Gratuity Settlement Application Form
This form is an application for claiming gratuity payments as entitled under the Payment of Gratuity Act, 1972. It is essential for employees who have completed five years of service in their organization. Properly filling out this form ensures timely processing of gratuity claims.
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How do I fill this out?
To fill out this form, start by gathering necessary employment details. Next, ensure that you provide accurate personal information, including your name and address. Finally, review your completed form before submission to avoid any mistakes.

How to fill out the Gratuity Settlement Application Form?
1
Gather personal and employment details.
2
Fill out the form with accurate information.
3
Clearly state the reason for gratuity claim.
4
Review the completed form for errors.
5
Submit the form as per the guidelines.
Who needs the Gratuity Settlement Application Form?
1
Employees retiring after long service need this form.
2
Individuals resigning from their job after five years require it.
3
Employees transferring to another company within the same organization must fill it.
4
Those reaching superannuation age should use this form.
5
Workers claiming gratuity due to other reasons must apply via this form.
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What are the instructions for submitting this form?
Submit this form to your HR department by email or in person. For email submissions, use hr@yourcompany.com. If applicable, a physical copy can be faxed to 123-456-7890 or mailed to the HR address provided in your company handbook.
What are the important dates for this form in 2024 and 2025?
In 2024, ensure to submit your gratuity form before the end of your employment period to avoid delays. For 2025, check with HR for any deadlines related to gratuity claims. Revisit key dates that may influence your gratuity payment processing.

What is the purpose of this form?
The purpose of the Gratuity Settlement Application Form is to allow employees to formally request the payment of gratuity upon termination of their employment. It ensures that the employees can access their entitled benefits under the Payment of Gratuity Act, 1972 after completing a specific tenure. This form also helps organizations to process gratuity claims methodically and transparently, adhering to legal requirements.

Tell me about this form and its components and fields line-by-line.

- 1. Name in Full: The complete name of the applicant.
- 2. Permanent Address: Home address for communication.
- 3. Department /Section: The department where the employee last worked.
- 4. Technical / Non-Technical: Classification of the role held by the employee.
- 5. Designation /Title: Job title at the time of employment.
- 6. Employee Code: Unique identification number assigned to the employee.
- 7. Date of Appointment: The starting date of employment.
- 8. Date and cause of cessation of employment: The last working date and reason for leaving.
- 9. Total period of service: Total duration of employment in the organization.
- 10. Amount of wages last drawn - BASIC PAY: Final basic salary before cessation.
- 11. Amount of gratuity claimed: The total gratuity amount the employee is requesting.
- 12. Payment Preference: Preferred method for receiving the gratuity, typically a Demand Draft.
What happens if I fail to submit this form?
If this form is not submitted, the employee will not be able to claim their gratuity benefits. Consequently, they may miss out on substantial financial entitlements due to non-compliance with the regulations. Timely submission is crucial for ensuring eligibility and receipt of these benefits.
- Loss of Gratuity Benefits: Failure to submit may lead to a loss of eligible gratuity.
- Delayed Payments: There may be unnecessary delays in receiving payments.
- Legal Complications: Not submitting can potentially lead to disputes regarding entitlements.
How do I know when to use this form?

- 1. Retirement: Used when an employee retires after eligible service.
- 2. Resignation: Utilized by those voluntarily leaving the organization.
- 3. Termination: Applicable for employees terminated under company policy.
- 4. Transfer: For those transferring within the same organization.
- 5. Superannuation: Applicable when reaching the mandatory retirement age.
Frequently Asked Questions
How do I start filling out the gratuity form?
Begin by downloading the form and gathering your employment details.
Can I edit the PDF after downloading?
Yes, you can edit the PDF using PrintFriendly's online PDF editor.
What information do I need for this form?
You will need your personal information, work history, and details about your separation from employment.
How is the gratuity amount calculated?
The calculation is based on your last drawn salary and the number of years worked in the organization.
What if I have questions while filling out the form?
Refer to the guidelines provided with the form or contact HR for assistance.
Where should I submit my completed form?
Submit your form to the HR department or the designated trustee as instructed.
Can I save my edits to the PDF?
You can download your edited PDF after making changes.
How long does it take to process the gratuity claim?
Typically, it takes a few weeks to process after submission.
Is there an online submission option?
Check with your HR department for any online submission methods available.
Can I track my gratuity claim status?
Yes, you can inquire about your claim status with HR after submission.
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