The evidence/witnesses in support of my total disablement are as follows: I was rendered totally disabled as a result of I beg to apply for payment of gratuity to which I am entitled under sub-section (1) of section 4 of the Payment of Gratuity Act, 1972 on account of my superannuation/retirement/resignation after completion of not less than five years of continuous service/ total disablement due to accident/ total disablement due to disease with effect from the …………… Necessary particulars relating to my appointment in the establishment are given in the statement below:ĭepartment/Branch/Section where last employed.
Home > Acts Implemented > Details of the Acts Implemented > The Payment of Gratuity 1972 > Forms > Form 'I'- Application of gratuity by an employeeįorm 0- Notice for appearance before the controlling authorityįorm D- Notice for excluding husband from familyįorm E- notice of withdrawal of notice for excluding 27 husband from familyįorm I- Application of gratuity by an employeeįorm J- Application for gratuity by a nomineeįorm K- Application for gratuity by a legal heirįorm M- Notice rejecting claim for payment of gratuityįorm Q- Particulars of application under section 7įorm S- Notice for payment of gratuity as determined by Appellate Authorityįorm T- Application for recovery of gratuityįorm 'I'- Application of gratuity by an employee
