Death Gratuity Claim Form (Ghana)
Death Gratuity Claim Form
LABOUR ACT 2003 (ACT 651) — SECTION 63
Death Gratuity Claim Form
To: [Employer Name], [Employer Address]
This Death Gratuity Claim Form is submitted on [Claim Date] by [Claimant Name] in respect of the death of [Deceased Name], a former employee of [Employer Name], pursuant to Section 63 of the Labour Act 2003 (Act 651).
1. Deceased Worker's Particulars
Full legal name: [Deceased Name]
Ghana Card number: [Deceased Ghana Card]
SSNIT number: [Deceased SSNIT Number]
Date of birth: [Deceased DOB]
Date of death: [Date Of Death]
Cause of death: [Cause Of Death]
Death certificate registration number: [Death Certificate Number]
2. Employment Details
Employer: [Employer Name], [Employer Address]
Job title: [Job Title]
Date employment commenced: [Commencement Date]
Total length of service: [Years Of Service]
Last basic monthly salary: GHS [Last Basic Salary]
Death gratuity amount claimed: GHS [Gratuity Amount], calculated in accordance with Section 63 of the Labour Act 2003 (Act 651) and the applicable employment contract or collective bargaining agreement.
3. Claimant's Details
Claimant's full name: [Claimant Name]
Relationship to deceased: [Claimant Relationship]
Ghana Card number: [Claimant Ghana Card]
Residential address: [Claimant Address]
Telephone: [Claimant Phone]
Payment bank account: [Bank Name], Account No. [Bank Account]
4. Declaration
I, [Claimant Name], hereby declare that:
I am entitled to claim the death gratuity as a dependant / personal representative of [Deceased Name] in accordance with Section 63 of the Labour Act 2003 (Act 651).
No other person has previously received payment of the death gratuity in respect of the employment of [Deceased Name] with [Employer Name].
All information provided in this form is true and accurate to the best of my knowledge.
I request that [Employer Name] process and pay the death gratuity of GHS [Gratuity Amount] within a reasonable time. If payment is not made, I reserve the right to refer this claim to the National Labour Commission (NLC) under Part XV of Act 651.
5. Employer Acknowledgment
For completion by the employer:
Claim received by: _________________________ Date: _________________________
Calculated gratuity amount (GHS): _________________________
Expected payment date: _________________________
Claimant
________________
Signature
What Is a Death Gratuity Claim Form (Ghana)?
A Death Gratuity Claim Form in Ghana records the particulars required for the matter it documents.
The Labour Act 2003 (Act 651) is the primary legislation governing employment relationships in Ghana and applies to all workers in Ghana with limited exceptions for members of the Ghana Armed Forces, Ghana Police Service, and the Prison Service. Section 63 of Act 651 specifically addresses the payment of a death gratuity and provides a minimum statutory entitlement for the dependants of deceased workers. The quantum of the death gratuity is calculated by reference to the worker's length of service and the applicable terms of the employment contract or collective bargaining agreement.
The National Pensions Act 2008 (Act 766) establishes the three-tier pension system in Ghana administered by the Social Security and National Insurance Trust (SSNIT) and the National Pensions Regulatory Authority (NPRA). SSNIT pays a survivor's benefit to dependants of a deceased contributor under the Tier 1 mandatory pension scheme. The death gratuity under Act 651 s.63 is separate from and in addition to SSNIT survivor benefits and Tier 2 pension death benefits paid by the NPRA-regulated fund manager.
The Workmen's Compensation Act 1987 (PNDC Law 187) provides for compensation to workers who are injured or killed in the course of employment. Where a worker's death is attributable to a workplace accident or occupational disease, the dependants may also be entitled to compensation under PNDC Law 187, administered through the National Labour Commission (NLC) and the courts. The Death Gratuity Claim Form (Ghana) should cross-reference claims under both Act 651 and PNDC Law 187 where applicable.
Claims for a death gratuity under Act 651 may also trigger an investigation by the Occupational Safety and Health Department of the Labour Commission and a report under the Factories, Offices and Shops Act 1970 (Act 328) where the death occurred at a workplace. The Death Gratuity Claim Form is the primary document initiating the employer's obligation to pay and the dependants' right to receive the statutory gratuity.
The legal framework governing the Death Gratuity Claim Form (Ghana) in Ghana draws on several key statutes and regulatory bodies. Under the Labour Act 2003 (Act 651), the National Labour Commission (NLC) adjudicates workplace disputes in Ghana. Section 12 of the Labour Act 2003 requires written terms of employment. The National Pensions Act 2008 (Act 766) mandates employer contributions to the Social Security and National Insurance Trust (SSNIT). The Ghana Revenue Authority (GRA) administers PAYE under the Income Tax Act 2015 (Act 896). The Labour Division of the High Court hears employment appeals. Parties executing a Death Gratuity Claim Form (Ghana) in Ghana should confirm the document reflects current law, including any amendments enacted since the original drafting date. The Labour Act 2003 (Act 651) sets the foundational requirements.
When Do You Need a Death Gratuity Claim Form (Ghana)?
A Death Gratuity Claim Form in Ghana is required in the following circumstances.
A Death Gratuity Claim Form is needed when a worker employed by a company incorporated under the Companies Act 2019 (Act 992) dies during the subsistence of their employment contract, whether by accident, illness, or other cause, and the worker's dependants or personal representatives wish to claim the death gratuity payable by the employer under Section 63 of the Labour Act 2003 (Act 651).
A Death Gratuity Claim Form is required when a worker dies as a result of a workplace accident at a factory, office, construction site, or other place of business in Ghana, and the dependants wish to claim both the statutory death gratuity under Act 651 s.63 and compensation under the Workmen's Compensation Act 1987 (PNDC Law 187).
A Death Gratuity Claim Form is needed when a worker enrolled in the SSNIT Tier 1 pension scheme dies before reaching retirement age, and the dependants are claiming the SSNIT survivor benefit in parallel with the employer's statutory death gratuity under Act 651, requiring documentation of the employment relationship and the worker's salary for calculation of entitlements.
A Death Gratuity Claim Form is required when a worker dies during a probationary period and the employer disputes whether the death gratuity obligation under Act 651 s.63 applies, necessitating a formal claim and, if unresolved, referral to the National Labour Commission (NLC) or the High Court (Labour Division).
A Death Gratuity Claim Form is needed when the personal representatives of a deceased worker are administering the worker's estate before the High Court (Probate Division) and need to document all employment-related entitlements — including the death gratuity, unpaid salary, accrued leave pay, and SSNIT benefits — as assets of the estate for the purposes of the Intestate Succession Law 1985 (PNDC Law 111) or a will.
Parties in Ghana should complete the Death Gratuity Claim Form promptly after the worker's death and submit it to the employer together with the certified death certificate and proof of relationship, to avoid delays in payment and to preserve the right to refer the claim to the National Labour Commission (NLC) if the employer fails to pay within a reasonable time.
What to Include in Your Death Gratuity Claim Form (Ghana)
A valid Death Gratuity Claim Form in Ghana under the Labour Act 2003 (Act 651) s.63 must contain the following essential elements.
Deceased Worker Details: Full legal name of the deceased worker; Ghana Card number or other government-issued identity document number; SSNIT number; date of birth; date of death; cause of death; and last known residential address in Ghana.
Employment Details: Name and registered address of the employer; company registration number issued by the Office of the Registrar of Companies (ORC) under the Companies Act 2019 (Act 992); job title and department of the deceased; date of commencement of employment; date of termination (death); last basic salary in Ghana Cedis (GHS); and total length of service in years and months. These details are needed to calculate the quantum of the death gratuity under Act 651 s.63 and the applicable employment contract or collective bargaining agreement.
Claimant Details: Full legal name of the claimant; Ghana Card number or other government-issued identification; relationship to the deceased (spouse, child, parent, or other dependant); residential address; contact telephone number; and bank account details at a Bank of Ghana-licensed financial institution for payment of the gratuity.
Supporting Documents: Certified copy of the death certificate issued under the Births and Deaths Registration Act 1965 (Act 301) by the Registrar of Births and Deaths; proof of relationship — such as a marriage certificate under the Marriages Act 1884-1985, birth certificate, or customary marriage registration certificate under PNDC Law 112; and a copy of the deceased worker's employment contract or offer letter confirming the terms of employment.
Declaration: A declaration by the claimant confirming the accuracy of the information provided and that no other person has previously received payment of the death gratuity in respect of the deceased worker's employment.
Employer Acknowledgment: Space for the employer's authorised representative to acknowledge receipt of the claim, record the calculated gratuity amount, and confirm the expected payment date.
Additional elements include: reference to the National Labour Commission (NLC) as the forum for disputes under Act 651; cross-reference to Workmen's Compensation Act 1987 (PNDC Law 187) claims where the death was work-related; and SSNIT and Tier 2 pension claim references. Forms-legal.com provides this template as a starting point for death gratuity claims in Ghana.
Additional compliance elements for a Death Gratuity Claim Form (Ghana) used in Ghana include: Under the Labour Act 2003 (Act 651), the National Labour Commission (NLC) adjudicates workplace disputes in Ghana. Section 12 of the Labour Act 2003 requires written terms of employment. The National Pensions Act 2008 (Act 766) mandates employer contributions to the Social Security and National Insurance Trust (SSNIT). The Ghana Revenue Authority (GRA) administers PAYE under the Income Tax Act 2015 (Act 896). The Labour Division of the High Court hears employment appeals. Forms-legal.com provides this template as a starting point for Ghana-compliant documentation.
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note = {Free legal document template}
}Frequently Asked Questions
Section 63 of the Labour Act 2003 (Act 651) requires an employer in Ghana to pay a death gratuity to the dependants of a worker who dies during the course of employment. The death gratuity is a lump-sum payment calculated by reference to the worker's length of service and the applicable terms of the employment contract or collective bargaining agreement negotiated between the employer and a recognised trade union under Act 651. The minimum statutory amount of the death gratuity is not fixed by Act 651 itself — rather, the Act requires the employer to make a payment that is fair and commensurate with the worker's service and remuneration. In practice, many Ghanaian employers calculate the death gratuity as a multiple of the worker's monthly basic salary per year of service. The death gratuity under Act 651 s.63 is distinct from and in addition to SSNIT survivor benefits under the National Pensions Act 2008 (Act 766) and any compensation payable under the Workmen's Compensation Act 1987 (PNDC Law 187).
The death gratuity under Section 63 of the Labour Act 2003 (Act 651) is payable to the dependants of the deceased worker. In Ghana, dependants typically include: the spouse of the deceased (whether under an ordinance marriage under the Marriages Act 1884-1985 or a registered customary marriage under PNDC Law 112); dependent children under 18 years of age or dependent children in full-time education up to age 25; and dependent parents or other persons who were financially dependent on the deceased worker at the time of death. Where the deceased worker has no surviving dependants, the death gratuity forms part of the worker's estate and is distributed in accordance with the Intestate Succession Law 1985 (PNDC Law 111) if the worker died without a will, or in accordance with the worker's will if one exists and has been admitted to probate by the High Court (Probate Division). The Death Gratuity Claim Form (Ghana) should identify all claimants and their relationship to the deceased.
The death gratuity under Section 63 of the Labour Act 2003 (Act 651) and the SSNIT survivor benefit under the National Pensions Act 2008 (Act 766) are separate and independent entitlements payable from different sources. The death gratuity is paid directly by the employer from the employer's own funds and is based on the worker's length of service and the terms of the employment contract or collective bargaining agreement. The SSNIT survivor benefit, by contrast, is paid by the Social Security and National Insurance Trust (SSNIT) from the national pension fund, and is based on the deceased worker's total SSNIT contributions over their working life. The SSNIT survivor benefit is claimed separately from SSNIT by submitting a Survivor Benefit Claim Form to the nearest SSNIT office in Accra, Kumasi, or the relevant regional capital. Dependants of a deceased worker in Ghana may be entitled to both the death gratuity and SSNIT survivor benefits simultaneously — the receipt of one does not affect entitlement to the other.
To support a Death Gratuity Claim Form in Ghana under the Labour Act 2003 (Act 651) s.63, claimants should provide: (1) a certified copy of the death certificate issued by the Registrar of Births and Deaths under the Births and Deaths Registration Act 1965 (Act 301); (2) proof of the claimant's relationship to the deceased — such as a marriage certificate under the Marriages Act 1884-1985, a customary marriage certificate under PNDC Law 112, or a birth certificate for a child claimant; (3) a copy of the deceased worker's employment contract, offer letter, or payslip confirming the terms of employment, job title, and last basic salary; (4) the deceased worker's Ghana Card or other government-issued identity document; (5) the claimant's Ghana Card and proof of residential address; and (6) the claimant's bank account details at a Bank of Ghana-licensed institution for payment. Where the death occurred in the workplace, an accident report filed under the Factories, Offices and Shops Act 1970 (Act 328) should also be obtained and submitted with the claim.
If an employer in Ghana refuses to pay the death gratuity under Section 63 of the Labour Act 2003 (Act 651) or fails to respond to the Death Gratuity Claim Form within a reasonable time, the claimant has the following remedies. First, the claimant may refer the dispute to the National Labour Commission (NLC), which is the statutory body established under Part XV of Act 651 to adjudicate employment disputes in Ghana. The NLC has the power to mediate the dispute and, if mediation fails, to refer it to arbitration. An arbitration award by the NLC has the same effect as a judgment of the High Court. Second, the claimant may institute proceedings before the High Court (Labour Division) in Accra, Kumasi, or the relevant regional capital for recovery of the death gratuity as a debt due. Third, where the death occurred at a workplace, the claimant may also pursue a claim under the Workmen's Compensation Act 1987 (PNDC Law 187) simultaneously with the claim under Act 651.
The Labour Act 2003 (Act 651) applies to all workers in Ghana, including casual and part-time workers, with limited exceptions for members of the Ghana Armed Forces, Ghana Police Service, and the Prison Service. Section 63 of Act 651, which provides for the death gratuity, does not expressly exclude casual workers. However, the quantum of the death gratuity for a casual worker is typically calculated by reference to the worker's actual earnings and length of service, which may be shorter and lower than for a permanent employee. Where a casual worker has been employed on a recurring basis over an extended period, Ghanaian courts and the National Labour Commission (NLC) may treat the relationship as continuous employment for the purposes of calculating the death gratuity, particularly if there was no genuine break in the employment relationship between engagements. Employers should document the employment status of all workers — whether permanent, fixed-term, or casual — in a written contract to avoid disputes about entitlements under Act 651.
Under the Income Tax Act 2015 (Act 896), certain employment-related payments made on the death of a worker may be exempt from income tax in Ghana, depending on the nature of the payment and the applicable exemptions. The Ghana Revenue Authority (GRA) administers income tax and PAYE obligations in Ghana. In general, compensation paid to the dependants of a deceased worker in respect of a death arising from employment — including the death gratuity under the Labour Act 2003 (Act 651) s.63 and compensation under the Workmen's Compensation Act 1987 (PNDC Law 187) — may be treated as a non-taxable death benefit. However, the tax treatment depends on the specific characterisation of the payment and the quantum involved. Employers and claimants should consult a tax advisor registered with the GRA before finalising the death gratuity payment, particularly for senior employees with large entitlements. The Death Gratuity Claim Form (Ghana) should record the gross amount claimed and note that the net amount payable is subject to GRA guidance.
This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer
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