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    Gratuity 3

    Uploaded by

    Dinesh N
    This document is a nomination form for gratuity payment to be made to the nominee(s) after the employee's death. The employee, PRASATH R, nominates his mother, R Santhi, to receive the full gratuity amount. The form includes personal details of the employee and declarations regarding family status and dependency.

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

    Gratuity 3

    Uploaded by

    Dinesh N
    2 views2 pages
    This document is a nomination form for gratuity payment to be made to the nominee(s) after the employee's death. The employee, PRASATH R, nominates his mother, R Santhi, to receive the full gratuity amount. The form includes personal details of the employee and declarations regarding family status and dependency.

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    © © All Rights Reserved

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    This document is a nomination form for gratuity payment to be made to the nominee(s) after the employee's death. The employee, PRASATH R, nominates his mother, R Santhi, to receive the full gratuity amount. The form includes personal details of the employee and declarations regarding family status and dependency.

    Copyright:

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

    Gratuity 3

    Uploaded by

    Dinesh N
    This document is a nomination form for gratuity payment to be made to the nominee(s) after the employee's death. The employee, PRASATH R, nominates his mother, R Santhi, to receive the full gratuity amount. The form includes personal details of the employee and declarations regarding family status and dependency.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 2

    FORM F

    [See sub-rule (1) of rule 6]


    NOMINATION
    TO
    NatWest Digital Services India Private Limited, (Formerly known as RBS Services India Private Limited)
    6th Floor, Building - 2, Tower-A, GIL IT/ ITES SEZ, Candor Techspace, Sector-21, Dundahera, Gurugram,
    Haryana - 122016.
    (Give here name or description of the establishment with full address)
    1. shri.shrimati/Kumari PRASATH R (Name in full here)
    Whose particulars are given in the statement below, hereby nominate the person(s) mentioned below to
    receive the gratuity payable after my death as also 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 the nominee(s).

    2. I hereby certify that the person(s) mentioned is/are member(s) of my family within the meaning of Cl.
    (h) of Sec. 2 of the Payment of Gratuity Act, 1972.

    3. I hereby declare that I have no family within the meaning of Cl. (h) of Sec.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 proviso to Cl. (h) of Sec.2 of the said Act.

    6. Nomination made herein invalidates my previous nomination.

    NOMINEE(S)
    Relationship Proportion by
    Age of
    Name in full with full address of nominee(s) with the which the gratuity
    nominee
    employer will be shared
    1 2 3 4
    R Santhi
    1/532, S1 B BLOCK , UMA FLATS, , GAJENDRA NAGAR
    Mother 42 100.00
    4TH STREET, , PERUMBAKKAM , CHENNAI , TamilNadu ,
    INDIA - 600100.

    STATEMENT
    1. Name of employee in full -PRASATH R
    2. Sex - Male
    3. Religion
    4. Whether unmarried/married/widow/widower - Unmarried
    5. Post held with Ticket or Serial. No., if any - 8201330
    6. Department/Branch/Section where employed - CC1 CQ LETTERS
    7. Date of appointment - 28-Dec-2023
    8. Permanent address - 1/532, S1 B BLOCK , UMA FLATS, , GAJENDRA NAGAR 4TH STREET, ,
    PERUMBAKKAM , CHENNAI , TamilNadu , INDIA - 600100.

    Village……………………Thana…………….sub-division………………………
    Post office………………District…………………State………………………

    Signature/Thumb-impression of the employee.


    Place....................
    Date....................

    DECLARATION BY WITNESSES
    Fresh nomination signed/thumb-impressed before me.
    Name in full and full address of: Signature of
    witnesses:
    1……………………… 1……………………………
    2……………………… 2……………………………
    Place...................
    Date....................

    CERTIFICATE BY THE EMPLOYER


    Certificate that the particulars of the above nomination have been verified and recorded in this establishment.
    Employer’s Reference No., if any.
    Date....................

    Signature of the employer/


    officer authorised.
    Designation. Name and address of the establishment
    Or rubber stamp thereof

    ACKNOWLEDGMENT BY THE EMPLOYEE

    Received the duplicate copy of nomination in Form f filed by me and duly certified by the employer.

    Date....................
    Signature
    of the employee.
    Note,- strike out the words and paragraphs not applicable

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