To
[Name and address of the applicant employee/nominee/legal heir]
You are hereby informed as required under clause (i) of sub-rule (1) of rule 8 of the Payment of Gratuity (Central) Rules, 1972 that a sum of Rs (Rupees ) is payable to you as gratuity/as your share of gratuity in terms of nomination made by on
and recorded in this as a legal heir of an employee of
this establishment.
36 The Payment of Gratuity (Central) Rules, 1972
2. Please call at on [date] at for collecting your
[Here specify place] [time]
payment in cash/open or crossed cheque.
3. Amount payable shall be sent to you by Postal Money Order at the address given in your application after deducting the Postal Money Order commission, as desired by you.
Brief statement of calculation
1. Total period of service of the employee concerned: years months.
2. Wages Last drawn.
3. Proportion of the admissible gratuity payable in terms of nomination/as a legal heir.
4. Amount payable.
Place Signature of the employer?
Date Authorised Officer
Name or description of establishment or rubber stamp thereof.
Copy to : The Controlling Authority:
Note: Strike out the words not applicable.
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