FORM 9 – Application for the Grant of Death Gratuity: CCS (Payment of Gratuity under NPS) Rules, 2021

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FORM 9 – Application for the Grant of Death Gratuity: CCS (Payment of Gratuity under NPS) Rules, 2021

FORM 9 - Application for the Grant of Death Gratuity: CCS (Payment of Gratuity under NPS) Rules, 2021 FORM 9 Application for the Grant of Death Grat

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FORM 9 – Application for the Grant of Death Gratuity: CCS (Payment of Gratuity under NPS) Rules, 2021

FORM 9
Application for the Grant of Death Gratuity
[See rule 48 ]

(To be filled in separately by each claimant and in case the claimant is minor, the form should be filled in by the guardian on his/her behalf. Where there are more than one minor and one guardian for all of them, the guardian should claim gratuity in one Form on their behalf)

1. Details of deceased Government servant:

Name and designation Date of death DD/MM/YYYY
Office/Department/Ministry in which the deceased served last

2. Details of claimant(s):

Sl.

No.

Name Date of birth (DD/MM/YYYY) Share Relationship with the deceased Govt. servant Postal address
1.
2.
3.

3. In case the claimant(s) is/are minor or suffering from disorder or disability of mind, including mental retardation, details of guardian:

Name Date of birth (DD/MM/YYYY) Share Relationship with the minor/mentally disabled Relationship with the deceased Govt. Servant Postal address

4. Details of bank:

Bank’s Name A/c No. IFS Code

Place:
Date:
Mobile no.:

(Signature of the claimant/guardian)


Enclosure:
a. Death certificate.
b. Guardianship Certificate/ Indemnity Bond and Date of Birth Certificate in case the claimant is a minor.
c. Guardianship Certificate/ nomination and Medical Certificate in case the claimant is mentally disabled.

form-9-application-for-the-grant-of-death-gratuity

FORM 9 – Application Hindi and English PDF

Previous: FORM 8 – Letter to the nominee/ member of family

Next: Form 10 – Assessment and Authorisation of Payment of Death Gratuity

Central Civil Services (Payment of Gratuity under National Pension System) Rules, 2021 – Notification G.S.R. 658 (E)

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