TNAG-2687-FCO40-3889-Hong-Kong-Her-Majesty-s-Overseas-Civil-Service-(HMOCS)-poli-1993 — Page 84

I.

Annex III

Widows and Orphans Pension Scheme/Surviving Spouses' and Children's Pensions Scheme

ELECTION FORM B

(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

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.

(the implementation date) 4/93 and to retain the pension benefits

Signature of

Witness

Name in

BLOCK LETTERS

Hong Kong I.C. No.

Date

Signature

Name in

BLOCK LETTERS

Hong Kong I.C. No.

TRN

Date

B

(Day) (Month)

(Year)

II. To: Director of Accounting Services

I have returned the triplicate copy of this form to the officer for his retention.

• Delete 25 appropriate

Distribution Original

to be forwarded to the Treasur Duplicate to be retained by the Department Triplicate - to be returned to the applicant G.F. 564B

for (

(Head of Department)

Date

>