Notice for Payment of Gratuity

Form ‘L’
[See clause (i) of sub-rule (1) of rule 8]

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.

2. Please call at ……………… (Here specify place) on ………….. (Date) at …………….. …………..(Time) for collecting your 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

	Years	Months	
1. Total period of service of the employee concerned :			
2. Wages last drawn : 			
3. Proportion of the admissible gratuity payable in terms of nomination/as a legal heir :			
4. Amount payable :			

Signature of the employer/Authorised Officer
Name or description of establishment or
rubber-stamp thereof.

Place :………
Date :……….

Copy to : The Controlling Authority.

Note :- Strike out the words not applicable.