Free form template · Word

Meal Card Request Form

A meal card request form handles card-level service requests after an employee is already enrolled in the meal benefit: issuing a first card, replacing a lost or damaged one, blocking it, or switching from physical to digital. It gives the vendor the KYC and delivery details needed to act.

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[Company Logo][Company Name]

MEAL CARD SERVICE REQUEST

Company:: [Company Name]
Vendor:: [Vendor Name]
Request No.:: [Reference Number]
Date:: [Date]

Employee Details

Employee Name (as on card)
Employee ID
Department
Registered Mobile Number
Email ID

Request Type

New card (enrolled but not received)
Replacement: lost / stolen / damaged
Block card
Unblock card
Switch from physical to digital
Update registered mobile number

Card Details

Existing Card Number (last 4 digits only)
Date Lost / Damaged
Already blocked via vendor app: Yes / No
Transfer remaining balance to new card: Yes / No
New Mobile Number (if updating)

Delivery

Collect from Office	[Work Location]
Deliver to Address	[Address]

Fee

A replacement fee of ₹[Amount] applies for lost or stolen cards. I authorise deduction of this fee from my salary. No fee applies to cards damaged in transit or first issue.

Declaration

I confirm that the details above are correct and that I will not use the old card if it is recovered after blocking. I authorise [Company Name] to share my details with [Vendor Name] for this request.

Employee
[Employee Name]
Date: [Date]

HR / Admin
[HR Name]
Sent to vendor: [DD/MM/YYYY]
Card activated: [DD/MM/YYYY]

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What this template includes

Request type: new, replacement, block, unblock, physical to digital
Existing card number (last 4 digits) for replacement
Mobile number linked to the card for KYC and OTP
Delivery address or office collection
Balance transfer to the new card
Any replacement fee recovered from salary

When to use it

An enrolled employee has not yet received a card
A meal card is lost, stolen or damaged
An employee wants to switch to a digital wallet version
A card is blocked after wrong PIN attempts or mobile number change

How to customise this template

1Insert your vendor's replacement fee and turnaround
2Add the vendor helpline for immediate blocking
3State whether cards are delivered to office or home
4Align with your enrollment form's employee ID format

HR tips

Ask employees to block a lost card through the vendor app first
Collect only the last 4 digits of the old card
Track delivery and confirm activation
Waive replacement fees for cards damaged in transit

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Frequently asked questions

What should I do if I lose my meal card?+

Block it immediately through the vendor app or helpline, then submit a meal card request form for a replacement. The balance is usually transferred to the new card.

Is there a charge for a replacement meal card?+

Some vendors charge a small fee, which the company may recover from salary. The form states any fee.

Can I use a digital meal card instead of a physical card?+

Many vendors offer a digital wallet or UPI-linked option. Choose physical-to-digital on the form.

All 50 employee benefits & insurance →

[Company Logo][Company Name]
EMPLOYEE BENEFITS ENROLLMENT FORM
Company:
[Company Name]
Form No.:
[Reference Number]
Date of Submission:
[Date]
Enrollment Deadline:
[DD/MM/YYYY]
Please complete all sections within the enrollment window and return this form to [HR Name], Human Resources. Benefits will be activated only after HR verification.
Section A: Employee Details
Employee Name (as per PAN)
Employee ID
Designation
Department
Date of Joining
Work Location
Date of Birth
Gender
Mobile Number
Personal Email
PAN
Aadhaar (last 4 digits only)
Section B: Statutory Benefits
UAN (if already allotted)
Previous PF Account / Member ID
ESI IP Number (if applicable, for gross wages up to ₹21,000/month)
Opting for higher PF contribution: Yes / No
Form · Word
Employee Benefits Enrollment Form
Download .docx

Employee Name (as per PAN)
Employee ID
Designation
Department
Date of Joining
Work Location
Date of Birth
Gender
Mobile Number
Personal Email
PAN
Aadhaar (last 4 digits only)

UAN (if already allotted)
Previous PF Account / Member ID
ESI IP Number (if applicable, for gross wages up to ₹21,000/month)
Opting for higher PF contribution: Yes / No

[Company Logo][Company Name]

FLEXIBLE BENEFITS SELECTION FORM

Company:: [Company Name]
Financial Year:: [FY 20XX-XX]
Submission Date:: [Date]
Payroll Cut-off:: [DD/MM/YYYY]

Part 1: Employee Information

Employee Name
Employee ID
Designation
Department
Annual CTC: ₹[CTC]
Annual Flexi Basket: ₹[Amount]
Tax Regime Opted: Old / New

Part 2: Allocation of Flexi Basket

Component	Company Limit per Month (₹)	My Monthly Allocation (₹)	Annual Allocation (₹)	Bills Required
Meal Card / Food Coupons	[Amount]	[Amount]	[Amount]	No (card based)
Fuel and Vehicle Maintenance	[Amount]	[Amount]	[Amount]	Yes
Telephone and Internet	[Amount]	[Amount]	[Amount]	Yes
Leave Travel Allowance	[Amount]	[Amount]	[Amount]	Yes, travel proof
Books and Periodicals	[Amount]	[Amount]	[Amount]	Yes
Employer NPS Contribution	[Amount]	[Amount]	[Amount]	No
Total (must equal flexi basket)	-	[Amount]	[Amount]	-

Part 3: Terms

Form · Word

Benefits Selection Form

Download .docx

[Company Logo][Company Name]

GROUP INSURANCE NOMINATION FORM

Company:: [Company Name]
Policy:: Group Term Life / Group Personal Accident
Insurer:: [Insurer Name]
Policy No.:: [Policy Number]
Date:: [Date]

Employee Details

Employee Name
Employee ID
Designation
Department
Date of Birth
Date of Joining
Marital Status

Nominee Details

Nominee Name	Relationship	Date of Birth	Address and Mobile	Share (%)
[Nominee Name]	[Relationship]	[DD/MM/YYYY]	[Address, Mobile]	[%]
[Nominee Name]	[Relationship]	[DD/MM/YYYY]	[Address, Mobile]	[%]
[Nominee Name]	[Relationship]	[DD/MM/YYYY]	[Address, Mobile]	[%]
Total				100%

Appointee (only if a nominee is a minor)

Form · Word

Group Insurance Nomination Form

Download .docx

[Company Logo][Company Name]
MEDICLAIM DECLARATION
Company:
[Company Name]
Policy Year:
[DD/MM/YYYY] to [DD/MM/YYYY]
Date:
[Date]
A. Employee Particulars
Employee Name
Employee ID
Department
Designation
Date of Birth
Contact Number
B. Choice of Cover (tick one)
- I opt IN to the group mediclaim for myself and the dependants listed in Part C.
- I opt IN for myself only.
- I opt OUT of the group mediclaim. I am covered under policy no. [Policy Number] with [Insurer Name]. I understand I cannot claim under the company policy and may rejoin only at renewal, if permitted.
C. Dependants Declared for this Policy Year
Form · Word
Mediclaim Declaration Form
Download .docx
[Company Logo][Company Name]
HEALTH INSURANCE CLAIM SUBMISSION FORM (INTERNAL)
Company:
[Company Name]
Insurer / TPA:
[Insurer Name] / [TPA Name]
Policy No.:
[Policy Number]
Internal Claim Ref.:
[Reference Number]
Date of Submission:
[Date]
Important: This form helps HR process your claim. The insurer's or TPA's official claim form must also be completed, signed and attached where required.
1. Employee Details
Employee Name
Employee ID
Department
Mobile Number
Email ID
2. Patient Details
Patient Name
Relationship to Employee
Age
E-card / Member ID
TPA Claim Intimation No. (if any)
Form · Word
Health Insurance Claim Form
Download .docx
[Company Logo][Company Name]
INSURANCE CLAIM ASSISTANCE REQUEST
Company:
[Company Name]
Request No.:
[Reference Number]
Date:
[Date]
Priority:
Urgent (in hospital) / Normal
Employee and Policy
Employee Name
Employee ID
Department
Mobile Number
Policy Type: Group Health / Group Personal Accident / Group Term Life
Patient / Insured Member Name
TPA / Insurer Claim Number
Nature of Assistance Needed
- Cashless approval pending
- Reimbursement claim delayed
- Claim rejected, request review
- Claim partly settled / deductions unclear
- Document query from TPA
- Other: [Details]
Claim Summary
Form · Word
Insurance Claim Assistance Form
Download .docx

Patient Name
Relationship to Employee
Age
E-card / Member ID
TPA Claim Intimation No. (if any)

[Company Logo][Company Name]

EMPLOYEE INSURANCE DETAILS FORM

Company:: [Company Name]
Record Date:: [Date]
Last Updated:: [DD/MM/YYYY]

Employee Information

Employee Name
Employee ID
Designation
Department
Work Location
Date of Joining
Mobile Number

Coverage Summary

Cover	Insurer	Policy No.	Member / E-card ID	Sum Insured (₹)	Valid Till
Group Mediclaim	[Insurer Name]	[Policy Number]	[Member ID]	[Amount]	[DD/MM/YYYY]
Group Term Life	[Insurer Name]	[Policy Number]	[Member ID]	[Amount]	[DD/MM/YYYY]
Group Personal Accident	[Insurer Name]	[Policy Number]	[Member ID]	[Amount]	[DD/MM/YYYY]
Voluntary Top-up	[Insurer Name]	[Policy Number]	[Member ID]	[Amount]	[DD/MM/YYYY]

Statutory Coverage

Form · Word

Employee Insurance Details Form

Download .docx

[Company Logo][Company Name]
INSURANCE BENEFICIARY DESIGNATION / CHANGE FORM
Company:
[Company Name]
Form Ref.:
[Reference Number]
Date:
[Date]
Effective From:
[DD/MM/YYYY]
Employee Details
Employee Name
Employee ID
Department
Designation
Mobile Number
Policies Affected
- Group Term Life, Policy No. [Policy Number]
- Group Personal Accident, Policy No. [Policy Number]
- Voluntary Life Cover, Policy No. [Policy Number]
Type of Request
Form · Word
Insurance Beneficiary Form
Download .docx

Meal Card Request Form

Preview of the form

Employee Details

Request Type

Card Details

Delivery

Fee

Declaration

What this template includes

When to use it

How to customise this template

HR tips

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Frequently asked questions

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