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    Form 35

    Uploaded by

    hdpanchal86
    This document is a nomination form for payment of wages in lieu of unused leave in the event of a worker's death. The worker nominates an individual, such as a family member, to receive any balance of wages owed for leave not taken if the worker dies before returning to work. The form requires the worker's signature or thumbprint, witness signatures, and details of the nominated individual and worker.

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    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd

    Form 35

    Uploaded by

    hdpanchal86
    1K views1 page
    This document is a nomination form for payment of wages in lieu of unused leave in the event of a worker's death. The worker nominates an individual, such as a family member, to receive any balance of wages owed for leave not taken if the worker dies before returning to work. The form requires the worker's signature or thumbprint, witness signatures, and details of the nominated individual and worker.

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    © Attribution Non-Commercial (BY-NC)

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    This document is a nomination form for payment of wages in lieu of unused leave in the event of a worker's death. The worker nominates an individual, such as a family member, to receive any balance of wages owed for leave not taken if the worker dies before returning to work. The form requires the worker's signature or thumbprint, witness signatures, and details of the nominated individual and worker.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    1K views1 page

    Form 35

    Uploaded by

    hdpanchal86
    This document is a nomination form for payment of wages in lieu of unused leave in the event of a worker's death. The worker nominates an individual, such as a family member, to receive any balance of wages owed for leave not taken if the worker dies before returning to work. The form requires the worker's signature or thumbprint, witness signatures, and details of the nominated individual and worker.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
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    FORM NO.

    35 (Prescribed under Rule 100) Nomination for payment of wages in lieu of the quantum of leave to which he was entitled in the event of death of worker. I hereby nominate Shri . Who is my and resides at as to receive the amount of the balance of my wages in lieu of the quantum of leave not availed of, in the event of my death before resuming work. Dated this Day of 19 at Witness 1. Signature Name Address 2. Signature Name Address

    Signature or left thumb Impression of the worker Particulars of worker (such as serial number in the egister of adult/child workers, section or department, etc.)

    Date :

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