Rule 5 (3) FORM OF NOMINATION Account No.------------------ I, ---------------------------hereby nominate the persons(s) mentioned below who is/are member (s)/non -member(s) of my family as defined in Rule 2 of the General Provident Fund (Central Services) Rules, 1960, to receive the amount that may stand to my credit in the Fund as indicated below, in the event of my death before that amount has become payable or having become payable has not been paid. Name and full address of the nominee(s) 1 Relation-ship with the subscriber 2 Age of the nominee(s) 3 Share payable to each nominee 4 Contingenc-ies on the happening of which the nomination will become invalid 5 Name, address and relationship of the persons(s) if any to whom the right of nominee shall pass in the event of his/her predeceas-ing the subscriber 6 If the nominee is not a member of the family as provided in Rule 2, indicate the reason 7 Dated this -----------------------------------day of 200---------------at------------------------------ Signature of the subscriber--------------- Name in Block letters--------------------- Designation--------------------------------- Two witnesses to signature Name and address 1. 2. Signature 3. (Reverse of the form) Space for use by the Head of Office/Pay & Accounts Office Nomination by Shri/Smt/Kumari-------------------- Designation ----------------------------- Date of receipt of nomination---------Signature of Head of Office/Pay & Accounts Officer Designation----------------------------------------- Date------------------------------------------------ Instructions for the subscriber (a) Your name may be filled in. (b) Name of the fund may be completed suitably. (c) Definition of term "family" as given in the General Provident Fund (Central Services) Rules, 1960, is reproduced below. Family means (i) in the case of a male subscriber, the wife or wives, parents, children, minor brothers, unmarried sisters, deceased son's widow and children and where no parent of the subscriber is alive, a paternal grandparent: Provident that if a subscriber proves that his wife has been judicially separated from him or has ceased under the customary law of the community to which she belongs to be entitled to maintenance she shall henceforth be deemed to be no longer a member of the subscriber's family in matters to which these rules relate unless the subscriber subsequently intimates in writing to the Accounts Officer that she shall continue to be so regarded. (ii) In the case of a female subsrciber,the husband, parents,children, minor Brothers, unmarried sisters, deceased son's widow and children and where no parent of the subscriber is alive, a paternal grandparent: Provident that if a subscriber by notice in writing to the Accounts Officer expresses her desire to exclude her husband from her family, the husband shall henceforth be deemed to be no longer a member of the subscriber's family in matters to which these rules relate unless the subscriber subsequently cancels such notice in writing. Note:-- Child means legitimate child and includes an adopted child where adoption is recognized by the personal law governing the subscriber or a ward under the Guardians and Wards Act,1890 (8 of 1890 ) who lives with the Government servant and is treated as a member of the family and to whom the Government servant has,through a special will,given the same status as that of a natural born child. (d) Col.4. If only one person is nominated, the words "in full"should be written against the nominee. If more than one person is nominated, the share payable to each nominee over the whole amount of the Provident Fund shall be specified. (e) Col.5. Death of nominee(s) should not be mentioned as contingency in this column. (f) Col.6.Do not mention your name. (g) Draw line across the blank space below last entry to prevent insertion of any name after you have signed. NOTE---Deleted. 1.Substituted) vide G. I, Dept. of pen. & P.W., Notification No.20 (6)-Pen. & P.W./86,dated 2.Deleted ) the 6th February,1987.
