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Pension Regulation Army 2008 Part - I

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APPENDIX-VII APPENDIX-VIII
(Referred to in Regulation. 115(b) and 131(a)) (Referred to in Note 4 of Regulation 141)

DECLARATION FROM PARENTS/ ELIGIBLE BROTHERS/ STATEMENT OF ILLUSTRATIVE EXAMPLES OF CASES
SISTERS FOR DEPENDENT PENSION
Cases covered under clause (a)(i) of Regulation 141: Death Attributable to accidents while on
I……………………………………………………… (Name of applicant),
duty :
Father/Mother/Brother/Sister of Ex. No. ……………………… Rank …………………… 1. Death, as a result of an accident while travelling in a public, private or official vehicle or
Name ……………………………………….. Unit otherwise, of a Group ‘D’ employee, Dispatch Rider, Messenger, Postman, Notice server etc.
……………………….aged………….……years………………….,resident of deputed to distribute dak notices, etc., or of personnel on field duties.
…..………………………………………………… do hereby solemnly affirm and declare 2. Death occurring due to an accident while travelling on bonafide official duties in a service
as under:- aircraft.
3. Accidents during test flights of aircraft and non-scheduled flight of chartered aircraft
The deceased ……………………………………………(Name of the deceased
resulting in death of service personnel travelling on duty in public interest in such flights.
service personnel) was my son/daughter/brother/sister. 4. Death, in train accidents, of personnel undertaking official journeys on duty.
5. Accidents to ships, river steamers, etc. resulting in death of service personnel undertaking
I was dependent upon my late son/daughter/brother/sister mentioned above, for journeys on duty by these modes of travel.
pecuniary needs. 6. Death, as a result of accidents, of service personnel while proceeding on raids against anti-
social elements, etc.
DEPONENT 7. Death, due to contact with live electric/power lines, of personnel deployed on
flood/cyclone relief activities.
VERIFICATION 8. Death, due to electrocution, of service personnel engaged in rectification of defects in
generation and distribution of electricity.
9. Accidents while engaged in rectification of defects in machinery and equiper monthent.
I, the above said……………………………………………(Name of applicant), do
10. Death due to accidental explosion of boilers, storage tanks of inflammable materials,
hereby solemnly affirm and declare that the facts mentioned above are true to the best of chemicals etc.
my knowledge and belief and nothing has been concealed thereof. 11. Death due to fire accidents while on duty.
12. Death of fire fighting staff engaged in fire-fighting operations.

Cases covered under clause (a)(ii) of Regulation 141: Death Attributable to acts of violence
DEPONENT by terrorists & anti-social elements etc.

PLACE: 1. Death resulting from acts of violence or assault by terrorists, smugglers, dacoits, anti-social
elements etc. against an individual service personnel:-
(a) With the intention of deterring of preventing him from performing his duties; or
DATE:
(b) Because of any act done or attempted to be done in the lawful discharge of his
duties; or

(c) Because of his official position.
2. Service personnel killed in the course of performance of their duties as a result of violence
or attack by armed hostile, extremists, terrorists, anti-social elements, etc.
3. Service personnel on duty, killed in incident of terrorists violence in Jammu & Kashmir,
the North Eastern Region, Punjab, etc. other than in actual operations and encounters.
4. Death, due to stone-throwing, use of weapons and other violent acts by demonstrators,
anti-social elements, etc; service personnel while employed in aid of the civil administration in
quelling agitations, protest demonstrations, riots, etc.
5. Death of service personnel while proceeding on raids against anti-social elements, etc;

attributable to attacks by the parties so raided, including anti-social elements.

6. Death, while on duty, as unwitting victims of bomb blast in public places or vehicles,
indiscriminate-shooting incidents in public, etc. often resorted to by terrorists, anti-social elements,
etc.

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