CGEIS Form

FORM NO.13

[See Para 6]

Central Government Employee’s Group Insurance Scheme 1984

Date of Joining Govt. Service	Date of Admission to the CGEI Scheme	Group to Which admitted	Rate of monthly contribution (Rs.)	Period		Events with exact date affecting Cols.(3) and (4)	Remarks
				From	To
(1)	(2)	(3)	(4)	(5)		(6)	(7)