Common Nomination Form for Gratuity, General Provident Fund, [GPF] Central Government Employees Group Insurance Scheme [CGEGIS] and Ex-gratia Lump Sum Compensation.[See Rule 53 of CCS (Pension) Rules, 1972, Rule 5 of General Provident Fund (Central Services) Rules, 1960, Para 19.7 of Central Government Employees Group Insurance Scheme, 1980 and OM No. 38/37/2016- P&PW (A) dated 04.08.2016]
I, ………………… hereby nominate the person/ persons mentioned below and confer on him/ her/ them the right to receive in the event of my death, to the extent specified below, amount on account of the following:
i. any gratuity the payment of which may be authorised under rule 50 of CCS (Pension) Rules
ii. amount that may stand to my credit in the General Provident Fund
iii. any amount that may be sanctioned by the Central Government under the Central Government Employees Group Insurance Scheme, 1980
iv. Ex-gratia Lump sum compensation that may be authorised under OM No. 45/55/97- P&PW(C) dated 11th September, 1998 as amended from time to time.
These nominations supersede any nominations made by me earlier.
Place and date:
Signature of Government servant