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Gratuity Nomination Form

A gratuity nomination form records whom an employee wants to receive gratuity if they die before it is paid. This template is an internal company declaration that captures family and nominee details; employers should also use the prescribed statutory nomination format where the applicable rules require it.

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[Company Logo][Company Name]

GRATUITY NOMINATION DECLARATION (INTERNAL)

Employee Name:
[Employee Name]
Employee ID:
[Employee ID]
Date of Joining:
[Date of Joining]
Department:
[Department]

Note: This is an internal company declaration. The prescribed statutory nomination format will also be completed where required.

1. Family Details

NameRelationshipDate of BirthAddress
[Name][Relationship][DD/MM/YYYY][Address]
[Name][Relationship][DD/MM/YYYY][Address]
[Name][Relationship][DD/MM/YYYY][Address]

2. Nominees for Gratuity

Nominee NameRelationshipAgeAddressShare of Gratuity (%)
[Nominee Name][Relationship][Age][Address][%]
[Nominee Name][Relationship][Age][Address][%]
[Nominee Name][Relationship][Age][Address][%]

3. Minor Nominee – Guardian

Guardian Name
Relationship to Minor
Address

4. Declaration by Employee

I hereby nominate the person(s) named above to receive the gratuity payable to me in the event of my death before payment, in the shares stated. I confirm the nominees are members of my family where I have a family, and I will submit a fresh nomination if my family circumstances change.

Signature of Employee
[Employee Name]
Date: [Date]
Place: [Work Location]

5. Witnesses

Witness 1
Name and Address
Signature
Witness 2
Name and Address
Signature

6. Employer's Acknowledgement

Certified that the nomination has been signed by the employee in our presence and has been recorded on [Date].

For [Company Name]
[Authorised Signatory]
Date: [Date]

What this template includes

  • Explanation that gratuity becomes payable after 5 years' continuous service (and in death or disablement cases as per law)
  • Family member list, as gratuity rules favour family nominees
  • Nominee shares totalling 100%
  • Guardian for minors
  • Two witnesses
  • Employer acknowledgement with date

When to use it

  • Shortly after joining, as part of statutory onboarding
  • When the employee's family changes through marriage, birth or death
  • When the company moves gratuity to an insurer-managed fund and needs fresh nominations
  • During a nomination audit

How to customise this template

  1. 1Add your gratuity trust or insurer policy number if applicable
  2. 2Use the prescribed statutory form alongside this one where required
  3. 3Add a revision section for later changes
  4. 4Keep a copy in the personnel file and give one to the employee

HR tips

  • Encourage employees to nominate family members
  • Ask for a fresh nomination after marriage
  • Do not let a nominee act as a witness
  • Acknowledge receipt in writing

This is an internal company declaration form and not a copy of a statutory form. Use the prescribed nomination format where the Payment of Gratuity rules or the Code on Social Security and its rules require it, and review with a legal adviser.

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Frequently asked questions

When is gratuity payable?+

Generally after five years of continuous service at the rate of 15 days' wages for each completed year, and in cases of death or disablement as provided under law.

Who can be a gratuity nominee?+

Gratuity rules give priority to family members. If the employee has a family, nominations are generally expected in favour of family members.

Is this the statutory gratuity nomination form?+

No. It is an internal declaration. Use the prescribed format as required by the applicable rules as well.