Form 12 Application for Grant of Death Gratuity – Download PDF

If you can download here for Form 12 for application for the grant of Death Gratuity on the death of a Government servant.

FORM 12
[See rule 77(2)]
Form 12 of application for the grant of death gratuity on the death of a Government servant

(To be filled in separately by each claimant and in case the claimant is minor, the Form should be filled in by the guardian on his/her behalf. Where there are more than one minor and one guardian for all of them, the guardian should claim gratuity in one Form on their behalf)

1. 
   (i) Name of the deceased Government servant in respect of whom gratuity is being claimed
   (ii) Date of death of Government servant
   (iii) Office/Department/Ministry in which the deceased served last

Download PDF for Form 12 Death Gratuity of Government Servant