AFFIDAVIT OF GRATUITY

I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S/o / D/o Mr. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . aged . . . . . . . . . (yrs.) working in capacity
of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Designation & function) with Vodafone Idea Limited, hereby
declare as follows: -

1. That my PAN No. is . . . . . . . . . . . . . . . . . . . . . . . . . (copy enclosed)

2. (a) That I have resigned from the aforementioned post effective from . . . . . . . . . . . . . . . . . . . . . . .
(b) That I have superannuated from the aforementioned post effective from . . . . . . . . . . . . . . . . . . . . . . . . .
3. (a) That during my tenure of service with my past employers, I have received the Gratuity the Gratuity as follow.

Financial Name of Amount Amount Claimed

Address
Year Employer Received (Rs) Exempt (Rs)
         

(b) That during my tenure of service, I have not received any amount on account of Gratuity from any of my past
employment.

Financial Year Name of Employer Address

     

4. That the particular given above are true and correct to the best of my knowledge. The onus of producing
necessary documents/details/information before the income tax department lies with me and I hereby give
consent to be held personally liable for any tax demand that may arise out of any consequent action initiated by
the Income Tax Department arising out of this affidavit.
5. That I hereby undertake to indemnity and keep indemnified the Company, Its Directors and executives against
all claims, demands, costs, loss or damage including but not limited to any demand for payments of tax, penalty
and/or interest to that may arise against the company either from tax authorities or otherwise, pursuant to
payments made to me under this Affidavit and I shall be liable to make good all such costs, demands, loss or
damage immediately upon demand made by the Company without any demur.

Signed

Name: Date:

Employee Code: Place:

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 Form I [See sub-Rule (1) of Rule 7]

APPLICATION FOR GRATUITY BY AN EMPLOYEE

To,

Idea Cellular Ltd

11/1, Sharada Center, Off Karve Road

Erandwane, Pune-411004

Sir/Madam,

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:

STATEMENT

1
Name in full  
2 Address in full (With Pin Code) #

3 Department/Branch/Section where employed  

4 Post held with Ticket or Serial No, if any (Employee ID)  
5 Date of Appointment  
6 Date of Birth  
7 Date and cause of termination of service  
8 Total period of service(Years/Month/Days)  
9 Amount of wages last drawn  

I was rendered totally disabled as a result of ______________________________________________________________________

(Here give the details of the nature of disease or accident)

The evidences/witnesses in support of my total disablement are as follows: _____________________________________________

_______________________________________________________________________________________________________

Bank details to be given in Annexure given below.

As the amount of Gratuity payable is less than Rupees One Thousand. I shall request you to arrange for payment of the sum due to
me by Postal Money Order at the address mentioned above after deducting Postal Money Order commission there from

Yours Faithfully,

Place: Signature/Thumb-impression of the applicant-employee

Date:

HR Signature (for Validating employment details)

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 ANNEXURE:

1 Personal Email Id  
2 Contact Number  
3 Bank Account Details  
Yes/No
(a) If bank account is the same in which your last payroll from
  (If marked "Yes", no additional details
Idea was processed
to be given)
(b) In other cases, please write complete bank details (Bank
   
Name Address/NEFT,RTGS Code)(@)
Yes / No
4 Income Tax to be deducted on Gratuity Amount
(if marked "No", please refer to pint 5)
If "No" in point no.4, whether Notarized Affidavit on a stamp
5 Yes / No
paper of Rs. 100 has provided (**)

Please provide copy of cancelled cheque along with application

Please provide the complete address detail with Pin Code for further communication

If employee writes “Yes” in point no. (5), original form of affidavit to be attached with this Application Photocopy of the
same will not be accepted.

Yours Faithfully,

Place:

Date:

Employee Signature

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