(1) Every employed person shall make a declaration in Form-I, nominating a person conferring the right to receive the amount that may stand in his credit at the event of his death before that amount standing to his credit has become payable or where the amount has become payable, before payment has been made.
(2) If an employed person has a family at the time of making nomination, the nomination shall be in favour of the spouse or the spouse in preference followed by one more members of his family:
Provided that nominated made by an employed person having a family in favour of a person other than member of his family shall be invalid:
Provided further that a fresh nomination towards his/her spouse shall be made by the employed person on his marriage and any nomination made before such marriage shall be deemed to be invalid.
(3) Where the nomination is wholly or partly in favour of a minor, the employed person may appointed a major of his family, to be the guardian of the minor nominee or were there is no major person in the family, he may, at his discretion, appoint any other person to be a guardian of the minor nominee.
(4) If the employed person nominates more than one member, he shall specify in the nomination, the amount or share payable to each of his nominees at his own discretion so as to cover the whole of the amount that may stand to his credit.
Form-I
Nominated and Declaration Form
(See Rule 3)
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Name of person making nomination |
5. Marital Status |
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(In block letters) |
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Father's/Husband's Name |
6. Address |
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Permanent: |
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Temporary |
| 3. |
Date of Birth |
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| 4. |
Sex |
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I hereby nominated the person(s)/cancel the nomination made by me previously and nominate the person(s) mentioned below to receive any amount due to me from the employer, in the event to my death.
| Name of nominee/nominees |
Address |
Nominee's relationship with the member |
Date of Birth |
Total amount of share of accumulations in credit to be paid to each nominee |
If the nominee is minor, name relationship and address of the guardian who may receive the amount during the minority of nominee |
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(2) |
(3) |
(4) |
(5) |
(6) |
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1. Certified that I have no family and should I acquire a family hereafter, the above nomination shall be deemed as cancelled.
2. *Certified that my father/mother is/are dependent upon me.
3. *Strike out whichever is not applicable.
Signature or the thumb impression
of the employed person.
CERTIFICATE BY EMPLOYER
Certified that the above declaration and nomination has been signed/thumb inpressed before me by Shri/Smt./Kum employed in my establishment after he/she has read the entry/entries have been read over to him/her by me and got confirmed by him/her.
Signature of the employer or other authorised
officer of the establishment and
Designation
Place:
Date:
Name and Address of the Factory/
Establishment and rubber stamp thereof