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Gratuity Fund Nomination Form

Kumar Pradeep has nominated his spouse, Anjali Devi, as the sole beneficiary to receive the 100% of benefits payable from his gratuity fund in the event of his death. The nomination form provides his personal details like employee number, date of birth, address as well as the details of his spouse as the nominee including her name, address, date of birth, and share of money payable which is indicated as 100%. The form was signed by Kumar Pradeep on May 13, 2011 in front of the trustee of the Tata Consultancy Services Employees' Gratuity Fund.

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Pradeep Yadav
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2K views2 pages

Gratuity Fund Nomination Form

Kumar Pradeep has nominated his spouse, Anjali Devi, as the sole beneficiary to receive the 100% of benefits payable from his gratuity fund in the event of his death. The nomination form provides his personal details like employee number, date of birth, address as well as the details of his spouse as the nominee including her name, address, date of birth, and share of money payable which is indicated as 100%. The form was signed by Kumar Pradeep on May 13, 2011 in front of the trustee of the Tata Consultancy Services Employees' Gratuity Fund.

Uploaded by

Pradeep Yadav
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Gratuity Fund Nomination Form https://apps.ultimatix.org/OA_HTML/tcscustom/tcs_hr_gf_display.jsp?pr...

Emp No : 356994 Request No : 785885


Branch : TCS - Bangalore Location : Pioneer-Blr-Sez

FORM OF APPOINTMENT OF BENEFICIARY

(NOMINATION)

Name of Employee : Kumar, Mr. Pradeep


Father's/Husband's
: Mr. Asha Ram Yadav
Name
Marital
Sex : Male MARRIED
Status :
Date of Birth : 07 Apr 1983
: Village -Mou ,Post- Bhitar Gaon
Permanent Address
Distt-Rai Bareli

To
The Trustees
Tata Consultancy Services Employees’ Gratuity Fund
Air India Bldg., 11th Floor,
Nariman Point, Mumbai – 400 021.

Dear Sir,

I Kumar, Mr. Pradeep a Member of the TATA CONSULTANCY SERVICES Employee’s Gratuity Fund hereby agree
to abide by the Rules of the said Fund and do also hereby appoint in terms Rule of the Beneficiary / Beneficiaries / Nominee/s
mentioned hereunder to receive the benefits, payable under the Fund, in the event of my death before the amount become
payable has not been paid.

I hereby direct that the benefits under the Fund, payable in respect of me, shall be paid to the said Beneficiary / Beneficiaries/
Nominee/s in proportion indicated against their respective names as given below.

Name and address Nominee’s Date of Name and address Relationship of the Share of
of nominee or relationship Birth of the Guardian Guardian with minor moneys
nominees with employee nominee payable

MS. Anjali Devi Spouse 17/10/1990 Not Applicable Not Applicable 100
village Mou,Post
Bhitar Gaon
raibareli U.P. pin
229205

. Certified that I have no family and should I acquire a family hereafter, the above nomination should be deemed as cancelled.
1

2. Certified that my father/mother/sister(s) /minor brother(s) is/are not dependant upon me.

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Gratuity Fund Nomination Form https://apps.ultimatix.org/OA_HTML/tcscustom/tcs_hr_gf_display.jsp?pr...

Signed on 13th May 2011 at ___________________

Signature of the Member

I. (1) Signature : II. (1) Signature :

(2) Name : (2) Name :

(3) Address : (3) Address :

Certified that the above appointment of Beneficiary/Nominee has been signed by Kumar, Mr. Pradeep before me after he/she
has read the entries, the entries have been read to him/her by me and that the said appointment of Beneficiary/Nominee is
recorded under the Fund on 13th May 2011

____________________

Signature of Trustee/s
FOR SELF AND CO-TRUSTEES OF
Date : 13th May 2011 TATA CONSULTANCY SERVICES
EMPLOYEES’ GRATUITY FUND

2 of 2 5/13/2011 10:14 AM

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