Form VI

[(See Sub-Rule (11) and (12) of Rule-19]

Notice for Payment of Gratuity as Determined by Competent/Appellate

Authority

To:

(Name and address of employer)

1.Whereas Shri/Smt./Kumari ……………………………………………………………

…………………………….… of an employee……………………………………………………

(address)under you/a nominee(s)/legal heir(s) of late ………………………………an

employee under you, filed an application under section 56 of the Code on Social

Security, 2020, before me; or Whereas a notice was given to you on

…………………….requiring you to make payment of Rs…………………… to

Shri/Smt./Kumari………………………………as gratuity under the Code on Social

Security, 2020.

2. And whereas the application was heard in your presence on……….and after the

hearing have come to the finding that the said

Shri/Smt./Kumari………………………………………… is entitled to a payment of

Rs……………… as gratuity under the Code on Social Security, 2020; or Whereas

you/the applicant went in appeal before the appellate authority, who has decided

that an amount of Rs………………….. is due to be paid to

Shri/Smt./Kumari………………………….as gratuity due under the Code on Social

Security, 2020.

Now, therefore, I hereby direct you to pay the said sum of Rs.

……………………….to Shri/Smt./Kumari………………………………. within thirty

days of the receipt of this notice with an intimation thereof to me. Given under

my hand and seal, this ……………. day of……………….20………... Competent

Authority under the Code on Social Security Code, 2020.

Copy to:

1. The Applicant- He is advised to contact the employer for collecting payment.

2. The Appellate Authority if applicable.

Note. ---(Strike out paragraphs if not applicable)