructions and shall comply with them.

Name _____________________Rank ________________No. __________________Date _________________

WEEK EXO’S REMARKS/SIGNATURE

CO’S REMARKS/ SIGNATURE

Tele: 26881925 INS IndiaDalhousie RoadNew Delhi – 110 011

103/1 2013

NAME ___________________ RANK _________________ NO. _______________

QTR NO. _________________ sailors married accommodation NSB I/II and NSB III.

Meter reading while handing over accommodation-------------------------------------------------

NOTICE FOR VACATION OF GOVT. MARRIED ACCOMN

1. You have been in occupation of Govt. married accommodation Qtr No. ____________________ since ____________________ and you are required to vacate the said qtr and hand over to the accommodation office INS India by _________________________ on following reason:-

(a) On completion of three/two years of occupation.

(b) On proceeding permanent transfer/course of 26 weeks or more.

(c) On release from service.

(d) On disciplinary ground.

2. If you fail to vacate the quarter by the date mentioned in para one above you will be charged for the period as over staying without further notice at the assessed or market rate which ever is higher for the rent and allied charges in addition if to any with existing regulation.

3. Any damage to be made good before handing over the Govt. married accommodation.

(Santosh Kumar)CommanderAccommodation Officerfor Commanding Officer

GENERAL REQUEST FORM – SAILORS

Name: ______________________ Rank: _____________ No: __________________

Dept: ____________ Divisional Officer: ______________________

Dept Officer: _____________________

Request to see Divisional Officer/Departmental Officer/Executive Officer/Commanding Officer through proper channel regarding __________________

Sailor’s Signature __________Divisional Officer:

Dept Officer:

GENERAL REQUEST FORM – SAILORS

Name: ______________________ Rank: _____________ No: __________________

Dept: ____________ Divisional Officer: ______________________

Dept Officer: _____________________

Request to see Divisional Officer/Departmental Officer/Executive Officer/Commanding Officer through proper channel regarding __________________

Sailor’s Signature __________Divisional Officer:

Dept Officer:

NOTICE

NAME _________________ RANK ________ NO _______ QTR NO ____

You have to report in accommodation office at ___________On_________

In connection with.


NOTICE

NAME _________________ RANK ________ NO _______ QTR NO ____

You have to report in accommodation office at ___________On_________

In connection with.


GUEST PASS FORM(30 days)

(Name) _____________________ (Rank) ___________(No)___________________

may please be permitted to keep following guest in quarter no. _________________at

NSB I/II/III for a period ______________________days/months w.e.f _____________

Particulars of guest are as follows:-

S.No. Name Age Relation Home Address

(i)

(ii)

(iii)

(iv)

(v)

(vi)

Reason __________________________________________________________

Number of family members of allottee ________Adults_______Childrens_______

Number of family members of sharer_________Adults_______Childrens_______

Divisional Officer’s Signature Sailors Signature_____________ With stamp

With ships stamp Date________________

APPROVED/NOT APPROVED

(Santosh Kumar) Commander

Accommodation Officerfor Commanding Officer

SHARING FORM

Name _____________________ Rank ________________ No ________________

Unit __________________ Date ____________________ Valid up to _____________

SHARING OF GOVT MARRIED ACCOMMODATION

(a) 1. It is requested that I may be permitted to share quarter no ___________of _______________ for period of _______________ months w.e.f._________2. I am on married accommodation roster for _____________ - (rank). I am willing to pay the subscription towards the SMQ maint. Fund at the exiting rate.

Div Officer’s Signature Sailor Signature.With ships, stamp (Sharer)

(b) 1. I am willing to accommodate _______________________ in my quarter No ___________________ - for a period of _____________ months 2. The member of my family are adults _____________ children _________3. Certified that no other family is sharing in my quarter.

Div Officer’s Signature Allotee;s SignatureWith ships stamp

Name: ________________Rank & No- _____________

(c) Approved for ______________ months W.e.f ________________________

(d) FINES(a) 1to 10 days - no fine(b) 11 to 30 days - Rs 25 by allottee & sharer each

Disciplinary action will be taken

(e) Received Rs ______________ vide receipt No----------- dated _______________


SPECIAL LIBERTY

Name …………………………….. Rank ………………… P No ………………………..

Dept …………………………….Div Officer ……………………………………………….

The above mentioned sailor may be permitted to proceed ashore to……………...

……………………………………………… from………………………on……………………

Sailor’s Signature

Div. Officer’s Remarks……………………………

Dept. Officer’s Remarks………………………….

DUTY ASHORE

Name …………………………….. Rank ………………… P No ………………………..

Dept …………………………….Div Officer ……………………………………………….

The above mentioned sailor may be permitted to proceed ashore to……………...

……………………………………………… from………………………on……………………

Sailor’s Signature

Div. Officer’s Remarks……………………………

Dept. Officer’s Remarks………………………….

APPLICATION FOR RETENTION OF ACCOMMODATIONON CHILDREN EDUCATION/RETIREMENT

NAME------------ RANK--------------- NO---------------- DEP----------------------

QTR. NO----------------- PLACE------------DATE OF ALLOTMENT-----------

DATE OF TRANSFER--------------------------NEW UNIT (ON TRANSFER OF

RETIREMENT -----------------------------

REASON FOR RETENTION -------------------------------------------------___________________________________________________________

PERIOD OF RETENTION ----------------------------------------------------

PARTICULARS OF CHILDREN STUDYING:-

NAME OF CHILDREN-------------------------------------------- --------------------------------------------- ---------------------------------------------

TERMINATION OF CURRENT ACADEMIC SESSION --------------------------

CERTIFIED THAT I WILL VACATE THE ACCOMMODATION

IMMEDIATELY ON COMPLETION OF THE CURRENT ACADEMIC

SESSIONAL / APPROVED PERIOD OF RETENTION I.E ----------------------

DIVISION OF OFFICER’S REMARK SAILOR SIGNATURESIGNATURE WITH SHIPS STAMP

II

APPROVED / NOT APPROVED

NOTE:- APPLICATION FOR ACADEMIC GROUNDS IS TO BE SUPPORTED WITH CERTIFICATION (SCHOOL’S PRINCIPAL) SIGNATURE

LEAVE REQUEST – SINGLE WINDOWS SYSTEM

NOTE:- ALL ENTRIES TO BE FILLED IN CAPITAL LETTERS, PARA I TO III TO BE FILLED BY INDIVIDUAL SAILORS AND TO BE DROPPED IN LEAVE REQUEST BOX,

AFTER DULY CLEARED FROM LEAVE COUNTER (INS INDIA) UNFILLED/ IMPROPERLY FILLED LEAVE REQUEST WILL NOT BE ACCEPTED

PART-INAME--------------------------------- RANK----------------PART II. Q------------No-------------------DEPARTMENT----------------------------TEL NO--------------------- RATION------------------------DIV OFFICER----------------------------------- DEPT. OFFICER---------------------------------------

REQUEST THROUGH PROPER CHANNEL FOR---------------DAYS----------LEAVE OF--------INCLUDING------DAYS (TT) WP/WOP W.E.F--------------------------------------------(WITH PERMISSION TO ENCASH----------DAYS LEAVE ALONG WITH LTC FOR THE YEAR--------) WITH PERMISSION TO PREFIX ON----------AND SUFFIX ON-----------BEING--------------- CV REQUIRED/NOT REQUIRED

PART II

LEAVE ADDRESS________________RAILWAY STATION_____________________C/O--------------------------------------- RELATION--------------H.NO/NAME-------------------------VILLAGE/TOWN------------------------------POST OFFICE--------------------------------------------TEL. OFFICE-----------------------POLICE STATION---------------------------------------------------DIST-------------------------------STATE-------------------------PIN---------------------------------------TELEPHONE (WITH STD CODE) ------------------MOBILE NO-----------------------------------NEAREST MILITARY HOSPITAL------------------------------DIST-----------------------------KMSNEAREST CIVIL HOSPITAL------------------------------------DIST-----------------------------KMSDSSA BOARD------------------------------------------------------DIST------------------------------KMS

1. CERTIFIED THAT THE ABOVE PARTICULARS ARE CORRECT2. IT IS FURTHER CERTIFIED THAT I HAVE ENCASHED----------DAYS LEAVE IN MY SERVICECAREER.

SAILOR’S SIGNATURE_____________

PART III

SD SECTION REMARKS-----------------------------SIGNATURE------------------------------------

MI ROOM REMARKS------------------------------SIGNATURE----------------------------------------

DIV OFFICER REMARKS------------------------SIGNATURE----------------------------------------

PART IV

CDR’S OFFICER REMARKS-------------------SIGNATURE-----------------------------------------

PART V

GRANTED-------------------DAYS-----------------------LEAVE OF 20--------------INCLUDING------------------DAYS TT WP/WOP, W.E.F-------------------VIDE MY GX

NO---------------------DATED-------------WITH PERMISSION TO PREFIX ON------------------------------AND SUFFIX-----------------------

D SECTION---------------------------CDR OFFICE----------------------------------------------------

APPLICATION FORM FOR ISSUE OF TEMPORARY PASSFOR INS INDIA/SS COMPLEX, NAU SENA BAGH & KH

1. Full Name of the employee ………………………………………………………

2. Employed as and Department ………………………………………………………

3. Place of Employment ………………………………………………………

4. Father’s Name ………………………………………………………

5. Date of Birth ………………………………………………………

6. Height ………………………………………………………

7. Colour of Hair ………………………………………………………

8. Colour of Eyes ………………………………………………………

9. Complexion ………………………………………………………

10. Visible Identification Mark ………………………………………………………

11. Local Address ………………………………………………………

………………………………………………………

………………………………………………………

12. Pmt. Address ………………………………………………………

………………………………………………………

………………………………………………………

Place: (Signature of the Individual)

Date:

(Left Thumb Print)……………………

Department Letter No.And date…………………

IICOUNTERSIGNED

(HOD WITH OFFICE STAMP)

(Certified that the above particulars are correct)

APPLICATION FOR SAILOR’S ACCOMMODATION BOOKING

Dear Sir,

Kindly book the transit accommodation of NSB______ for me as per the details below. I am aware of rules, regulation and charges.

1. Rank, Name & Number::_________________________________

2. Unit/Dte: -_______________________

3. Name and Address of the Guest:-____________________________

Phone No________________

4. Reason for visit__________________________________________

5. Relation and Purpose of Visit:_______________________________

6. Nationality:-___________________

7. Date and duration of Booking_______________To_______________

Date- Div Officer’s SignatureWith stamp

Receipt No. Amount Rs. DatedII

Recommended/Not Recommended

Officer-in-ChargeTransit Accommodation

IIIApproved

Note : - If booking cancelled booking charge will not be refunded.

NOTICE

SAILORS NOT SHIFTING AS PER ORDER WILL MARCH OFF TO EXO

BY ORDER

NOTICE

SAILORS NOT SHIFTING AS PER ORDER WILL MARCH OFF TO EXO

BY ORDER

RULES ON TAKING OVER A QUARTER








9. You are requested to pay the subscription in accommodation office NSBI/II/III before 10 th

of every month, failing which a fine will be charged from you as per existing rules.








OFFICER TOILET

INS IndiaDalhousie RoadNew Delhi – 110 011

103/2 Date ___________

ALLOTMENT OF ACCOMMODATION

Meter reading with allotment ----------------------------------------------------------------------Name KS Rajput Rank HAV No. 15569239-H

1. You have been allotted Qtr No.___________________in NSB II for 02 years and you are to take over quarter form accommodation office INS India by DOA – 19 JUL 2012 DOV – 18 JUL 2014








9. You are requested to pay the subscription in accommodation office NSBI/II/III before 10 th

of every month, failing which a fine will be charged from you as per existing rules.



-2-






(Santosh Kumar)CommanderAccommodation Officer for Commanding Officer

II

I have read and understood above instructions and shall comply with them.

Name _____________________Rank ________________No. __________________Date _________________

RECEIPT

Received a sum of Rs. 20,000/- (Rupees Twenty Thousand only) towards advance payment of tentage in Diwali Mela on 11 Nov 12.

Sandeep

VR NO. _____________

DATE______________MAINTENANCE / BDF / VENDORS / GUEST ROOM/ TRANSIT


_______________________) From ________________________ towards Maintenance / BDF /

Vendor / Guest Room/ Transit Charges from Receipt No. _______ to _______.

Received by ______________

Name ___________________

Rank ___________________

P.No. ___________________

(Santosh Kumar)CommanderOfficer-in-charge Fund

Date : / /2013

---------------------------------------------------------------------------------------------------------------------

VR NO. _____________

DATE______________MAINTENANCE / BDF / VENDORS / GUEST ROOM/ TRANSIT


_______________________) From ________________________ towards Maintenance / BDF /

Vendor / Guest Room/ Transit Charges from Receipt No. _______ to _______.

Received by ______________

Name ___________________

Rank ___________________

P.No. ___________________

(Santosh Kumar)CommanderOfficer-in-charge Fund

Date : / /2013

DEPENDENT CERTIFICATE

This is to certify that under mentioned family members are dependent on me:-

(a) Mrs. Saroj Yadav Wife

(b) Subham Yadav Son

(c) Nisha Yadav Daughter

(d) Sugriv Singh Father

(e) Gindo Devi Mother

(SS Yadav)CPO114173-K

Divisional Officer

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