FORM OF
NOMINATION
(NIP/300Pads/2005)
Account No
..
I
hereby nominate the person (s) mentioned
below who is/are member (s) of my family as defined in Rule 2 of the General
Provident Fund (central Service) Rules 1960 to receive the amount that may
having become payable has not paid.
1.
Name (in block letters): 2.
Fathers/Husband Name:
3.
Address: 4. Sex:
5.
Marital Status
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Name and full address of the nominee(s) |
Relationship with the subscriber |
Age of the nominee (s) |
Share payable to each nominee |
Contingencies on the happening of which the nomination will become invalid |
Name, address and relationship of the person (s) if
any to whom the right of nominee shall pass in the event of his/her predeceasing
the subscriber |
If the nominees is not a member of the family as provided in Rule 2, indicate the reasons. |
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Dated
this
.day of 2000
.at
.This is in super cession of nomination (s)
submitted by me earlier
Two witnesses two signature Signature
of the subscriber
........................
Name
and address Signature Name
in block letters
.
1. Designation
2. Employee Code No
CERTIFICATE BY H.O.D
Certified that the above declaration and nomination
has been signed/thumb impress before me by Sh./ Smt/ .Km
. employed as
after he/she has read the entries/Entries
have been read over to him/her by me and confirmed by him/her.
Signature
of the Head
Under
whom he/she working
Space for the use by the Head of Office/Pay &
Accounts Officer
(Reverse of the form)
Nomination
by Sh./Smt./Km
.....................................................Designation
.................................................
Date
of receipt of nomination
.
..Signature of Head of Officer
Designation
.A.O.(Fund)
..
Date
Instructions
for the subscriber:-
(a)
Your name may be
filled in.
(b)
Name of the fund
may be completed suitably.
(c)
Definition of
term family as given in the General provident Fund (Central Services) Rules,
1960, is reproduced below:-
FAMILY MEANS:-
(i)
In the case of a male subscriber, the wife
or wives, parents, children, minor brothers, unmarried sister, deceased sons
widow and children and where no parent
of the subscriber is alive, a paternal grandparent.
Provided
that if a subscriber proves that his wife has been judicially separated from
him or has ceased under the customary law of the community
to which she belongs to be entitled to maintenance she shall henceforth be
deemed to be no longer a member of the subscribers family subscribers family
in matters to which these rules relate unless the subscriber subsequently
intimates in writing to he Accounts Officer that she shall continue to be so
regarded
(ii)
In the case of a
female subscriber, the husband, parents, children, minor brothers, unmarried
sister, deceased sons widow and children and here no parent of the subscriber
is alive, a paternal grandparent.
Provided
that if a subscriber by notice in writing to the Accounts Officer express her
desire to exclude her husband from her family, the husband shall henceforth be
deemed to be no longer a member of the subscriber family in matters to which
these rules relate unless the subscriber subsequently cancels such in writing.
NOTE:-Child means legitimate child and includes an adopted child where adoption is
recognized by the personal law governing the subscriber or award under the
Guardians and Wards Act, 1890 (8 of 1890) who lives with lives with the Government
servant status as that of a natural born child.
(d) Col. 4
if only one person is nominated the words in full should be written against
the nominee. If more that one person is nominated, the share payable to each nominee
over the whole amount of the provident Fund shall be specified.
(e) Col.5 Death
of nominee (s) should not be mentioned as contingency in this column.
(f) Col.6 Do not mention your name.
(g)
Draw line across
the blank space below last entry to prevent insertion of any name after you
have signed.