Free form template · Word

Transport Opt-Out Form

A transport opt-out form records an employee's decision to stop using the company cab or bus service. It sets the last date of use, stops any transport deduction from the next payroll and confirms the employee will make their own arrangements, which matters especially for night shifts.

Editable Word (.docx)
Made for India
9 fill-in fields highlighted
Free, no sign-up

Download Word (.docx) — free

Preview of the form

[Highlighted] = fill in

[Company Logo][Company Name]

COMPANY TRANSPORT OPT-OUT FORM

Company:: [Company Name]
Form No.:: [Reference Number]
Date:: [Date]

Employee Details

Employee Name
Employee ID
Department
Shift
Current Route No. / Pickup Point
Mobile Number

Opt-Out Details

Last Date of Using Transport	[DD/MM/YYYY]
Opt-out Type: Pickup only / Drop only / Both
Reason: Own vehicle / Relocation / Remote work / Timing issues / Other	[Details]

Feedback (optional)

What could make you use company transport again?

Night-Shift Acknowledgement (if applicable)

I understand that company transport is available for my shift for safety reasons. I have chosen to make my own arrangements and will inform the transport desk if I need a drop on any particular day.

Declaration

I request [Company Name] to remove me from the transport roster from the date above and to stop the monthly transport deduction of ₹[Amount] from the next payroll. I understand that I may re-enrol subject to route and seat availability.

Employee
[Employee Name]
Date: [Date]

Reporting Manager
[Reporting Manager]
Date: [Date]

For Office Use

Vendor roster updated on [DD/MM/YYYY]
Payroll informed to stop deduction from [Month]
Transport ID card returned

Download Word (.docx) — free

What this template includes

Last date of using transport
Reason for opting out, for route planning
Stop-deduction instruction to payroll
Acknowledgement of own travel arrangements
Night-shift safety acknowledgement where relevant
Re-enrolment rule

When to use it

An employee buys a vehicle or moves close to the office
Work moves to remote or hybrid and daily transport is no longer needed
An employee is unhappy with timings and prefers own travel
Employees decline transport during a new route rollout

How to customise this template

1Set the notice period for opting out, for example one week
2Add the payroll cut-off for stopping deductions
3Include any conveyance allowance paid instead of transport
4Remove the night-shift section if not relevant

HR tips

For women on night shifts, check whether policy or state rules still require company drop before accepting an opt-out
Update the vendor's roster the same day
Track reasons to improve the service
Do not penalise employees who later wish to rejoin

Some state Shops and Establishments rules attach conditions, such as transport, to night work by women. Check applicable rules before accepting an opt-out for night shifts.

For HR & hiring managers

Experienced and fresher candidates across India — blue, grey and white collar. Post a job in 5 minutes and start receiving applications.

Post a job free See plans

Post in 5 minutesDescribe the role in one line — we write the job description.
Verified applicantsEvery applicant has a verified mobile number.
Resume databaseSearch experienced candidates by skill, city and experience.

Frequently asked questions

How do I opt out of company transport?+

Submit the opt-out form to the transport or admin desk with your last date of use. HR will stop any deduction from the next payroll.

Will I get conveyance allowance if I opt out?+

Only if your company policy offers it. Many companies simply stop the deduction without paying an allowance.

Can I opt back into company transport later?+

Usually yes, subject to seat availability on the route. Fill a fresh enrollment 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

Transport Opt-Out Form

Preview of the form

Employee Details

Opt-Out Details

Feedback (optional)

Night-Shift Acknowledgement (if applicable)

Declaration

For Office Use

What this template includes

When to use it

How to customise this template

HR tips

Hire top talent from BetterJobs

Frequently asked questions

Related HR templates