Alive Self Declaration Letter
हयातीचा दाखला / self declaration of being alive, for pension and scheme renewals.
हयातीचा दाखला / स्वयंघोषणापत्र
मी, श्री./श्रीमती , वडिलांचे / पतीचे नाव , वय वर्षे, राहणार , याद्वारे स्वयंघोषित करतो / करते की,
- आजरोजी मी हयात असून सुस्थितीत आहे.
- मी या योजनेचा / निवृत्तिवेतनाचा लाभार्थी आहे.
- माझा योजना / पी.पी.ओ. क्रमांक असा आहे.
- सदर लाभ या बँक शाखेतील खात्यावर जमा होतो.
- वरील माहिती खरी असून, ती खोटी आढळल्यास भारतीय कायद्यानुसार होणाऱ्या कारवाईस मी पात्र राहीन.
ठिकाण :
दिनांक :
()
लाभार्थ्याची सही / अंगठा
प्रमाणित करण्यात येते की, वरील नमूद व्यक्ती आज माझ्यासमोर हजर होती व हयात असल्याचे मी प्रमाणित करतो.
सक्षम अधिकाऱ्याची सही व शिक्का
(ग्रामसेवक / सरपंच / तलाठी / बँक व्यवस्थापक / राजपत्रित अधिकारी)
What you type stays on this device — it is saved in your browser so you can come back to it, and it is never sent to us.
How to use it
- Fill in the pensioner's details and the scheme or pension the certificate is for.
- Check the page and print it.
- Most offices want it signed in front of the officer, or attested by a gazetted officer, sarpanch or bank manager — leave that block blank until you are there.
Questions about this tool
What is a hayati dakhla?
हयातीचा दाखला — a life certificate. Pension schemes require the pensioner to confirm each year that they are alive, or payments stop.
When is it due?
Usually every November for central and state pensions, though scheme rules differ. Check with the office or bank that pays you.
Can I submit it digitally instead?
Central pensioners can use Jeevan Pramaan with a biometric device or the face-authentication app, which avoids the trip entirely. Many state schemes still want paper — this is for those.
Who can attest it?
The certificate leaves room for a gram sevak, sarpanch, talathi, bank manager or gazetted officer to sign and stamp — any one of those is generally accepted.
What if the pensioner cannot travel to sign?
Many offices allow a gram sevak, postman or bank representative to visit and attest at home when the pensioner cannot travel — ask the office that pays the pension.
Does this work for any pension, not just one specific scheme?
Yes — the scheme name is a free-text field, so it works for any pension or scheme that asks for an annual life certificate, not only the ones named in the form.