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Gratuity

This document is an application for gratuity by an employee named Bhawna Sagar, who is claiming gratuity after resigning from Genpact India Pvt. Ltd. The application includes personal details, employment history, and a request for payment via Postal Money Order. The employee confirms they have not received gratuity benefits from their previous employer.

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36 views3 pages

Gratuity

This document is an application for gratuity by an employee named Bhawna Sagar, who is claiming gratuity after resigning from Genpact India Pvt. Ltd. The application includes personal details, employment history, and a request for payment via Postal Money Order. The employee confirms they have not received gratuity benefits from their previous employer.

Uploaded by

rahulmalik5649
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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FORM I

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


APPLICATION FOR GRATUIIY BY AN EMPLOYEE

To
Name of the Legal Entity,
OHR ID : …………………………
703266444
Genpact India Pvt. Ltd. Mobile : ………………………...
9582157563
703266444
Address of the Legal Entity, E-mail ID : ………………………..
[email protected]
12A (Ground Floor), Prakash Deep Building, 7,
Tolstoy Marg, New Delhi – 110 001

Sir/Gentlemen,

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, after completion of not less than five years of continuous service,
on my:

 Superannuation
 Retirement
 Resignation 
 Total disablement due to accident
 Total disablement due to disease

with effect from (DOR)________________Necessary


5/02/2025 particulars relating to my appointment in the
Establishment are given in the statement below:

STATEMENT

1. Name in full __________________________________________________________________


Bhawna sagar

2. Address in full __________________________ ______________________________________


11839/7 Sat nagar karol bagh new delhi 110005
3. Name of the Company_ _________________________________________________________
Genpact

4. Post held with Ticket or Serial No. if any ( Designation)________________________________


Assistant Manager

5. Date of appointment ____________________________________________________________


17/06/2020

6. Date and cause of termination of service _____________________


Resignation _______________________
7. Total period of service ___________________________________________________________
8. Amount of Basic wages last drawn __Rs. ____________________________________________
9. Amount of gratuity claimed __Rs. ___Leave it blank _______________________________________
2. I was rendered totally disabled as a result of—
(Here give the details of the nature of disease or accident)__________N/A_______________________
The evidences/witnesses in support of my total disablement are as follow:-
___________________________________N/A____________________________________________

3. Payment may please be made in RTGS/NEFT.

4. 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. N/A

Signature required

Yours faithfully,
Place: Signature/ Thumb-impression
Date : of the applicant-employee
Name of the Legal Entity,
Genpact India Pvt. Ltd

Address of the Legal Entity,


12A (Ground Floor), Prakash Deep Building, 7,
Tolstoy Marg, New Delhi – 110 001

Declaration
I ____________________________ S/0,D/0,W/o _____________________ Resident of _
__________________________________________________________Employee
no.__________________ has resigned from the services of_______________________as on
_________________.

I hereby declare that I have received a total sum of Rs. __________________ from my previous
employer as my gratuity benefit.

My PAN No. is _________________

Thanking you,

Signature required

Yours Faithfully,
(Name of the Employee)
Address: ________________________
________________________________
________________________________
________________________________

Place: _______________
Dated: _______________

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