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Gratuity Form
Gratuity Form
Gratuity Form
Sirls,
4 of the Payment of
lbeg to apply for payment ol gratuity to which Iam entitled under sub-seotion (1) ol section
Gratuity Act, 1972 on account of my superannuation/retiremenUreslgnation after compeion of not less than
due to disease with ellect
.five years of continuous servicetotal disablement due to accidentotal disablement
trom Necessary particulars rolating to my appointment In the estabishment aro given in
the sialement below.
STATEMENT
2.
cheque/Demand Drat.
(3) Payment may please be made by cash/open or crossed bank
Yours faithiuly.