Annex III
Widows and Orphans Pension Scheme/Surviving Spouses' and Children's Pensions Scheme
ELECTION FORM B
I. (To be completed in triplicate by a married contributor who wishes to discontinue contributing to WOPS/SSCPS)
To: Director of Accounting Services
via.
(Head of Department)
I hereby elect to discontinue contributing to the *Widows and Orphans Pension Scheme/Surviving Spouses' and Children's Pensions Scheme with effect from
1.2.1993
4/93
(the implementation date) and to retain the pension benefits
in accordance with the terms of Civil Service Branch Circular No. which I have acquired at that date.
I understand and accept that this election is irrevocable.
Signature of Witness
Name in
BLOCK LETTERS ........
Hong Kong I.C. No.
Date
Signature.....
Name in
BLOCK LETTERS
Hong Kong I.C. No.
TRN
T
Date
(Day)
(Month)
II. To: Director of Accounting Services
I have returned the triplicate copy of this form to the officer for his retention.
Deleté as appropriate
Distribution
Original to be forwarded to the Treasury Duplicate to be retained by the Department Triplicate to be returned to the applicant
G.F. 564B
for (
Date
(
(Year)
IL
B
(Head of Department)
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