NOMINATION FOR GRATUITY — FORM F
Filed under Section 6 of the Payment of Gratuity Act, 1972 read with Rule 6 of the Payment of Gratuity (Central) Rules, 1972.
To,
The [Employer / Controlling Authority],
[Company Name], [Address]
I, [Employee Name], whose particulars are given below, nominate the following person(s) to receive the gratuity payable after my death.
| Employee Name | [Employee Name] | Employee Code | [EMP-____] |
| Sex | [Male/Female] | Religion | [__________] |
| Marital Status | [__________] | Date of Appointment | [DD/MM/YYYY] |
| Department / Branch | [Department] | ||
| Name of Nominee(s) | Relationship with Employee | Age of Nominee | Proportion of Gratuity (%) |
|---|---|---|---|
| [Nominee Name] | [Relationship] | [___] | [___%] |
| [Nominee Name] | [Relationship] | [___] | [___%] |
Statement: I have no family within the meaning of Section 2(h) of the Act. / I have family and my nominee(s) are members of my family. (Strike out whichever is not applicable.)
Place: [Place] Date: [DD/MM/YYYY] _______________________
Signature / Thumb impression of Employee
Declaration by Employer (acknowledgement): Nomination received on [DD/MM/YYYY]. _______________________ (Authorised Signatory)
Compliance note: If the employee has a family, nomination must be in favour of family members only; otherwise it is void. Fresh nomination (Form F) is required on acquiring a family; use Form G/H for modification.