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FUNERAL ASSISTANCE

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FUNERAL ASSISTANCE

DADRA AND NAGAR HAVELI

FORM X

FUNERAL ASSISTANCE

Eligible Criteria:

An application in prescribed Form-X shall be submitted to the Member secretary (BOCWWB) in case of death of a registered member or spouse. The Board may sanction an amount of Rs.20,000/-(Rs.Twenty Thousand only) to the nominees/dependents towards funeral expenses.

Submit

Name of Applicant

Address of Applicant

Relationship of Applicant with the Worker/Beneficiary

Name of Beneficiary

Date of Birth

Age

Gender

Marital Status

Mobile No.

Aadhaar Number

Temporary Address:

Address Line1

Address Line2

Landmark

Village/Town/City

Taluka

District

State

Pincode

Permanent Address:

Address Line1

Address Line2

Landmark

Village/Town/City

Taluka

District

State

Pincode

Duration Of Membership

Date Of Death Of Worker

(a) Death Certificate

(b) Upload Applicant ID Proof

Amount of Benefit, applied for

Date of payment of subscription

Whether applicant is nominee of worker

Whether applicant submitted dependent certificate

Whether Nominees are minor:

Name of Nominee

Birthdate of Nominee

Age of Nominees

Relation of Nominee

Name Of Guardian

Whether consent letters from other nominees submitted

Whether certificate of guardianship submitted

Bank Details:

Bank Account Number

Name Of Bank

Name Of Branch

IFSC Code

Submit

Department Addresses

DNH Details

Old Circuit House Building,
Opp. Bal Bhawan, Silvassa,
Dadra and Nagar Haveli - 396230

0260 - 2642374

labour-dnh@nic.in

Daman Details

Vidhyut Bhavan, Kachigam,
Daman 396215

0260 - 2261059

lelidaman@gmail.com

Diu Details

Labour & Employment Office
Collectorate Diu 362520

02875 – 252444

Useful Links

Website QR Code

Last Update on Date: 15/03/2021