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    FormF.DOCX (2)

    Uploaded by

    Gyanapriya Pradhan

    Copyright:

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

    FormF.DOCX (2)

    Uploaded by

    Gyanapriya Pradhan
    10 views2 pages

    Copyright

    © © All Rights Reserved

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    10 views2 pages

    FormF.DOCX (2)

    Uploaded by

    Gyanapriya Pradhan

    Copyright:

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

    FORM ‘F’

    THE PAYMENT OF GRATUITY ACT


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

    To. TTEC INDIA CUSTOMER SOLUTIONS PVT. LTD.

    (Give here name or description of the establishment with full address)


    1 Shri/Shrimati/Kumari
    Gyanapriya Pradhan
    (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)
    Proportion by
    Name in full with full address of Relationship with the Date Of Birth & Age
    which the gratuity will be
    nominee(s) employer of Nominee(s)
    shared
    1 2 3
    4
    1 Jayanti Pradhan Mother 02.05.1970 100%
    54 year

    so on,
    STATEMENT
    1. Name of employee in full: Gyanapriya Pradhan
    2. Sex: Male
    3. Religion: Hindu
    4. Whether unmarried/married/widow/widower: Unmarried
    5. Department/Branch/Section where employed: Undergoing Training
    6. Post held with Ticket or Serial. No., if any.
    7. Date of appointment. 27.09.2024
    8. Permanent address : Flat 3B7, Annapurna tower, Bhubaneswar, Odisha

    Village :________Kantilo_____________ Thana : Airfield_____________ Sub-division :_____________________


    Post Office :____________Kuha______________ District : Khordha State : Odisha
    Place: Bhubaneswar
    Date: 27.09.2024 Signature/Thumb impression of the Employee

    DECLARATION BY WITNESSES
    Nomination signed/thumb-impressed before me.
    Signature of witnesses
    Name in full and full address of:
    1.

    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.

    Name and address of the establishment Or rubber stamp Signature of the Employer/Authorised officer.
    thereof
    Designation Date:

    ACKNOWLEDGMENT BY THE EMPLOYER


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

    Note - Strike out the words and paragraphs not applicable. Signature of the employee

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