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    Form F Gratuity Nomination

    Uploaded by

    Rayees Shaikh
    1. The document is a nomination form for an employee to nominate beneficiaries to receive any gratuity payment due after the employee's death. 2. It requests information about the employee such as name, gender, religion, marital status, department, and permanent address. 3. The employee provides details of the nominated beneficiaries including their name, address, relationship to the employee, age, and proposed share of any gratuity.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Form F Gratuity Nomination

    Uploaded by

    Rayees Shaikh
    157 views2 pages
    1. The document is a nomination form for an employee to nominate beneficiaries to receive any gratuity payment due after the employee's death. 2. It requests information about the employee such as name, gender, religion, marital status, department, and permanent address. 3. The employee provides details of the nominated beneficiaries including their name, address, relationship to the employee, age, and proposed share of any gratuity.

    Original Description:

    Gratuity form

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    1. The document is a nomination form for an employee to nominate beneficiaries to receive any gratuity payment due after the employee's death. 2. It requests information about the employee such as name, gender, religion, marital status, department, and permanent address. 3. The employee provides details of the nominated beneficiaries including their name, address, relationship to the employee, age, and proposed share of any gratuity.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    157 views2 pages

    Form F Gratuity Nomination

    Uploaded by

    Rayees Shaikh
    1. The document is a nomination form for an employee to nominate beneficiaries to receive any gratuity payment due after the employee's death. 2. It requests information about the employee such as name, gender, religion, marital status, department, and permanent address. 3. The employee provides details of the nominated beneficiaries including their name, address, relationship to the employee, age, and proposed share of any gratuity.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    FORM - “F”

    (See sub rule (I) of Rule 6)

    NOMINATION

    To
    The _________________________

    _____________________________

    _____________________________

    (Give here name of description of the establishment with full address)

    I, Shri ______________________________________________________ whose particulars


    (Name in full)
    are given in the statement below, hereby nominate the person(s) mentioned below to receive the Gratuity payable
    after my death as also the gratuity standing to my credit in the event of my death before that amount has become
    payable or having become payable has not been paid and direct that the said amount of gratuity shall be paid in
    proportion indicated against the name(s) of nominee (s)

    2. I hereby certify that the person(s) nominated in a /are member (s) of my family within the meaning of the
    clause (h) of Section 2 of the payment of Gratuity Act-1972

    3. I hereby declare that I have no family within the meaning of clause (h) of section (2) of the said act.

    4. (a) My father / Mother / parents is /are not dependent on me.


    (b) My husband’s father / mother / parents is /are not dependent on my husband.

    5. I have excluded my husband from my family by a notice dated the _____________ to the controlling authority
    in terms of the provision to clause (h) of section 2 of the said Act.

    6. Nomination made herein invalidates my previous nomination.

    N o m i n e e (s)
    Name in full with full address of Relationship with Age of Proportion by which the
    Nominee(s) the employee. Nominee gratuity will be shared
    1 2 3 4

    1. Name of the employee in full :

    2. Sex. :

    3. Religion. :
    ..2..
    ..2..

    4. Whether unmarried / married/Widow/widower :

    5. Department / Branch / section where employed :

    6. Post held with Ticket order No.or Sr.No.if any :

    7. Date of appointment. :

    8. Permanent Address. :

    Village - Thana District

    State

    Place –
    Signature /Thumb impression
    Date - of the employee.
    -------------------------------------------------------------------------------------------------------------------------------------------------------
    Declaration by witnesses

    Nomination signed / thumb impressioned before me

    Name in full and full address of witness.

    Signature of witness

    1. _________________________________________________

    2. _________________________________________________

    __________________________________________________________________________________________

    CERTIFICATE BY THE EMPLOYER

    Certified that the particulars of the above nomination have been verified and recorded in this establishment.
    Employer’s reference No. if any ________________

    Signature of the employer officer/authorized

    __________________________________________________________________________________________
    Acknowledgement by the employee

    Received the duplicate copy of the nomination in form “F” filed by me and duly certified by the employer.

    Signature of the employee.

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