.............................................

Signature of the employer/Authorised Officer

Name or description of establishment of rubber stamp thereof.

Place : ........................................

Date : ...........................................

Copy to: the Controlling Authority:

Note: Strike out the words not applicable.

FORM 'M'

[See clause (ii) of sub-rule (1) of rule 8]

Notice Rejecting Claim For Payment Of Gratuity

To

.......................................................... [Name and address of the applicant employee/nominee legal heir]

You are hereby informed as required under clause (ii) of sub-rule (i) of rule 8 of the Payment of Gratuity (Central) Rules, 1972 that your claim for payment of gratuity as indicated on your application in Form ........ under the said rules is not admissible for the reasons stated below:

Reasons

[Here specify the reasons]

Signature of the employer/Authorised Officer.

Name or description of establishment or rubber stamp thereof.

Place .......................................

Date .........................................

Copy to: The Controlling Authority:

Note: Strike out the words not applicable.

FORM 'N'

[See sub-rule (i) of rule 10]

Application For Direction

Before the Controlling Authority under the Payment of Gratuity Act, 1972.

Application No.....................................

Date.....................................................

Between

........................................................................................................................................................................................................................ [Name in full of the applicant with full address]

and

....................................................................................................................................................................................................... [Name in full of the employer concerned with full address]

The applicant is an employee of the above-mentioned employer's nominee of late ........... an employee of the above mentioned employer's legal heir of late ................... and employee of the above-mentioned employer, and is entitled to payment of gratuity under section 4 of the Payment of Gratuity Act, 1972, on account of his own/aforesaid employees superannuation on .............. [date]./his own retirement/aforesaid employee's resignation on .............................[date] after completion of ..................... years of continuous service/his own/aforesaid employee's total disablement with effect from ...... [date] due to accident/disease/death of the aforesaid employee on .................