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Gratuity Claim Form (India)

Gratuity Claim Form (India)

Payment of Gratuity Act 1972 — Form I

APPLICATION FOR PAYMENT OF GRATUITY

Form I — Payment of Gratuity Act 1972 / Payment of Gratuity (Central) Rules 1972

To,

The Employer / Manager,

[Employer Name]

Date: [Claim Date]

1. CLAIMANT DETAILS

Name: [Employee Name]

Address: [Employee Address]

Employee ID: [Employee ID]

Designation: [Designation]

Department: [Department]

2. SERVICE DETAILS

Employer: [Employer Name]

Date of joining: [Date of Joining]

Last working day: [Last Working Day]

Reason for separation: [Separation Reason]

Total continuous service: [Years of Service]

3. GRATUITY CALCULATION

Last drawn Basic + DA: [Last Drawn Basic]

Completed years of service: [Years of Service]

Gratuity formula: (Basic + DA) ÷ 26 × 15 × years of service

Gratuity amount claimed: [Gratuity Amount]

4. PAYMENT DETAILS

Bank Account: [Bank Account Number]

IFSC: [IFSC Code]

Bank / Branch: [Bank Name]

5. DECLARATION

I, [Employee Name], hereby declare that the information provided above is true and correct. I am entitled to gratuity under the Payment of Gratuity Act 1972 and request the employer to determine and pay the gratuity amount within 30 days as required under Section 7(2) of the Act.

Claimant / Employee (or Nominee)

________________

Signature

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What Is a Gratuity Claim Form (India)?

A Gratuity Claim Form in India supplies the facts and figures the authority requires so the matter can be processed, assessed or verified.

The legal framework governing the Gratuity Claim Form (India) in India draws on several key statutes and regulatory bodies. Under Indian law, the Indian Contract Act 1872 governs contractual obligations, with Section 10 setting essential requirements for valid agreements. The Companies Act 2013 regulates corporate entities through the Registrar of Companies (ROC) and Ministry of Corporate Affairs (MCA). The Industrial Disputes Act 1947 and state labour commissioners govern employment disputes. The Information Technology Act 2000 and IT (Reasonable Security Practices) Rules 2011 protect personal data. The Income Tax Act 1961 and Goods and Services Tax Act 2017 govern tax obligations through the Central Board of Direct Taxes (CBDT) and GST Council. Parties executing a Gratuity Claim Form (India) in India should confirm the document reflects current law, including any amendments enacted since the original drafting date. The Industrial Disputes Act, 1947 sets the foundational requirements.

When Do You Need a Gratuity Claim Form (India)?

A Gratuity Claim Form is required to be filed in India whenever an employee who has completed five or more years of continuous service separates from an employer covered under the Payment of Gratuity Act 1972. The form must be filed upon: resignation after five years of continuous service; retirement on reaching superannuation age; termination of employment (with or without cause) after five years; voluntary retirement under a VRS scheme; and upon the death or total permanent disablement of the employee (where the five-year requirement is waived and the claim is filed by the nominee or legal heir). The claim must be filed within 30 days of the date on which gratuity becomes due. While a delay beyond 30 days does not extinguish the right to gratuity (courts have held that gratuity cannot be denied for late filing alone), timely filing is advisable to confirm prompt payment and to avoid complications. The Gratuity Claim Form must be submitted to the employer at the establishment where the employee was last employed.

Parties in India should prepare a Gratuity Claim Form (India) proactively rather than waiting for a dispute to arise. Courts interpret agreements based on the written terms rather than oral representations. Under Indian law, the Indian Contract Act 1872 governs contractual obligations, with Section 10 setting essential requirements for valid agreements. The Companies Act 2013 regulates corporate entities through the Registrar of Companies (ROC) and Ministry of Corporate Affairs (MCA). The Industrial Disputes Act 1947 and state labour commissioners govern employment disputes. The Information Technology Act 2000 and IT (Reasonable Security Practices) Rules 2011 protect personal data. The Income Tax Act 1961 and Goods and Services Tax Act 2017 govern tax obligations through the Central Board of Direct Taxes (CBDT) and GST Council. Where the transaction involves regulated activities, prior approval from the relevant authority may be required before execution.

What to Include in Your Gratuity Claim Form (India)

A Gratuity Claim Form for India under the Payment of Gratuity Act 1972 should contain the following elements: the employee full name, designation, department, and employee code; the establishment name and address; the date of joining and date of last working day; the total period of continuous service in years and months; the nature of separation (resignation, retirement, termination, death, disablement); the last drawn basic wages and dearness allowance per month; the calculated gratuity amount based on the formula: (Basic + DA) x 15/26 x completed years of service; the nominee details if the claim is filed by a nominee following death; the bank account details for payment (account number, IFSC code, bank name, and branch); a declaration that the information provided is true and correct; and the signature or thumb impression of the claimant with date. The form should be accompanied by: a copy of the appointment letter or service record; a copy of the separation letter or retirement notice; a copy of the death certificate and nomination form (for nominee claims); and a copy of the medical certificate (for disablement claims). The completed form must be submitted to the employer, with acknowledgement obtained.

Additional compliance elements for a Gratuity Claim Form (India) used in India include: Under Indian law, the Indian Contract Act 1872 governs contractual obligations, with Section 10 setting essential requirements for valid agreements. The Companies Act 2013 regulates corporate entities through the Registrar of Companies (ROC) and Ministry of Corporate Affairs (MCA). The Industrial Disputes Act 1947 and state labour commissioners govern employment disputes. The Information Technology Act 2000 and IT (Reasonable Security Practices) Rules 2011 protect personal data. The Income Tax Act 1961 and Goods and Services Tax Act 2017 govern tax obligations through the Central Board of Direct Taxes (CBDT) and GST Council. Forms-legal.com provides this template as a starting point for India-compliant documentation.

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Reference this free template in an article, syllabus, or research note:

APA

Forms Legal. (2026). Gratuity Claim Form (India) (India) [Legal document template]. Forms Legal. https://forms-legal.com/india/employment/termination/gratuity-claim-form-india

MLA

"Gratuity Claim Form (India) (India)." Forms Legal, 2026, https://forms-legal.com/india/employment/termination/gratuity-claim-form-india.

BibTeX
@misc{formslegal-gratuity-claim-form-india,
  author       = {{Forms Legal}},
  title        = {Gratuity Claim Form (India) (India)},
  year         = {2026},
  howpublished = {\url{https://forms-legal.com/india/employment/termination/gratuity-claim-form-india}},
  note         = {Free legal document template. Based on Industrial Disputes Act, 1947}
}

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Based on Industrial Disputes Act, 1947 — Template last modified June 2026Verify the source →

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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