FROM "B" OF NOMINATION WHEN THE SUBSCRIBER HAS NO FAMILY
APPENDIX “B” FROM “B” OF NOMINATION WHEN THE SUBSCRIBER HAS NO FAMILY
I hareby declare that I have no family, and that in the event of my death the amount at my credition the Provident Fund established under the Gujarat Medical Cuoncil Rules.1969 shall, in the event of my having no family at the time of death, be distributed among the persons in colum 1 in the maner shown against their names. The amount due to a nominee who is minor at the time of my death shall be paid to the person whose name appaears in colum 5 .
Name and address of the nominee or nomination
Relationship with the sub-scriber
Age of the Nominee
Amount or share of accumulations
Name and address of the person to whom payment is deconbehalf of the minor.
1
2
3
4
5
Dated the ___________ day of _________ 19____________ at Witness
1. _____________
2. _____________
_____________________ Signature of Subscriber.
By order and in the name of the Govenor of Gujarat.
