Maternity Benefit Deed Format

Maternity Benefit

Maternity Benefit Deed Format

I ………… Insurance No. …………………………wife of/daughter of ………… here claim maternity benefit with effect from the ………… day of ………… 19……… I hereby declare that I have ceased/shall cease to work for remuneration with effect from that date.

Present/last employer …………………………………………………….

Department, shift and occupation …………………………………….

Present address ………………………………………………………………

Date ……………

Signature or thumb impression

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