The Payment of Gratuity (Central) Rules, 1972
FORM 'Q'
[See sub-rule (1) of rule 19]
Particulars of application under section 7
1. Serial No.
2. Date of the Application.
3. Name and address -of the applicant.
4. Name and address of the employer.
5. Amount of gratuity claimed.
6. Dates of hearing.
7. Findings with date.
8. Amount awarded.
9. Cost, if any, awarded.
10. Date of notice issued for payment of gratuity.
11. Date of appeal, if any.
12. Decision of the appellate authority.
13. Date of issue of Final Notice for payment of gratuity.
14. Date ofpayment of Gratuity by Employer with mode ofpayment.
15. Date of Receipt of application for recovery of Gratuity.
16. Date oflssue of Recovery Certificate.
17. Date of Recovery.
18. Other remarks.
19. Signed.
20. Date
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