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Construction Worker Death Benefit and funeral Assistance
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Checklist of the documents required for Death Benefit Form.
1. ABOCWWB Id Card
2. Applicant's Photo
3. Death Certificate Issued By Govt Doctor/Appropriate Authority
4. Signature of the Applicant
5. Succession Certificate
6. Certificate Of Guardianship With Consent From The Other Family Members And Minor Nominee
7. Copy Of Payslip Of Account Paybook
8. Caste Certificate (Other than General category)
9. Applicant's Identification Certificate From The Govt Gaonburah And Village Panchayat Officer
10. Loan Recovery Documents
11. Age Proof Certificate For Minor
All
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Textbox are mandatory
Date
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District Office
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Asst. Labour Commissioner, Kamrup (Metro)
Office of the Labour Officer, Barpeta
Office of the Labour Officer, Nalbari
Office of the Labour Inspector, Rangia
Office of the Labour Inspector, Chaygaon
Office of the Labour Inspector, Bhawanipur
Office of the Labour Inspector, Rupsi
Office of the Asst. Labour Commissioner, Golaghat
Office of the Labour Officer, Bokakhat
Office of the Labour Officer, Bokajan
Office of the Labour Inspector, Sarupathar
Office of the Asst. Labour Commissioner, Sivasagar
Office of the Labour Officer, Sonari
Office of the Labour Inspector, Demow
Office of the Labour Inspector, Nazira
Office of the Asst. Labour Commissioner, Dibrugarh
Office of the Labour Inspector, Khowang
Officer of the Asst. Labour Commissioner, Tinsukia.
Office of the Labour Officer, Margherita
Office of the Labour Inspector, Hapjan
Office of the Labour Inspector, Kakopathar
Office of the Asst. Labour Commissioner, Jorhat
Office of the Labour Inspector, Majuli
Office of the Labour Inspector, Titabor
Office of the Asst. Labour Commissioner, Nagaon
Office of the Labour Officer, Morigaon
Office of the Labour Officer, Diphu
Office of the Labour Officer, Hojai
Office of the Labour Officer, Hamren
Office of the Labour Inspector , Batadraba
Office of the Labour Inspector , Kaliabor
Office of the Labour Inspector , Mayong
Office of the Labour Inspector , Rongkhong
Office of the Labour Inspector , Howraghat
Office of the Asst. Labour Commissioner, Tezpur
Office of the Labour Officer, Biswanath Chariali
Office of the Labour Officer, Lakhimpur
Office of the Labour Officer, Mangaldoi
Office of the Labour Officer, Dhemaji
Office of the Labour Inspector, Dhekiajuli
Office of the Labour Inspector, Behali
Office of the Labour Inspector, Narayanpur
Office of the Labour Inspector, Nowboicha
Office of the Asst. Labour Commissioner, Dhubri
Office of the Labour Officer, Bongaigaon
Office of the Labour Officer, Goalpara
Office of the Labour Inspector, Dudhnoi
Office of the Labour Inspector, Bilashipara
Office of the Labour Inspector, Mancachar
Office of the Labour Officer (Under BTAD) , Kokrajhar
Office of the Labour Inspector, Majbat
Office of the Labour Inspector, Khoirabari
Office of the Labour Inspector, Gossaigaon
Office of the Asst. Labour Commissioner, Silchar
Office of the Labour Officer, Karimganj
Office of the Labour Officer, Hailakandi
Office of the Labour Officer, Haflong
Office of the Labour Inspector, Patharkandi
Office of the Labour Inspector, Lakhipur
Labour inspector- Jatinga valley
Labour Inspector- Diyung valley
Labour inspector- Udarbond
Asst. Labour Commissioner, Kamrup (Rural)
Office of the Labour Officer, Udalguri
Office of the Labour Officer, Chirang
Office of the Labour Officer, Baksa
Office of the Labour Inspector, NAHARKATIA
Upload Photo
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Choose file
Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed
Name Of The Applicant
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Mobile Number
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Address Of The Applicant
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Caste Category
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General
Sc
St
OBC
Others
Relationship Of The Applicant With The Deceased Worker
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Name Of The Deceased Worker
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Address Of The Deceased Worker
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Registration Number Of The Deceased Worker
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Date Of Registration Of The Deceased Worker
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ABOCWWB Id Card
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Choose file
Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed
Details Of Monthly Contribution
#
Date Of First Payment Of Contribution
Date Of Last Payment Of Contribution
Name Of The Branch Of Bank Where Remitted The Contribution
1
Add
Whether Membership Of Deceased Worker
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No
Yes
Duration Of Membership Of Deceased Worker
Deceased Worker Whether Married Or Unmarried
*
- - - SELECT - - -
Married
UnMarried
Name Of Spouse
Age
*
Date of Birth Of The Deceased Worker
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Date of Death Of The Worker
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Nature Of Death
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Natural Death
Accidental Death
Murder
Suicide
Date of Death
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Time of Death
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Place Of Death
Employer's Certificate
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Choose file
Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed
Police Report
*
Choose file
Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed
Post Mortem Report
*
Choose file
Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed
Details Of The Family Members Of The Deceased Worker
SL No.
Name
Relationship
Age
1
Add
Particulars Of Nominees Already Declared By The Deceased Worker
SL No.
Name
Relationship
Age
1
Add
Whether Applicant Is The Nominee Of The Deceased Worker
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No
Yes
If Not,On What Position Has Submitted The Application
The Applicant To Submit Dependents And Other Family Members Consent Letter
*
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Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed
If The Applicant Is One OF The Nominee Already Declared By The Deceased Worker
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No
Yes
Submit The Consent Letter From The Other Nominees
*
Choose file
Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed
If The Nominee Or Family Member Are Minor?
*
No
Yes
If yes,Name Of The Guardian
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And His Relationship With The Children
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Amount Of Financial Assistance Applied For
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Whether Any Loan/Advance Received From The Board Earlier
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No
Yes
If Yes, Mention The Amount Of Such Loan/Advance
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Whether The Aforesaid Amount Is Completely Recovered
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No
Yes
If Not, What Amount remains To Be Recovered
Name Of The Branch Of The Bank
*
Address Of Bank
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Account No
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IFSC Code
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Attested Copy Of Id Card OF The Deceased Worker
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Choose file
Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed
Copy Of Payslip Of Account Paybook
*
Choose file
Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed
Death Certificate Issued By Govt Doctor/Appropriate Authority
*
Choose file
Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed
Succession Certificate
Choose file
Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed
Certificate Of Guardianship With Consent From The Other Family Members And Minor Nominee
Choose file
Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed
Applicant's Identification Certificate From The Govt Gaonburah And Village Panchayat Officer
*
Choose file
Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed
Loan Recovery Documents
Choose file
Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed
Age Proof Certificate For Minor
*
Choose file
Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed
Declaration by the Applicant
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Signature Of Applicant
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Choose file
Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed