FORM 'L'

[See clause (i) of sub-rule (1) of rule 8]



Notice for payment of gratuity



To ……………………………………………………………………………………………………….

[Name and address of the applicant employee/nominee/1egal heir]



You are hereby informed as required under clause (i) of sub-rule (1) of rule 8 of the Payment of Gratuity (Central) Rules, 1972 that a sum of Rs. ………. (Rupees…………………) is payable to you as gratuity/as your share 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 ………………….[date] at ……………… for collecting your

[Here specify place]



payment in cash/open or crossed cheque.



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.





Brief statement of calculation



1. Total period of service of the employee concerned: ……………… year ……… months.



2. Wages last drawn.



3. Proportion of the admission gratuity payable in terms of nomination/as a legal heir.



4. Amount payable.



Place Signature of the employer/

Date Authorised Officer



Name or description of

establishment of rubber

stamp thereof.



Copy to: the Controlling Authority:



Note: Strike out the words not applicable.