FORM OF APPOINTMENT OF NOMINEES UNDER THE RULE OF TACO GROUP
EMPLOYEES GRATUITY SCHEME
The Trustees,
TACO Group Employees GRATUITY SCHEME,
Beck House, 1st Floor, Damle Path, Off Law College Road,
Erandawana,Pune – 411 004.
I______________________________________________________ a member of TACO Group Employees GRATUITY
SCHEME, hereby agree to abide by the rules of the said scheme and do also hereby appoint in terms of Rule 18 of the Rules
governing the Scheme, the Nominees mentioned hereunder to receive the benefits, payable under the Scheme in the event of my
death before that amount becomes payable and having become payable has not been paid.
I hereby direct that the benefits under the Scheme, payable in respect of me, shall be paid to the said Nominee/s proportion
indicated against their respective names given below.
Proportion by
which the Gratuity
Name in full with full address of the Relationship with the
Sr No Age of the Nominee/s (Total Benefits)
Nominee/s Member(Employee)
will be shared by
each Nominee
I hereby certify that the person mentioned herein above is / are my spouse / children lawfully adopted child / dependent parents /
husband.
I hereby declare that I have no family and should I require family hereafter the appointment of Nominee made hereunder should
be deemed as cancelled.
Mt father/mother/parents/sister(s)/minor brother(s) is/are not dependent on me.
My husband’s father/mother/parents is/are not dependent on me.
I also declare that this appointment of Nominee/s made herein shall have the effect of my revoking the appointment of Nominee/s
made by me earlier.
I give below particulars about myself
1. Full Name :
2. Sex :
3. Religion :
4. Father’s Name :
5. Marital Status :
6. Spouse’s Name :
7. Date of Birth :
8. Permanent Address :
Signed at _______________________________ this _________________ day of ________________ 20___________
(Signature )
TWO WITNESS TO THE SIGNATURE
WITNESSED BY
Sr No. Name Address Signature
1.
2.
Certified that the above appointment of Nominee has been signed by Shri/Smt._____________________________________
Before me after he/she has read the entries and the said appointment of the Nominee is recorded under the Scheme For TACO
GROUP EMPLOYEES GRATUITY SCHEME
Place:
Date:
Note:-
1. Where an Employee/Member has a family at the time of appointing a Nominee, the Nomination should be made in
favour of the members of family only. Any nomination made by such Employee in favour of any other persons not
belonging to his family shall be invalid.
2. Appointment of Nominee made by the Member may be changed at any time, after giving a written notice to the Trustees
of his intention to do so. If the Nominee predecesses the Member (Employee) the interest of the Nominee shall revert to
the Member (Employee) or to his Estate.
3. The appointment of Nominee or any change thereof made from time to time shall take effect to the it is valid on the date
on which it has been received by the Trustees.
4. For the purpose of the Scheme “Family” means Member’s (Employee’s) Spouse, legitimate children/step children,
parents, sisters and minor brothers dependent upon him.
