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Free Life Certificate Form for Pensioners

Fill your name, PPO number and address — print the life certificate for the officer to sign and the bank to stamp in November.

CPAO Annexure XVII Bank acknowledgement Nothing uploaded
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Pensioner

Bank

The officer's name, designation and seal are left blank — they sign after seeing you.

Non-employment / re-employment certificate (Annexure XVIII)

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The officer signs after seeing the pensioner; the bank returns the acknowledgement slip.

Which life certificate this is

This is the paper Life Certificate (Annexure XVII) of the Central Pension Accounting Office (CPAO), for Central Government pensioners and family pensioners whose pension is paid through a bank. The form says it is submitted once a year in November. An authorised officer signs it after seeing you; the bank fills and stamps the acknowledgement slip at the bottom and gives it back. Source: CPAO, Forms for Pensioners — Annexure XVII and Annexure XVIII (read 4 November 2026); the wording here follows those forms.

The digital life certificate (Jeevan Pramaan) is the other way to give it; the paper form is for those who give it at the bank. State government pensioners, EPS (EPFO) pensioners and defence pensioners may have their own forms — ask your pension office or bank.

Who signs

The form leaves the officer's name, designation and seal blank — the authorised officer fills them. Para 15.1 of CPAO's Scheme Booklet sets out who is authorised; your bank branch can tell you.

Kaise use karein

  1. Naam, PPO number aur pata bharein.
  2. PDF print karein.
  3. November mein authorised officer se sign karwakar bank mein jama karein; acknowledgement wapas lein.

Dhyan dein

Jeevan Pramaan (digital life certificate) bhi ek tareeka hai.

Questions people ask

When is the life certificate submitted?
The CPAO form says once a year, in November.
Who fills the acknowledgement?
The receiving bank branch: it signs and stamps the slip at the bottom and returns it to you as proof.
What is the non-employment / re-employment certificate?
Annexure XVIII — a yearly declaration (also in November) about any re-employment, commercial employment, or employment under a government outside India. Tick "Add it" to print it with your choice marked.
Is this the form for every pensioner?
It is CPAO's form for Central Government civil pensioners paid through banks. State, EPS and defence pensioners may have different forms.
Is my data uploaded?
No. The form is filled in your browser and the PDF is made on your device.

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