Nomination and Declaration Form

Nomination & Declaration Form

I ……………………….S/o…………………… presently working as …………………in (company name) ………nominate to  …….……………who is my (relationship)…………………… to received.  All my dues payable by the company in the event of my death.

___________________

Signature of Employee

Present Address:

Permanent Address:

Witness   :

1.  _____________________                 ______________________

      Signature                                              Name

2.  _____________________                 ______________________

      Signature                                              Name

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