APPENDIX (1)

FORM OF APPOINTMENT OF BENEFICIARY (NOMINATION)

The Trustees,
Magic Software Pvt Ltd
Employees' Group Gratuity Assurance Scheme.

Dear Sirs,

I RAHUL TANWAR ______ a Member of Employees' Group Gratuity Scheme

hereby agree to abide by the Rules of the said Scheme and do also hereby appoint in terms of Rule
18 of the Rules Beneficiary/ies Nominee/s mentioned hereunder to receive the benefits, payable
under the Scheme, in the event of my death before the amount become payable has not been paid.
I hereby direct that the benefits under the Scheme, payable in respect of me, shall be paid to the
said Beneficiary/ies Nominee/s in proportion indicated against their respective names as given below:
Sr.No. Name of full with full address Relationship Age of Proportion by which
of Nominee/s/Benefi-ciary/ies with the Nominee/s gratuity (Total benefits)
Member Benefi- will be shared by each
(Employee) ciary/ies Nominee/Beneficiary

1 Mrs. Santosh Singh Mother 59 50%

2 Miss. Lata Tanwar Sister 33 25%

3 Miss. Asha Tanwar Sister 36 25%

I hereby certify that the person(s) mentioned hereinabove is/are my wife/children/lawfully adopted
child/dependant parents/husband.

I hereby declare that I have no family and should I acquire family hereafter the appointment of
Beneficiary/Nominee should be deemed as cancelled.

My father/mother/parents/sister('s)/minor brother(s) is/are not dependant on me.

My husband's father/parents is/are not dependent on me.

I also declare that this appointment of Beneficiary/ies/Nominee/s made herein shall have the effect
of my revoking the appointment of Beneficiary/ies/Nominee/s made by me earlier.
I give below the particulars about myself:

Full Name : ___RAHUL TANWAR_______ Sex : MALE Religion : HINDU _______

Father's Name : LATE SHRI. BHANU SINGH _ Husband's Name : N/A (For
married woman only)
Marital Status : __SINGLE______ (Whether married, unmarried, widow or widower)

Date of birth : 04/10/1992 Address : 683/35 WEST. RAJIV NAGAR GALI NO 2

SECTOR 12 GURGAON 122001 ,

Witness: Signature of the Employee

RAHUL TANWAR
(Digitally signed by Rahul Tanwar on 15.04.2022 at 15:49:00 +3’49)