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FORM NO. 40A for Form of Nomination. FORM NO. 40A is required to be filed in for nominating the recipient of the amount of provident fund or gratuity in the event of the death of the employee. (1) An employee may be allowed by the trustees of the provident fund to make a nomination conferring on one or more persons the right to receive the amount that may stand to his credit in the provident fund in the event of his death, before that amount becomes payable or, having become payable, has not been paid. Such a nomination shall be made in Form No. 40A or in a form as near thereto as may be necessary. (2) If an employee nominates more than one person under sub-rule (1), he shall, in his nomination, specify the amount or share payable to each of the nominees in such manner as to cover the whole of the amount that may stand to his credit in the provident fund. (3) Where an employee has a family at the time of making a nomination, the nomination shall be in favour of one or more persons belonging to his family. Any nomination made by an employee in favour of a person not belonging to his family shall be invalid. (4) If at the time of making a nomination the employee has no family, the nomination may be in favour of any person or persons, but if the employee subsequently acquires a family, such nomination shall forthwith be deemed to be invalid and the employee may be allowed to make a fresh nomination in favour of one or more persons belonging to his family. (5) A nomination made by an employee may, at any time, be modified by him after giving a written notice to the trustees of his intention of doing so in Form No. 40B or in a form as near thereto as may be. If the nominee predeceases the employee, the interest of the nominee shall revert to the employee, who may thereupon make a fresh nomination in respect of such interest. (6) A nomination or its modification shall take effect to the extent that it is valid on the date on which it is received by the trustees. Explanation : For the purposes of this rule, “family” means the employee’s spouse, legitimate children, step-children [deceased son’s widow, deceased son’s legitimate children, deceased son’s step-children] and dependent parents FORM NO. 40A |
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| [See rule 67A/rule 101A] | ||||||||
| Form of nomination | ||||||||
[name of fund]Provident Fund / [name of fund] Gratuity Fund |
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| 1. Name of employee [in block letters] Surname |
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| 2. Sex |
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| 3. Religion |
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| 4. Father’s name |
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| 5. Husband’s name | ||||||||
| [for married woman only] | ||||||||
| 6. Marital status | ||||||||
| [whether unmarried, married, widow or widower] | ||||||||
| 7. Date of birth : Day Month Year |
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| 8. Permanent address : | ||||||||
| Village |
Thana |
Taluka/Sub-Division |
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| Post Office |
District |
State |
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| I hereby nominate the person(s) mentioned below to receive the amount that may stand to my credit in the provident fund in the | ||||||||
amount of gratuity |
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| event of my death before that amount becomes payable or, having become payable, has not been paid, and direct that the said amount shall be distributed among the said person(s) in the manner shown against their names : | ||||||||
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Name and address of nominee or nominees |
Nominee’s relationship with the employee |
Age of nominee |
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1 |
2 |
3 |
4 |
| 1. Certified that I have no family and should I acquire a family hereafter, the above nomination should be deemed as cancelled. |
| 2. Certified that my father/mother/sister(s)/minor brother(s) is/are dependent upon me. |
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Dated this |
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Two witnesses to signature |
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1. |
Signature of employee |
2.
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Certified that the above declaration has been signed by Shri/Shrimati he/she has read the entries . |
| the entries have been read over to him/her by me. |
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Date |
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| Signature of the trustee or any | |
| person authorised by the | |
| trustees in this behalf |
