Form VIII

[(SEE RULE 8(2)]

NOTICE FOR PAYMENT/REJECTING CLAIM OF GRATUITY

(Strike out the words not applicable)

To

,……………………………………………………………………………

(Name and address of the applicant employee/nominee legal heir)

You are hereby informed that

(a) *as required under clause (b) sub-rule (2) of rule 8 of the Code on Social Security Rules, 2021,

that your claim for payments of gratuity as indicated on your application in Form-VII under the said rules

is not admissible for the reasons stated below:

Reasons (Here specify the reasons); or

(b) *as required under clause (a) sub-rule (2) of rule 8 of the Code on Social Security Rules, 2021

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 …………………….............. on……………….......……........… (Here specify place)

………………...(date) at………………. (time) for collecting your payment of gratuity crossed cheque.

3. Amount payable shall be sent to you through demand draft or shall be credited in your bank

account as desired by you.

4. Brief statement of calculation

(a) Date of appointment.

(b) Date of termination/superannuation/resignation/ disablement/death.

(c) Total period of service of the employee concerned: ........years……...months.

(d) Wages last drawn:

(e) Proportion of the admissible gratuity payable in terms of nomination/as a legal heir:

(f) Amount payable:

Place:

Date:

Signature of the Employer/

authorised officer.

Name or description of establishment or rubber stamp thereof.

Copy to: The Competent Authority in case of denial of gratuity.