Form 10 – Assessment and Authorisation of Payment of Death Gratuity
FORM 10
Assessment and Authorisation of Payment of Death Gratuity when a Government Servant dies while in Service
[See rules 49, 51 and 53 ]
Part I
Section I
1. Details of deceased:

2. Post held at the time of death:

5. Service in Autonomous Body/State Government, if any
Particulars of service

6. Service qualifying for death gratuity:


10. Details of the nominee(s) to whom death gratuity is payable:

11. Details of guardian/nominee who will receive payment of death gratuity in the case of minor/ mentally disabled children

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