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    FORM I (Application For Gratuity by An Employee)

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    Deep
    This document is an application form for an employee to apply for gratuity payment under the Payment of Gratuity Act of 1972 in India. The form requests information such as the employee's name, address, department, date of appointment, date of termination, period of service, last wages drawn, and amount of gratuity claimed. It also provides options for payment by cash, cheque, or postal money order if the amount is less than 1,000 rupees. The employee is applying for gratuity due to superannuation, retirement, resignation after 5 years of continuous service, or total disablement from an accident or disease.

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    FORM I (Application For Gratuity by An Employee)

    Uploaded by

    Deep
    3K views1 page
    This document is an application form for an employee to apply for gratuity payment under the Payment of Gratuity Act of 1972 in India. The form requests information such as the employee's name, address, department, date of appointment, date of termination, period of service, last wages drawn, and amount of gratuity claimed. It also provides options for payment by cash, cheque, or postal money order if the amount is less than 1,000 rupees. The employee is applying for gratuity due to superannuation, retirement, resignation after 5 years of continuous service, or total disablement from an accident or disease.

    Original Description:

    FORM I(Application for Gratuity by an Employee)

    Original Title

    FORM I(Application for Gratuity by an Employee)

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    This document is an application form for an employee to apply for gratuity payment under the Payment of Gratuity Act of 1972 in India. The form requests information such as the employee's name, address, department, date of appointment, date of termination, period of service, last wages drawn, and amount of gratuity claimed. It also provides options for payment by cash, cheque, or postal money order if the amount is less than 1,000 rupees. The employee is applying for gratuity due to superannuation, retirement, resignation after 5 years of continuous service, or total disablement from an accident or disease.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    3K views1 page

    FORM I (Application For Gratuity by An Employee)

    Uploaded by

    Deep
    This document is an application form for an employee to apply for gratuity payment under the Payment of Gratuity Act of 1972 in India. The form requests information such as the employee's name, address, department, date of appointment, date of termination, period of service, last wages drawn, and amount of gratuity claimed. It also provides options for payment by cash, cheque, or postal money order if the amount is less than 1,000 rupees. The employee is applying for gratuity due to superannuation, retirement, resignation after 5 years of continuous service, or total disablement from an accident or disease.

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    © All Rights Reserved
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    FORM I

    [See sub-Rule (1) of Rule 7]


    APPLICATION FOR GRATUIIY BY AN EMPLOYEE
    To

    Sir/Gentlemen,
    I beg to apply for payment of gratuity to which I am entitled under sub-section (1) of
    Section 4 of the Payment of Gratuity Act, 1972 on account of my Superannuation/ retirement/
    resignation after completion of not less than five years of continuous service total disablement
    due to accident/total disablement due to disease with effect from the ____________________
    Necessary particulars relating to my appointment in the Establishment are given in the
    statement below:
    STATEMENT
    1.
    2.
    3.
    4.
    5.
    6.
    7.
    8.
    9.

    Name in full
    Address in full
    Department/ Branch/ Section where employed
    Post held with Ticket or Serial No. if any
    Date of appointment
    Date and cause of termination of service
    Total period of service
    Amount of wages last drawn
    Amount of gratuity claimed

    2. I was rendered totally disabled as a result of ________________________________.


    3. Payment may please be made in cash/ open or crossed Bank Cheque.
    4. As the amount of gratuity payable is less than Rupees One Thousand. I shall request you to
    arrange for payment of the sum due to me by Postal Money Order at the address mentioned
    above after deducting Postal Money Order commission there from.
    Yours faithfully,
    Place:
    Date :

    Signature/ Thumb-impression
    of the applicant-employee

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