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INDEMINITY BOND

(For EPF Withdrawal)


( On Rs. 100/- Stamp paper)

I Shri / Smt. _________________________________ Age ____ yrs, residing at


________________________________________________
Solemnly affirm that
1. I was working in M/s ____________________________ from ____to _____
and I was member of P.F. bearing A/c No. __________________
2. I left the service on _______________________.
3. I have not withdrawn the P.F. dues due to _______________________ till today.
4. I have opened my Bank A/c with _______________________ A/c
No._______________________ On __________and still it is not closed.
5. I indemnify to the Central Board of Trustees, Employees Provident Fund
Organization against any loss and wrong payment which may be sustained by
Payment of P.F. and E.P.F. dues to me.

This affidavit- cum Indemnity Bond signed by me before 1st class Magistrate on this
_______________________day of _______________________ year.

_____________________________________________________
Created for Jagoinvestor Wealth Members
www.jiwealthclub.com
www.jagoinvestor.com

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