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FORM 'F'
See sub-rule (1) of Rule 6
Nomination
To,
(Give here name or description of the establishment with full address)
The ABC Company Ltd
Bangalore
Nominee(s)
Declaration by Witnesses
Place: Bangalore
Date: 25-03-2017
Certified that the particulars of the above nomination have been verified and recorded in this establishment.
Employer's Reference No., if any Employee Id : 2100421 Signature of the employer/Officer authorised
Designation
Employer Signature
Date: 25-03-2017 Name and address of the establishment or
rubber stamp thereof.
Address Stamp Of Establishment
Acknowledgement by the Employee
Received the duplicate copy of nomination in Form 'F' filed by me and duly certified by the employer.
Employee Signature
Date: 25-03-2017 Signature of the Employee