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    Form I Application For Gratuiiy by An Employee

    Uploaded by

    Manish_gupta75
    The document is an application for gratuity submitted by an employee to their employer after completing 5 or more years of continuous service. It provides details of the employee such as name, address, designation, date of appointment and termination. It specifies whether the application is for superannuation, retirement, resignation, disablement or disease. It requests payment of the claimed gratuity amount via RTGS/NEFT or postal money order if the amount is less than Rs. 1000 and deducts commission. It includes declarations of total disability details if applicable and receipt of prior gratuity payments from previous employers.

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    © All Rights Reserved
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    Form I Application For Gratuiiy by An Employee

    Uploaded by

    Manish_gupta75
    84 views3 pages
    The document is an application for gratuity submitted by an employee to their employer after completing 5 or more years of continuous service. It provides details of the employee such as name, address, designation, date of appointment and termination. It specifies whether the application is for superannuation, retirement, resignation, disablement or disease. It requests payment of the claimed gratuity amount via RTGS/NEFT or postal money order if the amount is less than Rs. 1000 and deducts commission. It includes declarations of total disability details if applicable and receipt of prior gratuity payments from previous employers.

    Original Description:

    Gratuity Form used in India

    Original Title

    Gratuity Form I

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    The document is an application for gratuity submitted by an employee to their employer after completing 5 or more years of continuous service. It provides details of the employee such as name, address, designation, date of appointment and termination. It specifies whether the application is for superannuation, retirement, resignation, disablement or disease. It requests payment of the claimed gratuity amount via RTGS/NEFT or postal money order if the amount is less than Rs. 1000 and deducts commission. It includes declarations of total disability details if applicable and receipt of prior gratuity payments from previous employers.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    84 views3 pages

    Form I Application For Gratuiiy by An Employee

    Uploaded by

    Manish_gupta75
    The document is an application for gratuity submitted by an employee to their employer after completing 5 or more years of continuous service. It provides details of the employee such as name, address, designation, date of appointment and termination. It specifies whether the application is for superannuation, retirement, resignation, disablement or disease. It requests payment of the claimed gratuity amount via RTGS/NEFT or postal money order if the amount is less than Rs. 1000 and deducts commission. It includes declarations of total disability details if applicable and receipt of prior gratuity payments from previous employers.

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    © All Rights Reserved
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    FORM I

    [See sub-Rule (1) of Rule 7]


    APPLICATION FOR GRATUIIY BY AN EMPLOYEE

    To
    Name of the Legal Entity,
    OHR ID : …………………………
    …………………………………….. Mobile : ………………………...
    Address of the Legal Entity, E-mail ID : ………………………..
    ………………………………………………

    ………………………………………………

    Sir/Gentlemen,

    I beg to apply for payment of gratuity to which I am entitled under sub-section (1) of Section 4 of the
    Payment of Gratuity Act, 1972 on account, after completion of not less than five years of continuous service,
    on my:

     Superannuation
     Retirement
     Resignation
     Total disablement due to accident
     Total disablement due to disease

    with effect from (DOR)________________Necessary particulars relating to my appointment in the


    Establishment are given in the statement below:

    STATEMENT

    1. Name in full __________________________________________________________________


    2. Address in full ________________________________________________________________
    3. Name of the Company_ _________________________________________________________
    4. Post held with Ticket or Serial No. if any ( Designation)________________________________
    5. Date of appointment ____________________________________________________________
    6. Date and cause of termination of service _____________________ _______________________
    7. Total period of service ___________________________________________________________
    8. Amount of Basic wages last drawn __Rs. ____________________________________________
    9. Amount of gratuity claimed __Rs. __________________________________________________
    2. I was rendered totally disabled as a result of—
    (Here give the details of the nature of disease or accident)_________________________________
    The evidences/witnesses in support of my total disablement are as follow:-
    _______________________________________________________________________________

    3. Payment may please be made in RTGS/NEFT.

    4. As the amount of gratuity payable is less than Rupees One Thousand. I shall request you to arrange for
    payment of the sum due to me by Postal Money Order at the address mentioned above after deducting Postal
    Money Order commission there from.

    Yours faithfully,
    Place: Delhi Signature/ Thumb-impression
    Date : of the applicant-employee
    Name of the Legal Entity,
    _____________________

    Address of the Legal Entity,


    ____________________________________

    ____________________________________

    Declaration
    I ____________________________ S/0,D/0,W/o _____________________ Resident of _
    __________________________________________________________Employee
    no.__________________ has resigned from the services of_______________________as on
    _________________.

    I hereby declare that I have received a total sum of Rs. __________________ from my previous
    employer as my gratuity benefit.

    My PAN No. is _________________

    Thanking you,

    Your’s Faithfully,

    (Name of the Employee)


    Address: ________________________
    ________________________________
    ________________________________
    ________________________________

    Place: _______________
    Dated: _______________

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