Declaration Form (2) (1) New 1

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SELF DECLARATION

Date:

I SURESH NEGI S/o or MADAN MOHAN SINGH NEGI, hereby declare that I am aware of the
benefits of the Provident Fund Scheme but still I am not interestedto be a part of the Provident
Fund. I also confirm that as on the date of my appointment I am not the member of Provident
Fund Scheme.Therefore I would like to request my organization - Ceasefire Industries Pvt.
Ltd.to please not to enroll me as provident fund member.

Name: SURESH NEGI


Designation: MANAGEMENT TRAINEE
Mobile Number: 9168763885
Email ID:suresh.negi0005@yahoo.com

Signature:

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