Schedule1 – Employees State Insurance Corporation (General Provident Fund) Rules, 1995

SCHEDULE I: Form of Nomination

[Rule 7(3)]

Account No…………

I, _______ hereby nominate the person(s) mentioned below who is/are member(s) of my family as defined in rule 2 to receive the amount that may stand to my credit in the fund as indicated below, in the event of my death before that amount has become payable or having become payable has not been paid.

Name and full address of the nominee(s)

Relationship with the subscriber

Age of 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 nominee is not a member of the family as defined indicate the reasons

1

2

3

4

5

6

7

 

 

 

 

 

 

 

Dated this ………. day of …….. 19 …… at ……….

                                                               Signature of subscriber

                                                               Name in block letters …………..

                                                                                                               

Signature

1._____________                                                               

2._____________

Two witnesses to signature

Name and address

1____________________

2 ___________________

(RESERVE OF THE FORM)

SPACE FOR USE BY THE HEAD OF OFFICE / PAY & ACCOUNTS OFFICE

Nomination by Shri / Smt./ Kumari ………..Designation ………

Date of receipt of nomination ……………………………………….

                           Signature of Head of office / accounts officer

                                                        Designation ………………

                                                                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 Funds (CS) Rules, 1960 is reproduced below:

Family means:-

(i) in the case of a male subscriber, the wife or wives, parents, children, minor brothers, unmarried sisters
, deceased son’s widow and children and where no partner 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 subscriber’s family in matters to which these rules relate unless the subscriber subsequently intimates in writing to the 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 sisters, deceased son’s widow and children and where no parent of the subscriber is alive, a paternal grandparent:

PROVIDED that if a subscriber by notice in writing to the accounts officer expresses her desire to exclude her husband from her family, the husband shall henceforth be deemed to be no longer a member of the subscriber’s family in matters to which these rules relate unless the subscriber subsequently cancels such notice in writing.

Note: Child means legitimate child and includes an adopted child where adoption is recognized by the personal law governing the subscriber.

(d) Col. 4 If only one person is nominated the words “in full” should be written against the nominee. If more than 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 a line across the blank space below last entry to prevent insertion of any name after you have signed. 

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