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    CG Gratuity Form F

    Uploaded by

    Sanjay Love

    Copyright:

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

    CG Gratuity Form F

    Uploaded by

    Sanjay Love
    6 views3 pages

    Original Title

    CG Gratuity Form F (1)

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    6 views3 pages

    CG Gratuity Form F

    Uploaded by

    Sanjay Love

    Copyright:

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

    (This form is not applicable for Interns)

    Gratuity Nomination Details

    Gratuity Benefit
    1 2 3 4 5

    Beneficiary Name
    JAYANTHI R

    Beneficiary Relationship

    Mother

    Beneficiary Date of Birth


    01/20/1981

    Beneficiary Guardian Name

    (If the nominee is a minor)

    Beneficiary Address 11/80, OLD POST


    OFFICE BACKSIDE,
    ATHANOOR
    Proportion of Lumpsum%
    100
    (This form is not applicable for Interns)
    FORM F
    See Sub−rule (1) of Rule 6
    Nomination

    To,
    Capgemini Technology Services India Limited Plant.2, Block A, Godrej IT
    Park, Godrej & Boyce compound, LBS Marg, Vikhroli (West),
    Mumbai−400079

    I, Shri/ Srimati/Kumari R Nivedha

    Whose recently 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.

    1. 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.

    2. I hereby declare that I have no family within the meaning of clause (h) of Section 2 of the said Act.

    3. (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.

    4. I have excluded my husband from my family by a notice dated the to the controlling authority in terms of the provision to
    clause (h)of

    5. Nomination made here in invalidates my previous nomination.

    Beneficiary Name in full with full address Beneficiary Relationship with the Beneficiary Date of Birth Proportion of Lumpsum %
    employee

    11/80, OLD POST Mother 01/20/1981 100


    JAYANTHI R
    OFFICE BACKSIDE,
    ATHANOOR

    Statement

    1. Full Name of member : R Nivedha


    :
    2. Sex : Female
    3. Religion ::
    4. Whether Unmarried/ married/widow/widower : Single
    :
    5. Department/Branch/Section where employed
    6. Post held with Ticket No. or Serial No., if any :

    7. Date of Appointment : 10/16/2024


    8. Permanent Address
    Village: Thana: Subdivision:
    ATHANOOR OLD POST OFFICE India
    BACKSIDE
    Post Office: District: State:
    636301 NAMAKKAL 30253

    Place: Salem
    Date: signature/Thumb-impressed of employee
    (This form is not applicable for Interns)

    Declaration by Witnesses

    Nomination signed/thumb-impressed before me


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

    2. 2. _____________________________________

    Salem
    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 authorized

    Designation

    Date:
    Name and address of the establishment or rubber stamp thereof.
    Capgemini Technology Services India Limited Plant.2, Block A,
    Godrej IT Park, Godrej & Boyce compound, LBS Marg, Vikhroli
    West), Mumbai−400079

    Acknowledgement by the Employee

    Received the duplicate copy of nomination in Form 'F' filed by me and duly certified by the employer.

    10/18/2024
    Date: Signature of the Employee
    Electronically signed by:
    R Nivedha
    Note− Strike out the words/paragraphs not applicable.

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