To
[Name and address of the applicant employee/nominee legal heir]
You are hereby informed as required under clause (ii) of sub-rule (i) of rule 8 of the Payment of Gratuity (Central) Rules, 1972 that your claim for payment of gratuity as indicated on your application in Form under the said rules is not admissible for the reasons stated below:
Reasons
[Here specify the reasons]
Place Signature of the employer?
Date Authorised Officer.
Name or description of
establishment or rubber
stamp thereof.
Copy to : The Controlling Authority:
Note: Strike out the words not applicable.
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