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    Form F Gratuity Nomination - Filled

    Uploaded by

    gunturisunilmanohar

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

    Form F Gratuity Nomination - Filled

    Uploaded by

    gunturisunilmanohar
    19 views3 pages

    Original Title

    Form F Gratuity Nomination_Filled

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    © All Rights Reserved
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    19 views3 pages

    Form F Gratuity Nomination - Filled

    Uploaded by

    gunturisunilmanohar

    Copyright:

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

    Payment of Gratuity (Central) Rules

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

    Nomination

    To, INNOMIDS SOFRWARE PRIVATE LIMITED


    (Give here name or description of the establishment with full address)
    Kala Jyothi Building, Survey No 185, Kondapur Village,
    Serilingampally, Hyderabad, Telangana - 500084.

    I, Shri/Shrimati/Kumari Sunil Manohar Gunturi


    (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 Not Applicable 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)

    Name in full with full Relationship with Age of Proportion by which


    address of nominee(s) the employee nominee the gratuity will be
    shared

    (1) (2) (3) (4)

    1. Lakshmi Naga Sarvani Gunturi Wife 35 100%


    2.
    3.
    So
    on.
    Statement
    1. Name of employee in full Sunil Manohar Gunturi

    2. Sex Male
    3. Religion Hindu
    4. Whether unmarried/married/widow/widower Married
    5. Department/Branch/Section where employed QA Department
    6. Post held with Ticket No. or Serial No., if any Not Applicable
    7. Date of appointment 29-Aug-2022
    8. Permanent address:
    Village Hyderabad Thana Miyapur Sub-division Miyapur
    Post Office Matrusri Nagar District Ranga Reddy State Telangana

    Place: Hyderabad
    Signature/Thumb-impression of the
    Employee
    Date: 20-Oct-2022

    Declaration by Witnesses

    Nomination signed/thumb-impressed before me


    Name in full and full address of witnesses. Signature of Witnesses.
    1. 1.

    2. 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 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: Signature of the Employee

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