Forms

@if($formName == 'joining-report') @php $familyMembers = $employee->families ?: []; $firstFamily = is_iterable($familyMembers) ? collect($familyMembers)->first() : null; $firstNominee = is_iterable($employee->nominees ?? null) ? collect($employee->nominees)->first() : null; $orgName = $orgName ?? ($employee->organization->name ?? 'FUN ZOO TOYS PRIVATE LIMITED'); $orgAddress = @$employee->organization->full_address ?: 'PLOT NO. 147, SECTOR-33, YEIDA, GREATER GREATER NOIDA, U.P-201310'; $place = @$employee->organization->place ?: 'Greater Noida'; $joinDate = !empty($employee->date_of_joining) ? date('d-M-Y', strtotime($employee->date_of_joining)) : ''; $dob = !empty($employee->dob) ? date('d-M-Y', strtotime($employee->dob)) : ''; $joinDMY = !empty($employee->date_of_joining) ? date('d-M-Y', strtotime($employee->date_of_joining)) : date('d-M-Y'); $firstFamilyName = @$firstFamily->name; $firstFamilyRelation = @$firstFamily->relationship; $firstFamilyDob = @$firstFamily->date_of_birth; $familyAddress = $firstFamily ? (@$firstFamily->address ?: @$firstFamily->geo_address ?: '') : ''; $nomineeName = @$firstNominee->name ?: $firstFamilyName; $nomineeRelation = @$firstNominee->relationship ?: $firstFamilyRelation; $nomineeDob = @$firstNominee->date_of_birth ?: $firstFamilyDob; // Nominee address = employee's permanent address (employee_members has no address column). $nomineeAddress = @$employee->geo_address; $nomineeShare = @$firstNominee->share ?: (@$firstNominee->percentage ?: '100 %'); $employeeSex = @$employee->sex ?: ((@$employee->gender) ?: 'Male'); $employeeReligion = @$employee->religion ?: 'Hindu'; $employeeMarital = @$employee->marital_status ?: 'Unmarried'; $salary = @$employee->salary ?: (@$employee->ctc ?: ''); @endphp

{{-- ================= PAGE 1 : EXACT BIO DATA ================= --}}

व्यक्तिगत विवरण फॉर्म

BIO DATA FORM

1.	अभ्यर्थित पद	(Post applied for)	{{ @$employee->designation->name }}
2.	विभाग	(Department)	{{ @$employee->department->name }}
3.	नाम साफ अक्षरों में	(Name in Capital Letters)	{{ strtoupper($employee->name) }}
4.	पिता / पति का नाम	(Father's/Husband's Name)	{{ $employee->father_name }}
5.	जन्म तिथि	(Date of Birth)	{{ $dob }}
6.	नियुक्ति की तिथि	(Date of Joining)	{{ $joinDate }}
7.	ई0 पी0 एफ0 नं0	(PF No.)	{{ @$employee->pf_no }}
8.	ई0एस0 आई0 सी0 नं0	(ESI No.)	{{ @$employee->esi_no }}
9.	राष्ट्रीयता	(Nationality)	{{ @$employee->nationality ?: 'Indian' }}
10.	धर्म	(Religion)	{{ $employeeReligion }}
11.	विवाहित / अविवाहित	(Married/Unmarried)	{{ $employeeMarital }}
12.	स्थानीय पता	(Local Address)	{{ @$employee->temporary_geo_address }}
13.	स्थाई पता	(Permanent Address)	{{ @$employee->geo_address }}
14.	अर्हताएं	(Qualification)	{{ @$employee->qualification }}
15.	तकनीकी अर्हताएं	(Technical Qualification)	{{ @$employee->technical_qualification }}
16.	भाषाएं (लिखना एवं पढ़ना)	(Language Read & Write)	{{ @$employee->languages }}
17.	अनुभव	(Experience)	{{ @$employee->experience }}

क्रमांक S.No	नियोजकता का नाम Name of Employer	धारित पद Post Held	अवधि From To	वेतन Salary	छोड़ने का कारण Reason for Leaving
1.
2.

@for($i=0;$i<5;$i++) @php $fm = is_iterable($familyMembers) ? collect($familyMembers)->values()->get($i) : null; @endphp @endfor

क्रमांक S.No	नाम Name	सम्बन्ध Relation	आयु Age	पता Address
18. पारिवारिक विवरण (Family Detail)
{{ $i+1 }}.	{{ @$fm->name }}	{{ @$fm->relationship }}	{{ @$fm->date_of_birth ? \App\Helpers\GeneralHelper::calculateAge($fm->date_of_birth) : '' }}	{{ @$fm->address ?: @$fm->geo_address }}

क्रमांक S.No	नाम Name	पता Address	सम्बन्ध Relation	दूरभाष Telephone
19. दो व्यक्तियों के नाम (सगे सम्बन्धियों को छोड़ कर) जो आपको भलीभांति जानते हों Give names, Telephone No. & Addresses of two Persons (excluding Relatives) who know you well.
1.
2.

{{-- ================= PAGE 2 : EXACT APPLICATION FORM ================= --}}

Application form

आवेदन पत्र

दिनांक :

सेवा में,

The Manager

विषय : {{ @$employee->designation->name }} हेतु आवेदन पत्र

महॊदय,

मुझे पता चला है कि आपकी कम्पनी में {{ @$employee->designation->name }} की जगह
खाली है। मुझे {{ @$employee->designation->name }} का काम करनेका अच्छा अनुभव है। यदि आप
मुझे एक बार सेवा का अवसर प्रदान करें तो मैं अपना काम बड़ी मेहनत और ईमानदारी से करूँगा/करूँगी तथा
किसी भी अवैध कार्य, राजनैतिक या असामाजिक गतिविधियों में भाग नहीं लूँगा/लूँगी।

स्थान {{ $place }}

दिनांक {{ $joinDate }}

(हस्ताक्षर)

{{-- ================= PAGE 3 : APPOINTMENT LETTER ================= --}}

नियुक्ति पत्र

आपके नौकरी के लिए आवेदन पत्र और साक्षात्कार (इंटरव्यू) के संदर्भ में आपकी {{ @$employee->designation->name }}
पद के लिए नियुक्ति करते हुए हमें हर्ष होता है।

नाम : {{ $employee->name }} पिता/पति का नाम: {{ $employee->father_name }}

अस्थायी पता : {{ @$employee->temporary_geo_address }}

स्थायी पता : {{ @$employee->geo_address }}

जन्म तिथि : {{ $dob }} काम शुरू करने की तारीख: {{ $joinDate }}

पद : {{ @$employee->designation->name }} विभाग : {{ @$employee->department->name }}

श्रेणी : (अकुशल, अर्द्धकुशल, कुशल, अतिकुशल)

वेतन : {{ $totalGross ?? '-'}}/- प्रति माह /रोजाना /पीस रेट के आधार पर

नियुक्ति की शर्तें

1. आप 6 महीने तक अस्थाई / प्रोबेशन पर नियुक्त रहेंगे। जरूरत पड़ने पर यह अवधि 3 महीने के लिए दोबारा बढ़ाई जा सकती है।

2. अस्थाई / प्रोबेशन कार्यकाल या बढ़ाई गई अस्थाई / प्रोबेशन कार्यकाल के दौरान आपको यह अधिकार होगा कि आप बिना किसी सूचना (नोटिस) दिए नौकरी छोड़ सकते हैं। इस अस्थाई / प्रोबेशन के दौरान कम्पनी को भी यह अधिकार होगा कि वह आपको बिना किसी सूचना (नोटिस) के नौकरी छोड़ने के लिए कह सकती है।

3. किसी एक दिन 8 घण्टा कार्य करने के उपरान्त और किसी एक हफ्ते में 48 घण्टा कार्य करने के बाद आप ओवर टाइम (OT) वेतन के हकदार हैं। फैक्ट्री एक्ट 1948 (धारा 59) के तहत ओवर टाइम (OT) हमेशा आपकी स्वीकृति से होगा।

4. काम की जरूरत के अनुसार कम्पनी आपका तबादला (ट्रांसफर) कम्पनी के किसी दूसरे विभाग या भारत में कम्पनी की किसी अन्य फैक्ट्री में कर सकती है। अगर आपका तबादला एक से दूसरे राज्य में किया जाता है तो आपकी यात्रा का खर्चा कम्पनी के द्वारा दिया जाएगा।

5. आपकी आयु 58 वर्ष की होने पर आपको कम्पनी द्वारा रिटायर कर दिया जाएगा। कम्पनी द्वारा आपकी उम्र के सबूत के तौर पर केवल स्कूल प्रमाणपत्र या आपके जन्म का प्रमाणपत्र ही माने जाएंगे। जन्म प्रमाण पत्र एक बार दिए जाने के बाद बदला नहीं जा सकता।

6. अस्थाई / प्रोबेशन कार्यकाल खत्म होने के बाद आपकी नियुक्ति पक्की की जायेगी, कम्पनी द्वारा इस संदर्भ में आपको पत्र दिया जाएगा।

(क) अगर आप मासिक वेतन पर कार्यरत हैं, तो पक्की नियुक्ति होने के बाद, अगर आप अपनी नौकरी छोड़ना चाहते हैं तो आपको कम्पनी को एक महीने का नोटिस देना पड़ेगा और नोटिस पीरियड/समय के दौरान आपको कार्य करना पड़ेगा या फिर आपकी सालाना छुट्टी बकाया है तो आप उसकी एडजस्टमेंट कर सकते हैं। अगर आप कम्पनी के पक्के कर्मचारी हैं और कम्पनी आपकी सेवाएं बर्खास्त करती है तो वह आपको एक महीने का नोटिस या फिर नोटिस न देने के स्थान पर एक महीने का वेतन देगी।

{{-- ================= PAGE 4 : APPOINTMENT TERMS CONTINUATION ================= --}}

(ख) अगर आप मासिक वेतन पर कार्यरत नहीं हैं : पक्की नियुक्ति होने के बाद, अगर आप अपनी नौकरी छोड़ना चाहते हैं तो आपको कम्पनी को दो हफ्तों का नोटिस देना पड़ेगा या फिर अगर सालाना छुट्टी बकाया है तो आप उसकी एडजस्टमेंट करा सकते हैं। अगर आप पक्के कर्मचारी हैं और कम्पनी आपकी सेवायें बर्खास्त करती है तो वह आपको दो हफ्ते का नोटिस या नोटिस देने के स्थान पर दो सप्ताह का वेतन प्रदान करेगी।

7. बुरे व्यवहार की शिकायत मिलने पर आपको नौकरी से निलंबित (सस्पैंड) किया जा सकता है, जब तक कि जाँच (इन्क्वायरी) पूरी नहीं होगी। आपको सस्पेंशन के दौरान 50% वेतन मिलेगा। यदि आपका बुरा व्यवहार साबित नहीं होता है तो कम्पनी आपको निलंबित समय का पूरा वेतन देगी।

8. जब तक आप इस कम्पनी में काम करते हैं, आपको बिना कम्पनी की आज्ञा लिए दूसरी किसी कम्पनी में काम करने की अनुमति नहीं है।

9. भारतीय श्रम कानून के नियम अनुसार जैसे ही आप इस कम्पनी में 240 दिन काम कर लेते हैं तो आपको 1 दिन की छुट्टी हर 20 कार्य दिनों के बाद वेतन सहित लेने का अधिकार होगा।

10. को वर्ष में 7 दिन का आकस्मिक अवकाश (CL) का अधिकार होगा पूरे वेतन के साथ।

11. को वर्ष में ESIC के नियमानुसार बीमारी के अवकाश का अधिकार होगा।

12. यदि आपका मेडिकल इंश्योरेंस नहीं है और यदि आपने कम से कम 80 दिन कम्पनी में कार्य किया है तो गर्भावस्था के समय आपको पूरे वेतन के साथ बिना काम किए 26 हफ्ते की गर्भावस्था छुट्टियाँ मिलेंगी।

13. नियमानुसार आपको और आपके परिवार को मेडिकल इंश्योरेंस (ESI) की सुविधा दी जायेगी। जिसके लिए आपके कुल वेतन का 1.75 प्रतिशत हर महीने काट लिया जाएगा और आपके योगदान के रूप में आपको ESI का कार्ड दिया जाएगा। इस कार्ड से आपको बीमार पड़ने पर छुट्टियों का पैसा मिलेगा और गर्भावस्था के दौरान भी पैसा मिलेगा। अस्थाई या स्थाई रूप से अपंग होने पर भी पैसा मिलेगा। इसके अतिरिक्त उन सब चीजों का पैसा मिलेगा जो कि एम्प्लॉयीज स्टेट इंश्योरेंस एक्ट में दिए गए हैं।

14. आपके नियमानुसार प्रोविडेंट फण्ड (PF) की सुविधा भी मिलेगी जिसके लिए आपके वेतन के मूल (BASIC) व महंगाई भत्ते (DA) का 12 प्रतिशत काट लिया जाएगा। आपके (PF) खाते में हर महीने जमा कराया जाएगा। कम्पनी भी अपनी ओर से 12 प्रतिशत उतना ही पैसा आपके खाते में जमा कराएगी।

15. यदि आप कम्पनी में 30 दिन से ज्यादा काम कर चुके हैं तो साल में कुल वेतन का कम से कम 8.33% या अधिक से अधिक 20% बोनस दिया जायेगा।

16. यदि आपने कम्पनी में बिना नौकरी छोड़े लगातार 5 साल तक काम किया है तो कम्पनी आपको नौकरी छोड़ने पर ग्रेच्युटी की सुविधा देगी जो कि ग्रेच्युटी पेमेंट एक्ट के तहत होगी।

17. यदि आपको ऊपर दी गयी शर्तें मंजूर हैं तो आप इस नियुक्ति पत्र की दूसरी प्रति पर स्वीकृति के लिए अपने हस्ताक्षर करें और दिनांक {{ $joinDate }} काम पर आयें।

मैंने ऊपर लिखी सभी शर्तें पढ़ और समझ ली हैं,
मैं उन्हें स्वीकार करता हूँ।

हस्ताक्षर प्रबन्धक (स्टाम्प)

हस्ताक्षर कर्मचारी

{{-- ================= PAGE 5 : PERMANENT APPOINTMENT ================= --}}

कर्मचारी का नाम {{ $employee->name }}

पिता / पति का नाम {{ $employee->father_name }}

पद {{ @$employee->designation->name }}

विभाग {{ @$employee->department->name }}

स्थायी नियुक्ति पत्र

आपको सूचित किया जाता है कि प्रबन्धन ने आपको कम्पनी की सेवाओं में दिनांक {{ $joinDate }} से दिनांक {{ date('d-M-Y', strtotime($employee->date_of_joining . ' + 183 days')) }} तक परिवीक्षाकाल पर रखा था। आपका कार्य एवं आचरण सन्तोष जनक रहा।

अतः आपको कम्पनी में आज दिनांक {{ date('d-M-Y', strtotime($employee->date_of_joining . ' + 184 days')) }} से आपको स्थाई रूप से नियुक्त किया जाता है। आपको कम्पनी द्वारा दी गई सुविधाओं का लेने का पूर्ण अधिकार होगा।

कर्मचारी के हस्ताक्षर

कृते {{ strtoupper($orgName) }}

प्रबन्धक

{{-- ================= PAGE 6 : EPF PART A ================= --}} @php // Up to 3 nominees; with none recorded, the first family member stands in (as before). $epfNominees = collect($employee->nominees ?? [])->take(3)->values(); if ($epfNominees->isEmpty() && $firstFamily) { $epfNominees = collect([$firstFamily]); } @endphp

NOMINATION AND DECLARATION FORM Form-2 (Revised)
(FOR UNEXEMPTED / EXEMPTED ESTABLISHMENTS)

Declaration & Nomination Form under the Employees' Provident Fund & Employees' Pension Scheme
(Paragraph 33 & 61(1) of the Employees' Provident Fund Scheme, 1952 & Paragraph 18 of the Employees' Pension Scheme, 1995)

1. Name (in block letters)	{{ strtoupper($employee->name) }}
2. Father's / Husband's Name	{{ $employee->father_name }}
3. Date of Birth	{{ $dob }}
4. Sex	{{ $employeeSex }}
5. Marital Status	{{ $employeeMarital }}

6. PF Account No.	{{ @$employee->pf_no }}
7. Permanent Address	{{ @$employee->geo_address }}
Temporary Address	{{ @$employee->temporary_geo_address }}
8. Date of Appointment	{{ $joinDate }}

PART - A (EPF)

I hereby nominate the person(s) / cancel the nomination made by me previously and nominate the person(s) mentioned below to receive the amount standing to my credit in the Employees' Provident Fund, in the event of my death.

@for($i = 0; $i < 3; $i++) @php $nm = $epfNominees->get($i); @endphp @endfor

Name of the nominee / nominees	Address	Nominee's relationship with the member	Date of Birth	Total amount or share of accumulations in Provident Fund to be paid to each nominee	If the nominee is a minor, name, relationship & address of the guardian who may receive the amount during the minority of nominee
1	2	3	4	5	6
{{ @$nm->name }}	{{ $nm ? $nomineeAddress : '' }}	{{ @$nm->relationship }}	{{ @$nm->date_of_birth ? date('d-M-Y', strtotime($nm->date_of_birth)) : '' }}	{{ $nm ? (@$nm->share ?: ($epfNominees->count() == 1 ? '100 %' : '')) : '' }}

1. *Certified that I have no family as defined in Para 2(g) of the Employees' Provident Fund Scheme, 1952 and should I acquire a family hereafter, the above nomination should be deemed as cancelled.

2. *Certified that my father / mother is / are dependent upon me.

* Strike out whichever is not applicable.

Signature or Thumb Impression of the Subscriber

{{-- ================= PAGE 7 : EPS PART B ================= --}}

PARA- B (EPS)
(Para 18)

I hereby furnish below particulars of the members of my family who would be eligible to receive widow/children pension in the event of my death.

@for($i=0;$i<7;$i++) @php $fm = is_iterable($familyMembers) ? collect($familyMembers)->values()->get($i) : null; @endphp @endfor

S.No.	Name & Address of the family	Address	Date of Birth	Relationship with Member
{{ $i+1 }}	{{ @$fm->name }}	{{ @$fm->address ?: @$fm->geo_address }}	{{ @$fm->date_of_birth ? date('d-M-Y',strtotime($fm->date_of_birth)) : '' }}	{{ @$fm->relationship }}

Certified that I have no family as defined in Para 2 (V11) of Employee's Pension Scheme , 1995 and should I acquire a family hereafter I shall furnish particulars thereon in the above form.

I Hereby nominate the following person for receiving the monthly widow pension (admissible under para 16 (2) a (1) & (11 in the event without leaving any eligible member for receiving pension.

Name & Address of the Nominee	Date of Birth	Relationship with Member
{{ $nomineeName }} {{ $nomineeAddress }}	{{ $nomineeDob ? date('d-M-Y',strtotime($nomineeDob)) : '' }}	{{ $nomineeRelation }}

Signature or thumb Impression of the
subscriber

CERTIFICATE BY EMPLOYER

Certified that the above declaration and nomination has been signed/thumb impressed before me by
Employed in my establishment after he/she has read the entries have been read over to him/her by me and got confirmed by him/her.

Place {{ $place }}

Date {{ $joinDate }}

Name & Address of the factory/Establishment
{{ strtoupper($orgName) }}

{{ strtoupper($orgAddress) }}

For {{ strtoupper($orgName) }}

Authority Signature

{{-- ================= PAGE 8 : FORM NO. 16 ================= --}}

FORM NO. 16

[RULE 107 (2) OF U.P. FACTORIES ACT, 1948]

I hereby declare that in the event of death before resuming work
the balance of my pay due for the period of leave with wages not availed of shall be paid to :

Shri/Smt/Km {{ $nomineeName }}

who is my {{ $nomineeRelation }}

Signature of worker

Witness :
1. Name {{ $employee->name }}
2. Date {{ $joinDate }}

Present Address
{{ @$employee->temporary_geo_address }}

Permanent Home Address
{{ @$employee->geo_address }}

Employer's Stamp and Signature

FORM 'F'

PAYMENT OF GRATUITY

(See sub-rule (1) of Rule 5)

NOMINATION

To,

(Give here name of description of the establishment with full address)

1. {{ $employee->name }}

(Name in the 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 the month has become has not been paid and direct that the said amount of gratuity shall be paid in proportion indicated against the name's of the month's.

2. I hereby certify the persons mentioned is/are a member's of my family within the meaning of clause that (h) of section 2 of the payment Act. 1972

3. I hereby declare that i have no family within meaning of clause (h) of section (2) of paid 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 from my family by a notice date ......................................... to the controlling authority in terms of the provision to clause (h) of section 2 of the paid Act.

6. Nomination made herein invalidates my previous nomination.

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	3	4
1. 2. 3. 4.	{{ $nomineeName??'' }} {{ $nomineeAddress??'' }}	{{ $nomineeRelation??'' }}	{{ $nomineeDob ? \App\Helpers\GeneralHelper::calculateAge($nomineeDob) : '' }}	{{ $nomineeShare }}

{{-- ================= PAGE 10 : STATEMENT ================= --}}

Statement

1.	Name of the employee in full	{{ $employee->name }}
2.	Sex	{{ $employeeSex }}
3.	Religion	{{ $employeeReligion }}
4.	Wether unmarried/married/widow/widower	{{ $employeeMarital }}
5.	Department/Branch/Section where employed	{{ @$employee->department->name }}
6.	Post held with Ticket No. or serial no if any	{{ @$employee->designation->name }}
7.	Date of appointment	{{ $joinDate }}
8.	Permanent Address	{{ @$employee->geo_address }}

Place {{ $place }} Signature/Thumb impression of the
employee

Date {{ $joinDate }}

Declaration by witness

Nomination signed/thumb impressed before me

Name in full addressSignature of witness

1.1.

2.2.

Place {{ $place }}

Date {{ $joinDate }}

Certificate by the employer

Certificate that the particulars of the above nomination have been verified and record in this establishment

Employer's refrence no if any Signature of the employer/officer authorised

Date Designation

Name address of the establishment

or rubber stamb thereof

Acknowlegement by the employer

Received the duplicate of the nomination in Form 'F' filled by me and duty certifie by the employer.

Date Signature of the employee

Note : Strike out ward /Paragraph not applicable

@endif @if($formName == 'gratuity-report')

Payment of Gratuity (Central) Rules
FORM 'F'

See sub-rule (1) of Rule 6

Nomination

To
{{ $orgName }}
I, Shri/Shrimati/Kumari	{{ $employee->name }}
(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/are a member(s) of my family within the meaning of clause (h) 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 my 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.
6.	Nomination made herein invalidates my previous nomination.

Nominee(s)

@php $nominees = $employee->nominees->take(3) ?: []; $firstNominee = !empty($nominees) ? $nominees->first() : null; @endphp @foreach ($nominees as $key => $nominee) @php $age = @$nominee->date_of_birth ? \App\Helpers\GeneralHelper::calculateAge($nominee->date_of_birth) : ''; @endphp @endforeach @for ($i = isset($key) ? $key + 1 : 0; $i < 3; $i++) @endfor

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)	(3)	(4)
{{ $key + 1 }}.	{{ @$nominee->name }}	{{ @$nominee->relationship }}	{{ $age }}
{{ $i + 1 }}.

Statement

Name of employee in full

Sex

Religion

Whether unmarried/married/widow/widower

Department/Branch/Section where employed

Post held with Ticket No. or Serial No., if any

Date of appointment

{{ $employee->date_of_joining ? date('d/m/Y', strtotime($employee->date_of_joining)) : '' }}

8.	Permanent address:

Village

Thana

Sub-division

Post Office

District

State

Place:	{{ $employee->organization->place }}
Date:	{{ date('d/m/Y') }}

Signature/Thumb-impression of the
Employee

Declaration by Witnesses

Nomination signed/thumb-impressed before me
Name in full and full address of witnesses.			Signature of Witnesses.
1.			1.

2.			2.

Place:	{{ $employee->organization->place }}
Date:	{{ date('d/m/Y') }}

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
Date: {{ date('d/m/Y') }}	Name and address of the establishment or rubber stamp thereof.

Acknowledgement by the Employee

Received the duplicate copy of nomination in Form 'F' filed by me and duly certified by the employer.
Date: {{ date('d/m/Y') }}		Signature of the Employee

Note.—Strike out the words/paragraphs not applicable.

FORM NO. 35

Prescried under Rule 100

(C) Details of the nominee u/s 71 of ESI ACT11948 / Rule 56(2) of ESI (Central) Rules 1950 for payment of cash benefit in the event of death

I hereby declare that the above particulars have been given by me and are correct to the best of my Knowledge and I beleif. I alos under take to intimate to the corporation any change in the membership of my family within 15 days of such change having occured.

Declaration and Nomination Form Under the Employee's Provident Funds & Employees' Pension Scheme

(Paragraph 33 & 61 (1) of the Employees' Provident Fund Scheme, 1952 & Paragraph 18 of the Employees's Pension Scheme, 1995)

Name of Nominee	Relationship with insured person	Address
{{ $member->name }}	{{ $member->relationship }}

Name & Address of the Nominee/ Nominees	Nominee's relationship with the member	Date of Birth	Total amount of share of accumalation in provident fund to be paid to each nominee	if the nominee is minor name & address & relationship of the guardian who may recive the amount
1	2	3	4	5

Payment of Gratuity (Central) Rules
FORM 'F'

See sub-rule (1) of Rule 6

FORM NO. 35

Prescried under Rule 100

New Form No.11- Declaration Form

FORM - 2 ( Revised)

FOR EXEMPTED / UNEXEMPTED ESTABLISHMENTS

I here by nominate the person(s) / cancel the nomination made by me previously and person(s) mentioned below to receive the amount standing to my credit in the Employees' Provident Fund, in the event of my death.

I hereby furnish below particulars of the members of my family who would be eligible to receive widow/children pension in the event of my death

Certified that I have no family as defined in para 2 (vii) of the Employee's Pension Scheme 1995 and should I acquire a family hereafter the above nomination should be deemed as cancelled

I hereby nominate the following person for receiving the monthly widow pension (admissible under para 16(2) (g) (I) & (ii) in the event of my death with out leaving any eligible family member for receiving pension.

Sl. No.	Name	Date of Birth	Relationship with insured person	Whether residing with him/her or not	If No. State place of Residence
				YES/NO	Town	State
1.
2.
3.
4.
5.
6.
7.

1)	Certified that the Particulars are true to the best of my Knowledge
2)	I authorize EPFO to use my Aadhar for verification / e KYC purpose for service delivery
3)	Kindly transfer the funds and service details, if applicable if applicable, from the previous PF account as declared above to the present P.F Account(The Transfer Would be possible only if the identified KYC details approved by previous employer has been verified by present employer
4)	In case of changes In above details the same Will be intimate to employer at the earliest
	Date: {{ date('d/m/Y') }}
	Place: {{ $employee->organization->place }}	Signature of Member

1	Name ( In Block Letters)		:	{{ strtoupper($employee->name) }}
2	Father's / Husband's Name		:	{{ $employee->father_name }}
3	Date of Birth		:	{{ $employee->dob ? date('d/m/Y', strtotime($employee->dob)) : '' }}
4	Sex		:	{{ $employee->gender }}
5	Marital Status		:	{{ $employee->marital_status }}
6	Account Number		:	{{ $employee->bank_account_no }}
7	Address	Permanent	:	{{$employee->geo_address}}
7	Address	Temporary	:	{{$employee->temporary_geo_address}}
8	Date of Joining	EPF	:
8	Date of Joining	EPS	:

1	Certified that I have no family as defined in para 2 (g) of the employee's Provident Fund Scheme 1952 and shoud I ladquireb a family hereafter the a above nomination should be deemed as cancel e
2	Certified that my father / mother is / are depended upon me.
3	Unmarried members in the absence of dependent parents may nominate any other person to receive the shares

S.No	Name of the Family Members	Address	Date of Birth	Relationship
{{ $key + 1 }}.	{{ $familyMember->name }}		{{ $familyMember->date_of_birth }}	{{ $familyMember->relationship }}
{{ $i + 1 }}

Name & Address of the Nominee	Date of Birth	Relationship with the member

Payment of Gratuity (Central) Rules FORM 'F'

See sub-rule (1) of Rule 6

FORM NO. 35

Prescried under Rule 100

New Form No.11- Declaration Form

FORM - 2 ( Revised)

FOR EXEMPTED / UNEXEMPTED ESTABLISHMENTS

I here by nominate the person(s) / cancel the nomination made by me previously and person(s) mentioned below to receive the amount standing to my credit in the Employees' Provident Fund, in the event of my death.

I hereby furnish below particulars of the members of my family who would be eligible to receive widow/children pension in the event of my death

Certified that I have no family as defined in para 2 (vii) of the Employee's Pension Scheme 1995 and should I acquire a family hereafter the above nomination should be deemed as cancelled

I hereby nominate the following person for receiving the monthly widow pension (admissible under para 16(2) (g) (I) & (ii) in the event of my death with out leaving any eligible family member for receiving pension.

Payment of Gratuity (Central) Rules
FORM 'F'