Employees Retirement and Pension Certificate (stamp) Under Supervision of People’s Government of Jiangsu Province In accordance with the national and provincial regulations, issue this Employees Retirement and Pension Certificate . Jiangsu Provincial Labor Department (Seal) Social security number: No. Unit of Issue: Labor Bureau Time of Issue: Name Gender Female Date of birth Ethnicity Han Household Register Type City and Town Retirement Type Retirement Starting time/date of first job/work/employment Retired time Years of payment of pension insurance 38 years 5.9 months Including Real years of payment 12 years 1.7 months Granted years of payment 16 years 4.2 months Converted years before the end of 1991 10 years months Former work place Residence after retirement 3 Provincial and civic average salary 1 The proportion of basic pension % 2 25 Basic pension 3=1*2 136.82 Estimated storage amount by the end of 1995 4 Accumulated storage amount of personal account 5 51261.3 Storage amount of personal payment 6 Individual account pension 7=(4+5)/120 427.18 Additional adjustment payments 8 80 9 10 Summary 11=3+7+8+9+10 644 Pension calculated by old way 435.7 Notes Confirmed Pension after contrast is :522.9. (items enclosed) 4 Records of basic pension v ariations Time of variation Additional amount Present pension Auditor (Seal) Audit unit (Seal) 5 Records of basic pension v ariations Time of variation Additional amount Present pension Auditor (Seal) Audit unit (Seal) 6 Records of basic pension v ariations Time of variation Additional amount Present pension Auditor (Seal) Audit unit (Seal) 7 Records of basic pension v ariations Time of variation Additional amount Present pension Auditor (Seal) Audit unit (Seal) 08/30/2000 Pension 600.80 Subsidy for house 14.10 Dependent immediate family members Name Date of birth Relationship Note 8 Application Notes 1. This Certificate is under supervision of Jiangsu Provincial People's government, filled in accordance with , issued by labor and administration department, kept by the retired employees. 2. The retired employees could draw basic pension from the assigned or consigned unit by the local social security units. 3. The retired employees shall submit this certificate to the local social security unit to audit and record when the pension standard is adjusted. 4. If this certificate is altered, seal of issuing department is requested. Otherwise it's invalid. 5. This certificate shall be properly kept. The loss must be reported to the issuing department to claim the annulment, and apply for reissue. 6. If this certificate is ruined or destroyed, shall apply from the issuing department to change a new one.
