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Annexure-1
The Employee’s Gratuity Fund
Of
MURATA MACHINERY BANGLADESH LTD.
Nomination Form
Date:………………………………………….
Name………………………….. ID No…………………………………………
Department:……………….. Designation:…………………………
I do hereby declare that in the first column of the table below whose name (s) is/are listed will be my authorized nominee(s) to receive the amount as would fall due on my death in the fifth column.
Name
Address
Relation with the member
Date of Birth
Amount or Share of Accumulation to be paid to be each
1
2
3
4
5
Witness
Signature: Signature:
Full Name: Full Name:
Address: Address:
Signature of the member Signature of the member