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    Gratuity Nomination Form PDF

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    moviegoer
    Pranay Kumar Sharma nominates his spouse Namita Kaushik to receive 100% of any gratuity payable after his death from his employer Sapient Consulting Private Limited. He certifies that Namita Kaushik is a member of his family as defined by law. The nomination invalidates any previous nominations and was signed and witnessed on July 15, 2016.

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    Gratuity Nomination Form PDF

    Uploaded by

    moviegoer
    413 views3 pages
    Pranay Kumar Sharma nominates his spouse Namita Kaushik to receive 100% of any gratuity payable after his death from his employer Sapient Consulting Private Limited. He certifies that Namita Kaushik is a member of his family as defined by law. The nomination invalidates any previous nominations and was signed and witnessed on July 15, 2016.

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    Gratuity Nomination Form .pdf

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    Pranay Kumar Sharma nominates his spouse Namita Kaushik to receive 100% of any gratuity payable after his death from his employer Sapient Consulting Private Limited. He certifies that Namita Kaushik is a member of his family as defined by law. The nomination invalidates any previous nominations and was signed and witnessed on July 15, 2016.

    Copyright:

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

    Gratuity Nomination Form PDF

    Uploaded by

    moviegoer
    Pranay Kumar Sharma nominates his spouse Namita Kaushik to receive 100% of any gratuity payable after his death from his employer Sapient Consulting Private Limited. He certifies that Namita Kaushik is a member of his family as defined by law. The nomination invalidates any previous nominations and was signed and witnessed on July 15, 2016.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    FORM .F.

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


    Nomination
    To
    Sapient Consulting Private Limited
    Tower B, Building 8, 1st Floor, Infospace Ltd,
    SEZ, Sector-21, Village Dundahera, Gurgaon,
    Haryana 122016
    1.
    I, Shri/Shrimati/Kumari PRANAY KUMAR SHARMA (Write your full Name) 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 the 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 a/are member(s) of my family within meaning of clause (h) of Section(s) of the 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/parents is/are not dependent on me.
    (b) My husbands 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 clause (h)
    of Section 2 of the said Act.
    6. Nomination made herein invalidates my previous nomination.

    NOMINEE(S)
    Full Name of the Nominee Full Address of the Nominee Relationship with the Age of Nominee Proportion by which
    Employee Gratuity will be shared
    Namita Kaushik 460/8A Beharipur Civil Lines, GGIC Road, Spouse 22-Nov-1985
    Bareilly ,UP 243001 100
    Statement

    1 Full Name of the Employee Pranay Kumar Sharma


    2 Gender M
    3 Religion Hindu
    4 Marital Status (single/married/widow/widower) Married
    5 Department/Branch/Section where employed Delivery
    6 Post held with Ticket or Serial No., If any
    7 Date of appointment 01-Sep-2014
    8 Permanent address 460/8A Beharipur Civil Lines, GGIC Road, Bareilly ,UP

    9 Place/Location Noida - Aachvis Sez


    10 Date 15-Jul-2016
    11 Signature/Thumb-impression of the employee

    Declaration by witnesses
    Nomination signed/thumb-impressed before me.
    Name in full and full address of witnesses:
    S.No Full Name Full Address Signature

    2
    Place_______________
    Date________________
    Certificate by the Employer

    Certified that the particulars of the above nomination have been verified and recorded in this
    establishment.

    Employer.s Reference No. if any


    Signatures of the employee/officer authorized
    Designation
    Name and address of the establishment Sapient Consulting Private Limited
    Tower B, Building 8, 1st Floor, Infospace Ltd, SEZ, Sector-21, Village
    Dundahera, Gurgaon, Haryana 122016

    Rubber Stamp

    Date

    Acknowledgement by the employee

    I received the duplicate copy of nomination in Form .F. filed by me and duly certified by the employer.

    Date
    Signature

    Note.Strike out the words/paragraph not applicable.

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