Payment of Gratuity Form H


 

FORM ‘H’

 

[See sub-rule (4 ) of rule 6 ]

 

       Modification of nomination




To ………………………………………………………………………………………………….. [Give h ere n a m e or description of the establishment with full address ]

  1. Shri/ Shrimati/ Kumari  ……………[Na m e in full h ere] whose particulars a re given in the statement below, hereby give notice that the nomination filled by m e on [date] and recorded under  your  reference No. ……………… dated  …………….. s h a ll s tan d  modified  in the following manner:

 

[Hear give details of the modifications in tended]

 

State m e n t

 

1

Na m e of the employee in full.

 

2

Sex.

 

3

Religion .

 

4

Whether unmarried/ married/ widow/ widower.

 

5

Department / Bra n ch / Section where employed.

 

6

Post held with ticked No. or Serial No., if a n y.

 

7

Date of appointment .

 

8

Address in full.

 



Pla
ce                                                                                       Signature/  Thumb impression

Date                                                                                         of the employee


 

Declaration by witnesses

 

Modification of n om in a t ion signed/ thumb impressed before me. Name in full and full Signature of witnesses. Address of witnesses .

1 .                                                                     1 .

2 .                                                                     2 .


Pla
ce Date

 

Certificate by the employ er

 

Certified that the above modification have been recorded.

Employer,s reference No., if any.                                      Signature of the employer/ Officer authorized

Designa t ion

Name and address of the


Establishment or rubber stamp thereof.

 



Ack
nowledgement by the employee

 

Received the duplicate copy of the notice for modification in form H filed by m eon

……………….. duly certified by the employer.

 

Date                                                                      Signature of the employee

 






Different types of forms of gratuity

Form Name Use of Form
Gratuity Form I
Application for the payment of gratuity
Gratuity Form J Used by the nominee to make application for payment of gratuity
Gratuity Form K Used by legal heir to make application for the payment of gratuity
Gratuity Form F To make nomination
Gratuity Form G To make fresh nomination
Gratuity Form H Modification of nomination
Gratuity Form L Issued by the employer to employee stating amount and date of payment
Gratuity Form M Issued by the employer stating the reason for the rejection of gratuity
Gratuity Form N Application made to the labour commissioner by an employee
Gratuity Form 0 Issued by the authority to appear for case hearing
Gratuity Form P Summons issued by the authority to be present for hearing
Gratuity Form R Issued by the authority directing to make gratuity payment