FORM ‘S’
[SEE SUB-RULE (5) OF RULE 18]
NOTICE FOR PAYMENT OF GRATUITY AS DETERMINED BY APPELLATE AUTHORITY

To
[Name and address of employer]
Whereas a notice was given to you on……………Form           ‘R’       requiring you
to make a payment of Rs…………..to Shri/Smt./Kumari…………as gratuity under the Payment of Gratuity Act, 1972;
Whereas you/ the applicant went in appeal before the appellate authority, who has decided that an amount of Rs…….is due to be paid to Shri/ Smt./Kumari…….as gratuity due under the Payment of Gratuity Act, 1972;
Now, therefore, I hereby direct you to pay the said sum of Rs………………to Shri /Smt./Kumari ………….within 30 days of the receipt of this notice with an intimation thereof to me.
Given under my hand and seal, this…………..day of……………. 19…………………
                                                                                                         Controlling Authority       
Copy to:
1. The Applicant.
He is advised to contact the employer for collecting payment.
2. The Appellate Authority.
Note: The portion not applicable to be deleted.