The Payment of Gratuity (Madhya Pradesh) Rules, 1973
In exercise of the powers conferred by sub-section (1) of Section 15 of
the Payment of Gratuity Act, 1972 (39 of 1972), the State Government hereby
makes the following rules, namely :-
Rule - 1. Short title.
These rules may be called the Payment of Gratuity (Madhya Pradesh) Rules,
1973.
Rule - 2. Definitions.
In these rules, unless the context otherwise requires,-
(a)
"Act" means
the Payment of Gratuity Act, 1972 (39 of 1972);
(b)
"appellate
authority" means the State Government or the authority
specified by the State Government under sub-section (7) of Section 7;
(c)
"Form" means
a form appended to these rules;
(d)
"nomination" means
nomination made under Section 6;
(e)
"section" means
a section of the Act.
Rule - 3. Notice of opening, change or closure of the establishment.
(1)
Within thirty days of the rules becoming
applicable lo an establishment, a notice in Form "A" shall be
submitted by the employer to the controlling authority of the area.
(2)
A notice in Form "B" shall be
submitted by the employer to the controlling authority of the area within
thirty days of any change in the name address, employer or nature of business.
(3)
Where an employer intends to close down
the business, he shall submit a notice in Form 'C' to the controlling authority
of the area at least sixty days before the intended closure.
Rule - 4. Display of Notice.
(1)
The employer shall display conspicuously
a notice at or near the main entrance of the establishment in bold letters in
English and in a language understood by the majority of the employees
specifying the name of the officer with designation authorised by the employer
to receive on his behalf notices under the Act, or the rules.
(2)
A fresh notice shall be displayed
immediately after the notice referred to in sub-rule (1) becomes illegible or
requires a change.
Rule - 5. Form of notice under proviso to Section 2 (h) (ii).
(1)
A notice under the proviso to sub-clause
(ii) of clause (h) of Section 2 shall be in Form 'D' and sent in triplicate by
the employee to the employer, who shall, after recording its receipt on one
copy thereof, return the copy to the employee and send the second copy to the
controlling authority of the area.
(2)
An employee may withdraw the notice
referred to in sub-rule (1) by giving another notice in triplicate in Form 'E'
to the employer, who shall follow the same procedure as in sub-rule (1).
Rule - 6. Nominations.
(1)
A nomination shall be in Form 'F' and
submitted in duplicate by personal service by the employee, after taking proper
receipt or by sending through registered post acknowledgement due to the
employer,-
(i)
in the case of an employee who is already in employment
for a year or more on the date of commencement of these rules, ordinarily,
within ninety days from such dale; and
(ii)
in the case of an employee who completes one year of
service after the date of commencement of these rules, ordinarily, within
thirty days of the completion of one year of service :
Provided that nomination in Form 'F' shall be accepted by the employer
after the specified period, if filed with reasonable grounds for delay, and no
nomination so accepted shall be invalid merely because it was filed after the
specified period.
(2)
Within thirty days of the receipt of a
nomination in Form 'F' under sub-rule (1), the employer shall get the service
particulars of the employee, as mentioned in the form of nomination verified
with reference to the records of i he establishment and return to the employee,
after obtaining a receipt thereof, the duplicate copy of the nomination in Form
'F' duly attested either by the employer or an officer authorised in this
behalf by him as a token of recording of the nomination by the employer and the
other copy of the nomination shall be recorded.
(3)
An employee who has no family at the
time of making a nomination shall, within ninety days of acquiring a family
submit in the manner specified in sub-rule (1), a fresh nomination, as required
under sub-section (4) of Section 6, in duplicate in Form 'G' to the employer,
and thereafter the provisions of sub-rule (2) shall apply mutatis
mutandis as if it was made under sub-rule (1).
(4)
A notice of modification of a
nomination, including cases where a nominee predeceases an employee shall be
submitted in duplicate in Form 'H' to the employer in the manner specified in
sub-rule (1), and thereafter the provisions of sub-rule (2) shall apply mutatis mutandis as if it was
made under sub-rule (1).
(5)
A nomination or a fresh nomination or a
notice of modification of nomination shall be signed by the employee or, if
illiterate, shall bear his thumb impression, in the presence of two witnesses,
who shall also sign a declaration to that effect in the nomination, fresh
nomination or notice of modification of nomination, as the case may be.
(6)
A nomination, fresh nomination or notice
of modification of nomination shall take effect from the date of receipt
thereof by the employer.
Rule - 7. Application for gratuity.
(1)
An employee who is eligible for payment
of gratuity under the Act, or any person authorised, in writing, to act on his
behalf, shall apply ordinarily within thirty days from the date the gratuity
became payable, in Form I to the employer :
Provided that where the date of superannuation or retirement of an
employee is known, the employee may apply to the employer before thirty days of
the date of superannuation or retirement.
(2)
A nominee of an employee who is eligible
for payment Of gratuity under the second proviso to sub-section (1) of Section
4 shall apply ordinarily within thirty days from the date gratuity became
payable to him, in Form 'J' to the employer:
Provided that an application in plain paper with relevant particulars
shall also be accepted. The employer may obtain such other particulars as may
be deemed necessary by him.
(3)
A legal heir of an employee who is
eligible for payment of gratuity under the second proviso to sub-section (1) of
Section 4 shall apply, ordinarily within one year from the date of gratuity
became payable to him, in Form 'K' to the employer.
(4)
Where gratuity becomes payable under the
Act, before the commencement of these rules, the period of limitation specified
in sub-rules (1), (2) and (3) shall be deemed to be operative from the date of
such commencement.
(5)
An application for payment of gratuity
filed after the expiry of the periods specified in this rule shall also be
entertained by the employer, if the applicant adduces sufficient cause for the
delay in preferring his claim, and no claim for gratuity under the Act, shall
be invalid merely because the claimant failed to present his application within
the specified period. Any dispute in this regard shall be referred to the
controlling authority of the area for his decision.
(6)
An application under this rule shall be
presented to the employer either by personal service or by registered post
acknowledgement due.
Rule - 8. Notice for payment of gratuity.
(1)
Within fifteen days of the receipt of an
application under Rule 7 for payment of gratuity, the employer shall-
(i)
if the claim is found admissible on verification, issue a
notice in Form 'L' to the applicant employee, nominee or legal heir, as the
case may be, specifying the amount of gratuity payable and fixing a date not
being later than the thirtieth day after the date of the application for
payment thereof; or
(ii)
if the claim for gratuity is not found admissible, issue
a notice in Form 'M' to the applicant employee, nominee or legal heir, as ' the
case may be, specifying the reasons why the claim for gratuity is not
considered admissible.
In either case a copy of the notice shall be endorsed lo the controlling
authority of the area.
(2)
In case payment of gratuity is due to be
made in the employer's office, the date fixed for the purpose in the notice in
Form 'LI, under clause (i) of sub-rule (1) shall be re-fixed by the employer,
if a written application in this behalf is made by the payee explaining why it
is not possible for him to be present in person on the date specified.
(3)
If the claimant for gratuity is a
nominee or a legal heir, the employer may ask for such witness or evidence as
may be deemed relevant for establishing his identity or maintajnabilily of his
claim as the case may be. In that case, the time limit specified for issuance
of notices under sub-rule (1) shall be operative with effect from the date such
witness or evidence as the case may be called for by the employer is furnished
to the employer.
(4)
A notice in Form C, or Form 'M' shall be
served on the applicant either by personal service after taking receipt or by
registered post with acknowledgement due.
(5)
A notice under sub-section (2) of
Section 7 shall be in Form 'L.
Rule - 9. Mode of payment of gratuity.
The gratuity payable under the Act shall be paid in cash or if so desired
by the payee, in Demand Draft, or bank cheque to the eligible employee, nominee
or legal heir, as the case may be ;
Provided that in case the eligible employee, nominee or legal heir, as the
case may be, so desires and the amount of gratuity payable is less than one
thousand rupees, payment may be made by postal order after deducting the postal
money order commission therefor from the amount payable :
Provided further that intimation about the details of payment shall also
be given by the employer to the controlling authority of the area.
Rule - 10. Application to controlling authority for direction.
(1)
If an employer-
(i)
refuses to accept a nomination or to entertain an
application sought lo be filed under Rule 7; or
(ii)
issues a notice under sub-rule (1) of Rule 8 cither
specifying an amount of gratuity which is considered by the applicant less than
what is payable or rejecting eligibility lo payment of gratuity; or
(iii)
having received an application under Rule 7 fails to
issue any notice as required under Rule 8 within the time specified therein,
the claimant employee, nominee or legal heir, as the case may be, may, what is
payable or rejecting eligibility to payment of gratuity, direction, apply in
Form 'N' to the controlling authority of the area for issuing a direction under
sub-section (4) of Section 7 with as many extra copies as are the opposite
party :
Provided that the controlling authority may accept any application under
this sub-rule, on sufficient cause being shown by the applicant, after the
expiry of the specified period.
(2)
Application under sub-rule (1) and other
documents relevant to such an application shall be presented in person to the
controlling authority or shall be sent by registered post acknowledgement due.
Rule - 11. Procedure for dealing with application for direction.
(1)
On receipt of an application under Rule
10 the controlling authority shall, by issuing a notice in Form 'O' calling
upon the applicant as well as the employer to appear before him on a specified
date, time and place, either by himself or through his authorised
representative together with all relevant documents and witnesses, if any.
(2)
Any person desiring to act on behalf of
an employer or employee, nominee or legal heir, as the case may be, shall
present to the controlling authority a letter of authority from the employer or
the person concerned, as the case may be, on whose behalf he seeks to act
together with a written statement explaining his interest in the matter and
praying for permission so to act. The controlling authority shall record
thereon an order either according his approval or specifying in the case of
refusal to grant the permission prayed for, the reasons for the refusal.
(3)
A party appearing by an authorised
representative shall be bound by the acts of the representative.
(4)
After completion of hearing on the date
fixed under sub-rule (1), or after such further evidence, examination of
documents, witnesses, hearing and enquiry, as may be deemed necessary, the
controlling authority shall record his finding as to whether any amount is
payable to the applicant under the Act. A copy of the finding shall be given to
each of the parties.
(5)
If the employer concerned fails to
appear on the specified date of hearing after due service of notice without
sufficient cause, the controlling authority may proceed to hear and determine
the application ex-parte.
If the applicant fails to appear on the specified date of hearing without
sufficient cause, the controlling authority may dismiss the application :
Provided that an order under this sub-rule may, on good cause being shown
within thirty days of the said order, be reviewed and the application re-heard
after giving not less than fourteen days' notice to the opposite party of the
date fixed for re-hearing of the application.
Rule - 12. Place and time of hearing.
The sittings of the controlling authority shall be held at such times and
at such places as he may fix and he shall inform the parties of the same in
such manner as he thinks fit.
Rule - 13. Administration of oath.
The controlling authority may authorise a clerk of his office to
administer oaths for the purpose of making affidavits.
Rule - 14. Summoning and attendance of witnesses.
The controlling authority may, at any stage of the proceedings before him,
either upon or without an application by any of the parties involved in the
proceedings before him, and on behalf of and under the direction of the
controlling authority by any sub-to any person in Form 'P' either to give
evidence or to produce documents or for both purposes on a specified date time
and place.
Rule - 15. Service of summons of notice.
(1)
Subject to the provisions of sub-rule
(2), any notice, summons, process or order issued by the controlling authority
may be served either personally or by registered post acknowledgement due or in
any other manner as prescribed under the Code of Civil Procedure, 1908 (Act No.
5 of 1908).
(2)
Where there are numerous persons as
parties to any proceeding before the controlling authority and such persons are
members of any trade union or association or arc represented by an authorised
person, the service of notice on the Secretary, or where there is no Secretary,
on the principal officer of the trade union or association, or on the
authorised person shall be deemed to be service on such persons.
Rule - 16. Maintenance of records of cases by the controlling authority.
(1)
The Controlling authority shall record
the particulars of each case under Section 7, in Form 'Q' and at the time of
passing orders shall sign and date the particulars so recorded.
(2)
The controlling authority shall, while
passing orders in each case, also record the findings on the merits of the case
and file it together with the memorandum of evidence with the order sheet.
(3)
Any record, other than a record of any
order or direction, which is required by these rules to be signed by the
controlling authority, may be signed on behalf of and under the direction of
the controlling authority by any subordinate officer appointed in writing for
this purpose by the controlling authority.
Rule - 17. Direction for payment of gratuity.
If a finding is recorded under sub-rule (4) of Rule 11 that the applicant
is entitled to payment of gratuity under the Act, the controlling authority
shall issue a notice to the employer concerned in Form R' specifying amount
payable and directing payment thereof to the applicant under intimation to the
controlling authority within thirty days from the date of receipt of the notice
to the employer. A copy of the notice shall be endorsed to the applicant
employee, nominee or legal heir, as the case may be.
Rule - 18. Appeal.
(1)
The Memorandum of Appeal under sub-section
(7) of Section 7 of the Act shall be submitted to the appellate authority with
a copy thereof to the opposite party and the controlling authority either
through delivery in person or under registered post acknowledgement due.
(2)
The Memorandum of Appeal shall contain
the facts of the case, the decision of the controlling authority, the grounds
of appeal and the relief sought.
(3)
There shall be appended to the
Memorandum of Appeal a certified copy of the finding of the controlling
authority and direction for payment of gratuity.
(4)
On receipt of the copy of Memorandum of
Appeal, the controlling authority shall forward records of the case to the
appellate authority.
(5)
Within 14 days of the receipt of the
copy of the Memorandum of Appeal, the opposite party shall submit his comments
on each paragraph of the memorandum with additional pleas, if any, to the
appellate authority with a copy to the appellant.
(6)
The appellate authority shall record its
decision after giving the parties to the appeal a reasonable opportunities of
being heard. A copy of the decision shall be given to the parties to the appeal
and a copy thereof shall be sent to the controlling authority returning his
records of the case.
(7)
The controlling authority shall, on
receipt of the decision of the appellate authority, make necessary entry in the
records of the case maintained in Form 'Q' under sub-rule (1) of Rule 16.
(8)
On receipt of the decision of the
appellate authority, the controlling authority shall, if required under that
decision, modify his direction for payment of gratuity and issue a notice to
the employer concerned in Form 'S' specifying the modified amount payable and
directing payment thereof to the applicant, under intimation to the controlling
authority within fifteen days of the receipt of the notice by the employer. A
copy of the notice shall be endorsed to the applicant employee, nominee or
legal heir, as the case may be and to the appellate authority.
Rule - 19. Application for recovery of gratuity.
Where an employer fails to pay the gratuity due under the Act in
accordance with the notice by the controlling authority under Rule 17 or Rule
18, as the case may be, the employee concerned, his nominee or legal heir, as
the case may be, to whom the gratuity is payable may apply to the controlling
authority in duplicate in Form 'T' for recovery thereof under Section 8 of the
Act.
Rule - 20. Display of abstract of the Act and rules.
The employer shall display an abstract of the Act and the rules made
thereunder in English and in the language understood by the majority of the
employees at a conspicuous place at or near the main entrance of the
establishment.
Form 'A'
[See sub-rule (1) of Rule 5]
Notice of Opening
(1)
Name and address of the Establishment.
(2)
Name and Designation of the Employer.
(3)
Number of persons employed.
(4)
Maximum number of persons employed on any day during the
preceding twelve months with date.
(5)
Number of employees covered by the Act.
(6)
Name of Industry.
(7)
Whether seasonal?
(8)
Date of opening.
(9)
Details of head Office/Branches.
(a)
Name and Address of the Head Office Number of employees
(b)
Names and addresses of other Branches in India.
I verify that the information furnished above is true to the best of my
knowledge and belief.
Place .........................
Date .........................
.........................
Signature of the Employer with name and designation.
To
The
Controlling Authority,
..............................
Form 'B'
[See sub-rule (2) of Rule 3]
Notice of Change
Name and Address of the Establishment.
Take notice that following changes have taken place with effect
from.........in the particulars furnished by me in notice dated on Form A :
Name
Address
Name of the Employer
Nature of Business.
Place .........................
Date .........................
.........................
Signature of the Employer
with name and designation.
To,
The
Controlling Authority,
.............................
Form 'C
[See sub-rule (3) of Rule 3]
Notice of Closure
Take notice that it is intended to close down the establishment with
effect from The other details are furnished below :-
1.
Name and address of the establishment.
2.
Name and address of the Head office, if any.
3.
Name and designation of the employer.
4.
Number of persons in employment.
5.
Number of employees entitled lo gratuity.
6.
Amount of gratuity involved.
Place .........................
Date .........................
.........................
Signature of the Employer
with name and designation.
To,
The
Controlling Authority,
.............................
Form 'D'
[See sub-rule (1) of Rule 5]
Notice For
Excluding Husband From Family
1.
Name of the female employee.
2.
Name or description of establishment where employed.
3.
Post held with ticket or Serial No. if any.
4.
Department/Branch/Section where employed.
5.
Permanent address.
Take notice
that I, Shrimati .......... desire to exclude my husband Shri.............from
my family for the purposes of the Payment of Gratuity Act, 1972.
Place .........................
Date .........................
.........................
Signature/Thumb impression, Signature
of witnesses.
Declaration
by Witnesses
The above notice was
signed/thumb impressed before me.
Name in full and full address of witnesses
1....................
2....................
....................
Signature of witnesses
1..........................
2..........................
Place .........................
Date .........................
To
The
Controlling Authority (through the employer).
(Name and
address of the employer here).
For use by
The Employer
Received and recorded in this establishment.
Reference No ....
Date
...........................................
Signature of the employer
or an officer authorised in this behalf by the employer.
To,
1.
(Employee).
2.
The Controlling Authority.
Form 'E'
[See sub-rule (2) of Rule 5]
Notice of
Withdrawal of Notice for Excluding Husband, From Family
1.
Name of the female employee.
2.
Name or description of establishment where employed.
3.
Post held with Ticket or Serial No. if any.
4.
Department/Branch/Section where employed.
5.
Permanent address.
Take notice
that I, Shrimati ...... hereby withdraw the notice dated whereby I exclude my
husband Shri.......... from my family for the purposes of the Payment of
Gratuity Act, 1972. The earlier notice was recorded under your reference
No..........dated.....
Place .........................
Date .........................
.........................
Signature/Thumb impression of
the employee
Declaration
by Witnesses
The above notice of withdrawal was signed/thumb impressed before me. Name
in full and full address of witnesses
1....................
2....................
....................
Signature of witnesses
1..........................
2..........................
Place .........................
Date .........................
To
The
Controlling Authority (through the employer).
(Name and
address of the employer here).
For use by
The Employer
Received and recorded in this establishment. ...........
Reference No............... .....................
Signature of the employer or an officer authorised Seal or rubber stamp of the
establishment.
Date.........
To,
1.
(Employee).
2.
The Controlling Authority.
Form 'F'
[See sub-rule (1) of Rule 6]
Nomination
To
(Give
here name or description of the establishment with full address).
1.
I, Shri/Shrimati/Kumari............(Name
in full here) whose particulars are given in the statement below, hereby
nominate the person(s) mentioned below to receive the gratuity payable after my
death as also the gratuity standing to my credit in the event of my death
before that amount has become payable or having become payable has not been
paid and direct-that the said amount of gratuity shall be paid in proportion
indicated against the name(s) of the nominee(s).
2.
I hereby certify that the person(s)
mentioned is a/are member(s) of my family within the meaning of clause (b) of
Section 2 of the Payment of Gratuity Act, 1972.
3.
I hereby declare that I have no family
within the meaning of clause (h) of Section 2 of the said Act.
4.
(a) My father/mother/parents is/are not
dependent on me.
(b) My husband's
father/mother/parents is/are not dependent on my husband.
5.
I have excluded by husband from my
family, by a notice dated the ........to the controlling authority in terms of
the proviso to clause (b) of Section 2 of the said Act.
6.
Nomination made herein invalidates my
previous nomination.
Nominee(S)
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Name in full
with full address of nominee(s)
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Relationship
with the employee
|
Age of nominee
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Proportion by
which the gratuity will be shared
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(1)
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(2)
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(3)
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(4)
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1.
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2.
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3.
|
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4.
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so on. ...
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STATEMENT
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1.
Name of employee in lull.
2.
Sex.
3.
Religion.
4.
Whether unmarried/married/widow/widower.
5.
Department/Branch/Section where employed.
6.
Post held with Ticket or Serial No. if any.
7.
Date of appointment.
8.
Permanent address
|
Village
|
Tehsil
|
Sub-division
|
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Post Office
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District
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State
|
Place
.........................
Date .........................
.........................
Signature/Thumb impression of the employee
Declaration
by Witnesses
Nomination signed/thumb
impressed before me.
Name in full and full address of witnesses
1....................
2....................
....................
Signature of witnesses
1..........................
2..........................
Place .........................
Date .........................
Certificate
by the Employer
Certified that the particulars of the above nomination have been verified
and recorded in this establishment. Employer's Reference No. if any.
Signature of the
employer/officer authorised.
Designation
Dated........
................................................
Name and address of the establishment or rubber stamp thereof.
Acknowledgement
by the Employee
Received the duplicate copy of the nomination in Form 'F' filed by me and
duly certified by the employer.
Date.........
...........................................
Signature of the employee.
Form 'G'
[See sub-rule (3) of Rule 6]
Fresh Nomination
To
(Give here name or description of the establishment with full address).
1.
I. Shri/Shrimati ........... (Name in
full here) whose particulars are given in the statement below, have acquired a
family within the meaning of clause (b) of Section 2 of the Payment of Gratuity
Act, 1972 with effect from the (date here) in the manner indicated below and
therefore nominate afresh the person(s) mentioned below to receive the gratuity
payable after my death as also the gratuity standing to my credit in the event
of my death before that amount has become payable, or having becoming payable
has not been paid in proportion indicated against the name(s) of the
nominee(s).
2.
I hereby certify the person(s) nominated
is a/are member(s) of my family within the meaning of clause (h) of Section 2
of the said Act.
3.
(a) My father/mother/parents is/are not
dependent on me.
(b) My husband's
father/mother/parents is/are not dependent on my husband.
4.
I have excluded by husband from my
family by a notice dated the to the controlling authority in terms of the
proviso to clause (h) of Section 2 of the said Act.
Nominee(S)
|
Name in full with
full address of nominee(s)
|
Relationship
with the employee
|
Age of nominee
|
Proportion by
which the gratuity will be shared.
|
|
(1)
|
(2)
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(3)
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(4)
|
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1.
2.
3.
4.
so on.
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Manner of Acquiring A 'Family'
(Here given details as to how a family was acquired, i.e., whether by marriage or parents
being rendered dependent or through other process like adoption).
Statement
1.
Name of the employee in full.
2.
Sex.
3.
Religion.
4.
Whether unmarried/married/widow/widower?
5.
Department/Branch/Section where employed.
6.
Post held with Ticket or Serial No. if any.
7.
Date of appointment.
8.
Permanent address.
|
Village
|
Tehsil
|
Sub-division
|
|
Post Office
|
District
|
State
|
Place
.........................
Date .........................
.........................
Signature/Thumb impression of the employee
Declaration
by Witnesses
Fresh nomination signed/thumb impressed before me.
Name in full and full address of witnesses
1....................
2....................
....................
Signature of witnesses
1..........................
2..........................
Place .........................
Date .........................
Certificate
by The Employer
Certified that the particulars of the above nomination have been verified
and recorded in this establishment. Employer's Reference No., if any.
Signature of the
employer/officer authorised.
Designation
Dated.........
..............................................................
Name and address of the establishment or rubber stamp thereof.
Acknowledgement by the Employee
Received the duplicate copy of the nomination in Form...........filed by
me on..........and duly certified by the employer.
Date.........
......................................................
Signature of the employee.
Form 'H'
[See sub-rule (4) of Rule 6]
Modification of Nomination
To,
(Give
here name or description of the establishment with full address)
I, Shri/Shrimati/Kumari..........(Name in full here) whose particulars are
given in the statement below, hereby give notice that the nomination filed by
me on.......... (Date) and recorded under your reference No
date.............shall stand modified in the following manner :-
(Here give details of the
modifications intended)
Statement
1.
Name of employee in full.
2.
Sex.
3.
Religion.
4.
Whether unmarried/married/widow/widower.
5.
Department/Branch/Section where employed.
6.
Post held with Ticket or Serial No. if any.
7.
Date of appointment.
8.
Address in full.
Place .........................
Date .........................
.........................
Signature/Thumb impression of the employee
Declaration by Witnesses
Modification of nomination
signed/thumb impressed before me.
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..................
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Name in full and
full address of witnesses
|
Signature of
witnesses
|
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1.
......................
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1.....................................................................
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2.
......................
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2.......................................................................
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Place........
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Dale.........
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Certificate
by The Employer
Certified that the above modifications have been recorded. Employer's
Reference No. if any.
Signature of the
employer/officer authorised.
Designation
Dated........
...........................................
Name and address of the establishment or rubber stamp thereof.
Acknowledgement
by the Employee
Received the duplicate copy of the notice for modification in Form 'H'
filed by me duly certified by the employer.
Date......... ................................................................
Signature of the employee.
Form 'I'
[See sub-rule (1) of Rule 17]
Application for Gratuity by an Employee
To
(Give
here name or description of the establishment with full address).
Sir/Gentlemen,
1.
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 of my superannuation/retirement/resignation after
completion of not less than five years of continuous service/total disablement
due to accident/total disablement due to disease with effect from the necessary
particulars relating to my appointment in the establishment are given in the statement
below :-
Statement
1.
Name in full.
2.
Address in full.
3.
Department/Branch/Section where last employed.
4.
Post held with Ticket No. or Serial No. if any.
5.
Date of appointment.
6.
Date and cause of termination of service.
7.
Total period of service.
8.
Amount of wages last drawn.
9.
Amount of gratuity claimed.
2.
I was rendered totally disabled as a
result of (here give the details of the nature of disease or accident).
The
evidences/witnesses in support of my total disablement are as follows :-
(Here give details)
3.
Payment may please be made in cash/open
or crossed bank cheque.
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 therefrom.
Yours faithfully,
..........................
Signature/thumb impression of the applicant employee.
Place......................
Date...........................
Note. - (1)
Strike out the words not applicable.
(2) Strike out paragraph or
paragraphs not applicable.
Form 'J'
[See sub-rule (2) of Rule 7]
Application for Gratuity by A Nominee
To,
(Give
here name or description of the establishment with full address).
Sir/Gentlemen,
1.
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 as a nominee of late ..... (Name of the employee) who was an
employee of your ........ establishment and died on the....... The gratuity is
payable on account of the death of the aforesaid employee while in
service/superannuation of the aforesaid employee on ......... retirement or
resignation of the aforesaid employee on after completion of years of
service/total disablement of the aforesaid employee due to accident or disease
while in service with effect from the .... Necessary particulars relating to my
claim are given in the statement below :-
Statement
1.
Name of applicant nominee.
2.
Address in full of the applicant nominee.
3.
Marital status of the applicant nominee.
(Unmarricd/marricd/widow/widower).
4.
Name in full of the employee.
5.
Marital status of employee.
6.
Relationship of the nominee with the employee.
7.
Total period of service of the employee.
8.
Date of appointment of the employee.
9.
Dale and cause of termination of service of the employee.
10.
Department/Branch/Section where the employee last worked.
11.
Post last held by the employee with Ticket or Serial No.
if any.
12.
Total wages last drawn by the employee.
13.
Date of death and evidence/witness as proof of death of
the employee.
14.
Reference No. of recorded nomination, if available.
15.
Total gratuity payable to the employee.
16.
Share of gratuity claimed.
2.
I declare that the particulars mentioned
in the above statements are true and correct to the best of my knowledge and
belief.
3.
Payment may please be made in
cash/crossed or open bank cheque.
4.
As the amount 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 therefrom.
Yours faithfully,
Signature/thumb impression of the applicant nominee.
Place.............
Date.............
Note. - (1)
Strike out the words not applicable.
(2) Strike out paragraph or paragraphs not applicable.
Form 'K'
[See sub-rule (3) of Rule 7]
Application for Gratuity by A Legal Heir
To,
(Give
here name or description of the establishment with full address).
Sir/Gentlemen,
1.
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 as a legal heir of late (Name of the employee) who was an
employee of your.............. establishment and died on the ........ without
making any nomination. The gratuity is payable on account of the death of the
aforesaid employee while in service/superannuation of the aforesaid
employee........on the.....retirement or resignation of the aforesaid employee
on the ........ after completion of years of service/total disablement of the
aforesaid employee due to accident or disease while in service with effect from
the ......... Necessary particulars relating to my claim are given in the
statement below :-
Statement
1.
Name of applicant legal heir.
2.
Address in full of the applicant legal heir.
3.
Marital status of the applicant legal heir.
(Unmarried/married/widow/widower).
4.
Name in full of the employee.
5.
Relationship of the applicant with the employee.
6.
Religion of both the applicant and the employee.
7.
Date of appointment and total period of service of the
employee.
8.
Department/Branch/Section where the employee worked last.
9.
Post last held by the employee with Ticket or Serial No.
if any.
10.
Total wages last drawn by the employee.
11.
Date and cause of termination of service of the employee
(Death or otherwise).
12.
Date of death of the employee and evidence/witness in
support thereof.
13.
Total gratuity payable to the employee.
14.
Percentage of gratuity claimed.
15.
Basis of the claim and evidence/witness in support
thereof.
2.
I declare that the particulars mentioned
in the above statements arc true and correct to the best of my knowledge and
belief.
3.
Payment may please be made in
cash/crossed or open bank cheque.
4.
As the amount 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 therefrom.
Yours faithfully,
Signature/thumb impression of the applicant legal heir.
Place.............
Date.............
Form 'L'
[See clause (i) of sub-rule (1)
of Rule 8]
Notice of Payment of Gratuity
To,
(Name
and address of the applicant employee /nominee legal heir).
.........................
1.
You are hereby informed as required under clause (i) of
sub-rule (1) of Rule 8 of the Payment of Gratuity (Madhya Pradesh) Rules, 1973
that a sum of Rs......... (Rupees ) is payable to you as gratuity/as your
shares 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).................. for collecting your payment in cash/open
or crossed cheque (time)..............
3.
Amount payable shall be sent to you by Postal Money Order
at the address given in your application after deducting the Postal Money Order
commission, as desired by you, by ........ Brief statement of calculation.
1.
Total period of service of the employee concerned............Years............months.
2.
Wages last drawn..........................
3.
Proportion of the admissible gratuity payable in terms of
nomination/as a legal heir....................
4.
Amount payable............................
...............Signature of the employer/ Authorised Officer
................................
Name or description of establishment or rubber stamp thereof.
Place...............
Date...............
Copy to the Controlling Authority
Form 'M'
[See clause (ii) of sub-rule (1)
of Rule 8]
Notice Rejecting Claims 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 (1) of Rule 8 of the Payment of Gratuity
(Madhya Pradesh) Rules, 1973 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
Place........
Dale.........
.....................................
Name or description of establishment
or rubber stamp thereof.
Copy to the Controlling Authority
Form 'N'
[See sub-rule (1) 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
1.
(Name in full of the employer concerned
with full address)............. The applicant is an employee of the above
mentioned employers/nominee of late.........an employee of the above mentioned
employers/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......../his own retirement/aforesaid employees' resignation
(date) ......... on.........after completion of.........years of continuous
service/his own/aforesaid employees' total disablement with effect
from.........due to accident/disease death of the aforesaid
.........(date).........employee on.................
2.
The applicant submitted an application
under rule of the Payment of Gratuity Act, 1972 on the .............. above
mentioned employer refused to entertain it but he issued a notice dated
the........under clause..........of sub-rule..........of rule.........offering
an amount of gratuity which is less than my due/issued a notice dated
the.............. under clause............. of sub-rule............. of
rule.................. rejecting my eligibility to payment of gratuity. The
duplicate copy of the said notice is enclosed.
3.
The applicant submits that there is a
dispute on the matter (Specify the dispute).
4.
The applicant furnishes the necessary
particulars in the annexure hereto and prays that the Controlling Authority may
be pleased to determine the amount of gratuity payable to the petitioner and
direct the above mentioned employer to pay the same to the petitioner.
5.
The applicant declares that the
particulars furnished in the annexure hereto arc true and correct to the best
of his knowledge and belief.
Date...................
...................
Signature of the applicant/Thumb impression of the applicant.
Annexure
1.
Name in full of applicant with full address.
2.
Basis of claim
(Death/superannuation/retirement/resignation/ disablement of employees).
3.
Name and address in full of the employee.
4.
Marital status of the employee (Unmarried/married/widow/
widower).
5.
Name and address in full of the employer.
6.
Department/Branch/Section where the employee was last
employed (if known).
7.
Post held by the employee with ticket or serial No. if
any (if known).
8.
Date of appointment of the employee (if known).
9.
Date and cause of termination of service of the employee
(Superannuation/retirement/resignation/disablement/death).
10.
Total period of service by the employee.
11.
Wages last drawn by the employee.
12.
If the employee is dead, date and cause thereof.
13.
Evidence/witness in support of death of the employee.
14.
If a nominee, No. and date of recording of nomination
with the employer.
15.
Evidence/witness in support of being a legal heir, if a
legal heir.
16.
Total gratuity payable to the employee (if known).
17.
Percentage of gratuity payable to the applicant as a
nominee/legal heir.
18.
Amount of gratuity claimed by the applicant.
Place..........
Date...........
......................................
Signature of the applicant/thumb impression of the applicant.
Form 'O'
[See sub-rule (1) of Rule 11]
Notice for Appearance before the Controlling Authority
From
The Controlling Authority
under the Payment of Gratuity Act, 1972.
To
(Name and address of the
employer/applicant)...............
Whereas, Shri........an
employee under you/a nominee(s) legal heir(s) of Shri ...., an employee under
the above mentioned employer, has/have filed an application under sub-rule (1)
of Rule 10 of the Payment of Gratuity (Madhya Pradesh) Rules, 1973 alleging
that-
(A copy of the said
application is enclosed)
Now, therefore, you are hereby
called upon to appear before me at ........either personally or through a
person duly authorised in this behalf for the purpose of answering all material
questions relating to the application on the day of 19..... at....... O'clock
in the forenoon/afternoon in support of/to answer the allegation; and as the
day fixed for your appearance is appointed for final disposal of the
application, you must be prepared to produce on that day all the witnesses upon
whose evidence, and the documents upon which you intend to rely in support of
your allegation/defence.
Take notice that in default of
your appearance on the day before mentioned the application will be
dismissed/heard and determined in your absence.
Given under my hand and seal,
this day of 19...............
Controlling Authority.
Form 'P'
[See Rule 14]
Summons
Before the Controlling Authority under the Payment of Gratuity Act, 1972.
To,
(Name and address).
Whereas your attendance is required to give evidence/your are required to
produce the documents mentioned in the list below, on behalf of............ in
the case arising out of the claim tor gratuity by ............... from
............... and referred to this Authority by an application under Section
7 of the Payment of Gratuity Act, 1972, you are hereby summoned to appear
personally before this authority on the date of 19 at O'clock in the
forenoon/afternoon and to bring with you (or to send to this Authority) the
said documents.
List of
Documents
1..................
2..................
3. So on.......... .............
......................................
Controlling Authority.
Dated this.................day of.....................19.................
Note. - (1)
The portion not applicable to be deleted.
(2) The summons shall be
issued in duplicate. The duplicate is to be signed and returned by the person
served before the date fixed.
(3) In case the summons is
issued only for producing a document and not to give evidence, it will be
sufficient compliance to the summons if the documents are caused to be produced
before the controlling authority on the day and hour fixed for the purpose.
Form 'Q'
[See
sub-rule (1) of Rule 16]
Particulars of Application Under Section 7
1.
Serial No.
2.
Date of application.
3.
Name and address of the applicant.
4.
Name and address of the employer.
5.
Amount of gratuity claimed.
6.
Dates of hearing.
7.
Findings with date.
8.
Amount awarded.
9.
Cost, if any, awarded.
10.
Date of notice issued for payment of gratuity.
11.
Date of appeal, if any.
12.
Decision of the appellate authority.
13.
Date of issue of final notice for payment of gratuity.
14.
Date of payment of gratuity by employer with mode of
payment.
15.
Date of receipt of application for recovery of gratuity.
16.
Date of issue of recovery certificate.
17.
Date of recovery.
18.
Other remarks.
19.
Signed.
20.
Date.
Form 'R'
[See Rule 17]
Notice for Payment of Gratuity
To,
(Name and address of
employer).
Whereas Shri/Smt./Kumari .............. of...........(address) an employee
under you/a nominee(s) legal heir(s) of late ...................... an employee
under you, filed an application under Section 7 of the Payment of Gratuity Act,
1972 before me;
And whereas the application was heard in your presence on and after the
hearing I have come to the finding, that the said Shri/Smt./Kumari ..........is
entitled to a payment of Rs........as gratuity under the Payment of Gratuity
Act, 1972;
Now, therefore, I hereby direct 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................19..................
.......................
Controlling Authority.
Copy to-
(Applicant under
rule................).
He is advised to contact the
employer for collecting payment.
Form 'S'
[See sub-rule (5) of Rule 18]
Notice for Payment of Gratuity as Determined by Appellate
Authority
To
(Name and address of
employer).
Whereas a notice was given to
you on...........Form 'R' requiring you to make a payment of Rs.......... to
Shri/Smt./Kumari.................as gratuity under the Payment of Gratuity Act,
1972;
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 Payment of Gratuity Act, 1972;
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.......19 ....
.....................
Controlling Authority.
Copy to-
1.
The Applicant.
He is advised to contact the
employer for collecting payment.
2.
The Appellate Authority.
Form 'T'
[See Rule 19]
Application for Recovery of Gratuity
Before the Controlling
Authority under the Payment of Gratuity Act, 1972.
Application No................................
Date................
Between
(Name in full of the applicant
with address).
and
(Name in full of the employer
with full address).
1.
The applicant is an employee of the
above-mentioned employer/a nominee of late............an employee of the above
mentioned employer/legal heir of late ............, an employee of the above
mentioned employer, and you were pleased to direct the said employer in your
notice dated the........ under Rule ............of that Payment of Gratuity
(Madhya Pradesh) Rules, 1973 for payment of a sum of Rs........... as gratuity
payable under the Payment of Gratuity Act, 1972.
2.
The appellant submits that the said
employer failed to pay the said amount of gratuity to me as directed by you although
I approached him for payment.
3.
The applicant therefore prays that a
certificate may be issued under section..........of the said Act for recovery
of the said sum of Rs.......due to me as gratuity in term of your direction.
Place..........
Date............
.................................
Signature/Thumb impression of the applicant.