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    Form F - Gratuity

    Uploaded by

    Hanan Basith

    Copyright:

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

    Form F - Gratuity

    Uploaded by

    Hanan Basith
    4 views2 pages

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
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    Download as pdf or txt
    4 views2 pages

    Form F - Gratuity

    Uploaded by

    Hanan Basith

    Copyright:

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

    FORM ’F’
    See sub-rule (1) of Rule 6

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

    IGT Solutions Pvt. Ltd.


    Mr. Hanan BASITH Basith
    1. I, Shri Shrimati Kumari
    ( 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 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/are a member(s) of my family within the meaning of clause (h) of Section 2 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 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 clause

    ( h) of Section 2 of the said Act

    6. Nomination made herein invalidates my previous nomination.

    Nominee(s)
    Proportion by which
    Name in Full with full Address of Relationship with the Age of
    the Gratuity will be
    Nominee(s) Employee Nominee
    Shared

    Ameekha VP
    Sister 14 100

    Statement
    1. Name of employee in full * Hanan BASITH Basith
    Male
    2. Sex

    3. Religion
    Single
    4. Whether unmarried/married/widow/widower

    United
    5. Department/Branch/Section where employed

    20156690
    6. Post held with Ticket No. or Serial No., if any

    7. Date of appointment 13/11/2024

    8. Permanent address: VP House, ullattinchiranilam, changala road, Kuttiyilthazham

    Sub-division Manavu, Calicut, PO kommeri, 673007


    Post Office District Calicut
    State
    Place: Calicut

    Date: 13/11/2024

    Declaration by Witnesses

    Nomination signed/thumb-impressed before me Signature of Witnesses


    Name in full and full address of witnesses.
    Abdul Jaleel
    1.
    1. Abdul Jaleel

    Mubitha KP
    2.
    VP House, ullattinchiranilam, changala
    2. Mubitha KP
    road, Kuttiyilthazham

    Place:
    Gurgaon-Falcon

    Date: 13/11/2024

    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 Signature of the employer/Officer

    Authorised 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: 13/11/2024

    Note.- Strike out the words/paragraphs not applicable

    Electronically signed by:


    Hanan Basith

    Signature of the Employee


    Electronically signed by:
    Hanan Basith

    Signature/Thumb-impression of the Employee

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