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    A Maheswararao Form F

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    mbmaheshmba

    Copyright:

    © All Rights Reserved
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    A Maheswararao Form F

    Uploaded by

    mbmaheshmba
    5 views2 pages

    Original Title

    A Maheswararao Form f

    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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    5 views2 pages

    A Maheswararao Form F

    Uploaded by

    mbmaheshmba

    Copyright:

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

    THE PAYMENT OF GRATUITY RULE, 1972.

    FORM F
    (See sub rule (1) of rule 6)
    Nomination

    Fed Bank Financial Services Limited


    To:

    1 Shri/Shrimati/ Kumari ATTHILIUMA DURGA MAHESWARARAO


    whose particulars are given in the statement below, hereby nominate the person(s) mentioned
    my credit in
    below tO receive the gratuity payable after my death as also the gratuity standing to payable
    amount has become payable, or having become has
    the event of my death before that indicated
    the said amount of gratuity shall be paid in proportion
    not being paid and direct that
    against the name(s) of the nominee(s).
    family within the
    2 Thereby certify that the person(s) mentioned is/are member(s) of my
    meaning of clause(h) of section 2 of the Payment of Gratuity act, 1972.
    section 2 of of the said
    3 Thereby declare that I have no family within the meaning of clause(h) of
    act.

    4. (a) My father/ mother/ parents is/ are not dependent on me.


    husband.
    (b) My husband's father/ mother/ parents is/ are not dependent on my
    to the controling
    5 Ihave excluded my husband from my family bya notice dated the said act.
    authority in terms of the provision to the clause(h)of section 2 of the
    6. Nomination made herein invalidates my previous nominations.

    NOMINEE(S)
    Name in full with address Relationship Age of the Proportion by
    of the nominee(s) with the nominee which the gratuity
    will be shared
    Sr No. employee
    (2) (3) (4)
    (1)
    1.
    47 So).

    2 Mo7tleR
    A:

    STATEMENT

    1.
    HINDU
    Religion
    2 Sex
    MALE
    Atthili Uma Durga Maheswararao

    3 Name of Employee in full

    4. Whether unmaried / married/ widow /widower


    5. Department/branch/section where employed

    6 Post held with ticket or serial number if any

    13-Mar-2024
    7 Date of appointment
    DOOR No 21-10/2-113 VIJAYADURGANAGAR, BUDAMERU MADHYA KATTAVIJAYAVWADA
    8 Permanent Address

    Thana Sub division


    Villagevj Ay 4waDA
    Post office AyANARay4 District State UIjAy Aw APA

    Place: v2]Ayaw ADA Signaturettumb impression


    Date: of the employee.

    DECLARATION BY WITNESS

    Nomination signed/thumb impressed before me.


    Name and full address of the witnesses.
    Signatufebf the witnesses
    1 1.
    2
    Joun
    Place:VAYAWAD4
    Date:

    CERTIFICATE BY THE EMPLOYER

    recorded in this establishment.


    Certify that the particulars of the above nomination have been verified and
    Employers reference No. If any:

    Signature of the employer/ officer authorized.

    Designation :
    Date
    Name and address of the establishment or
    rubber stamp therof

    ACKNOWLEDGMENT BY THE EMPLOYEE

    me and duty certifjed, by the employer:


    Received the duplicate copy of nomination in form "F" filed by

    Signatture of the employee:


    Date

    Note: Strike out the words/paragraphs not applicable.

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