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:
![](https://govtempdiary.com/wp-content/uploads/2021/11/1.png)
2. Post held at the time of death:
![](https://govtempdiary.com/wp-content/uploads/2021/11/2.png)
5. Service in Autonomous Body/State Government, if any
Particulars of service
![](https://govtempdiary.com/wp-content/uploads/2021/11/3.png)
6. Service qualifying for death gratuity:
![](https://govtempdiary.com/wp-content/uploads/2021/11/Microsoft-Word-229930.png)
![](https://govtempdiary.com/wp-content/uploads/2021/11/Microsoft-Word-229930-1.png)
10. Details of the nominee(s) to whom death gratuity is payable:
![](https://govtempdiary.com/wp-content/uploads/2021/11/Microsoft-Word-229930-1-1.png)
11. Details of guardian/nominee who will receive payment of death gratuity in the case of minor/ mentally disabled children
![](https://govtempdiary.com/wp-content/uploads/2021/11/Microsoft-Word-229930-2.png)