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GratuityFundFormpdf 1732511446054

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21 views4 pages

GratuityFundFormpdf 1732511446054

Uploaded by

vaghelaadesh11010
Copyright
© © All Rights Reserved
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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DECLARATION FOR CLAIMING THE GRATUITY FUND

I, VAGHELA AADESH LAKHMANBHAI, SO / WO / DO LAKHMANBHAI BHIKHABHAI VAGHELA declare


that before joining Aditya Birla Finance Limited, I had received an aggregate amount of Rs. ______ (in words
Rupees ______________________________________________________) towards payment of Gratuity as nontaxable
and Rs. ____________________ if claimed as taxable on which Rs. ________________________ is deducted as
income Tax.

OR

I, VAGHELA AADESH LAKHMANBHAI, SO/WO/DO LAKHMANBHAI BHIKHABHAI VAGHELA declare that


before joining Aditya Birla Finance Limited, I had not received any amount towards payment of Gratuity
from any employer as I was not eligible for the same.

The above declaration is true and in case anything contrary to the same is even found, I shall be liable for
appropriate legal action

Name of the employee: VAGHELA AADESH LAKHMANBHAI

Employee code:

Signature of the employee


Establishment or rubber stamp there of ________________________________________

NOMINATION

Form F

(See sub-rule(1) of
Rule 6)

To

Aditya Birla Finance Limited


_________________________________________
_________________________________________
_________________________________________
_________________________________________

1. I Shri/Shrimathi/Kumari VAGHELA AADESH LAKHMANBHAI Whose particulars are given in


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 every month of my death before the
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 here by certify that the person(s) mentioned is/are a member(s) of my family within the meaning
of Clauses(h) of Section 2 of 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/parent is/are not dependent on me.

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 here in invalidates my previous nomination.

Relationship Proportion by which


S
Name in full with full address of nominee(s) with the DOB the Gratuity will be
No.
employee shared
POOJA ADESH VAGHELA , 29-
05 FIRST STREET SARDAR PATEL SOCIETY NR 12-
1 Spouse 100%
SMVS MANDIR DABHOLI SURAT Gujarat (GJ) 2002
India 395004
Statement

1. Name of the employee in full: VAGHELA AADESH LAKHMANBHAI

2. Sex: Male

3. Religion: Hindu

4. Whether unmarried/married/widow/widower: Married

5. Department/Branch/Section where employed: Relationship Officer

6. Post held with ticket No. or serial No., if any:

7. Date of appointment:

8. Permanent Address:

Village VTC: SURAT CITY Thana _______________ Post office ____________________________ District SURAT
state Gujarat (GJ)

Place: 5 SARDAR PATEL SOCIETY,DABHOLI,VTC: SURAT CITY,PO: KATARGAM, SUB DISTRICT: SURAT
CITY,SURAT,Gujarat (GJ),395004,India

Signature/Thumb-impression of the employee


Date: 18-11-2024 6:53

Declaration by witnesses
Nomination signed/thumb-impressed before me name in
Signature of Witnesses
full and full address of witness.
1._________________________________________________ _________________________________________________
_________________________________________________
2._________________________________________________ _________________________________________________
_________________________________________________

Place: ________________________

Date: ________________________

Certificate by the employer


Certified that the particulars of the above nominations have been verified and recorded in the
establishment,
Employer's reference No., if any Signature of the employer/officer authorized
designation
Date:
Name and address of the establishment or rubber stamp thereof

Acknowledgement by the employee received the duplicate copy of nomination in form 'F' filed by
me and duly certified by the employer.
Date: 18-11-2024 6:53

Signature of the employee

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