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1. (i) Name of the deceased Govt. Servant : Late Shri Ashok B.Jogawade
(ii) Designation : Mate
(iii) Date of Birth : 19/3/1958
(iv) Date of Death : 24/9/2009
(v) Date of joining Govt. Service. : 1/5/1976
(vi) Length of Service rendered : 22yrs 7months 26days
2. Family Particulars
(b) Employment status/Monthly income of dependent family member as mentioned above with
employer details:
3.A
1 No Immovable property Yes
(i.e.House/Housing plot/Land)
Kacha Housing /Housing Plot No
2 (<750 Sq ft.)
Concrete House/Housing plot No
3 (< 750 Sq Ft.)
Kachha/ Concrete House/ Housing plot No
4 (> 750 Sq Ft.)
Land No
5 (<1000 Sq Ft without House/Housing Plot)
Land No
6 (<1000 Sq Ft with Kachha House/Housing Plot < 750 Sq Ft.)
Land No
7 (<1000 Sq Ft with Concrete House/Housing Plot < 750 Sq Ft.)
Land No
8 (>1000 Sq Ft with House/Housing Plot > 750 Sq Ft.)
(B) (i) Movable Assets Vehicle particulars giving its model, date of purchase.
Owner’s identity & its cost.
NIL
No
No
6. Specific recommendation of Welfare Officer giving reasons for recommending the case
for compassionate appointment, after taking into consideration of details given in paras 2 to 5
above.
It is certified that particulars given above are factually correct as per official records and
on the particulars given by the family of the deceased and self-assessment made by the
undersigned during spot visit to the family.