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Nomination Form

The document is a Nomination Declaration Form for employees to designate beneficiaries for gratuity, full and final settlement, and other compensation schemes in the event of their death. It includes sections for the employee's details, nominee information, and the percentage of benefits each nominee will receive. The form also states that these nominations supersede any previous nominations made by the employee.

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24 views1 page

Nomination Form

The document is a Nomination Declaration Form for employees to designate beneficiaries for gratuity, full and final settlement, and other compensation schemes in the event of their death. It includes sections for the employee's details, nominee information, and the percentage of benefits each nominee will receive. The form also states that these nominations supersede any previous nominations made by the employee.

Uploaded by

ravi.srcm
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Nomination Declaration Form

Common Nomination Form for Gratuity, Full & Final Settlement and any other Scheme or Policy

RAVI GUPTA F 5231


I, __________________________________, E m p l o y e e C o d e ___________ hereby nominate the person/persons
mentioned below and confer on him/her/them the right to receive any and/or all in the event of my death, to the extent specified
below, eligible amount/compensation on account of the following:
i. Any gratuity the payment of which may be authorized under Payment of Gratuity Act & Rules
ii. Amount that may stand to my credit/debit in the Full & Final Settlement
iii. Any amount that may be sanctioned by the Management under the prevailing Scheme or Policy currently in force.
iv. Aakash Educational Services Limited Employees Group Accident Insurance Scheme

Name, DOB
If nominee is Name, DOB,
Share Share (dd/mm/yyyy) and
minor, name, relationship and
Name, date of birth to be to be address of person
DOB and address address of alternate
S. (dd/mm/yyyy), address, Relation-ship with paid paid who may receive
of person who nominee in case the
No. contact no. and mail id employee to to the amount if
may receive the nominee under Column
of the nominee each each alternate nominee
amount on behalf (A) predeceases the
(%) (%) in Col. (5) is a
of minor employee
minor

A B C D E F G H

1 SHEETAL INIFE 50
GUPTA

2 MANAN SON 25
GUPTA
3 SURESH SON 25
GUPTA
4

These nominations supersede any nominations made by me earlier.


Place: ______________________________________
Date: _______________________________________
Signature of Employee: ________________________
Contact No. _________________________________
Permanent Address: ___________________________________________________________________________
____________________________________________________________________________________________

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