THE ITEMS OF PENSION

No.

Belongs        :

Name in Full   :

Resident ID No. :

May , 1995 .  Items of Pension

Items of Employment

Appointment Date :

Monthly Income   :                ( code :        )

Foundation Period :

Working Period   :

Expectation of Retirement Grants

Optional Items

◐ Select Lump Sum

Lump Sum        : ｀

Retiring Allowance : ｀

Total              : ｀

◐ Select Annuity

Monthly Annuity   : ｀          (   % of monthly income )

Retiring Allowance : ｀

◐ Select Lump Sum + Annuity

Monthly Annuity   : ｀           (   % of monthly income )

Lump Sum        : ｀

Retiring Allowance : ｀

Total          : ｀

Loan Outstanding Issues

Annuity Fund Loan       : ｀

Outstanding Issues       : ｀

Educational Expense Loan : ｀

Outstanding Issues        : ｀

GOVERNMENT   EMPLOYEES

PENSION   CORPORATION