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wer epfindia govn ote Number EMPLOYEES’ PROVIDENT FUNDS ORGANISATION ‘SOMPOSTTE CLAIM FORM (AADHAR) {APPLICABLE IN CASES WHERE EMPLOYEES COMPLETE DETAILS FORH-1 (EW), AADHAR MUMBER ANO BAN ACCOUNT DETAILS ARE AVAALABLE OM Wan [PORTAL AND UAN HAS BEEN ACOVATED) (eat. =19 (PF EAL SETTLEMENT OC (PENSION WITHDRAWAL RENEETS / 33a WETHDRAWALSS 1] Elaim applied for: Fina Pr Seternent ( ) i) Pension Wathrawal Bench {—y Ti) PF PART WETHORAWAL{ Tick whichever is/are applicable) | Name ofthe member: (1 CAPITAL LETTERS) 3 | Universal Azone Number (UAN) 7 | ada Rambo 5 | Date of ening the exablchment: 7 42) Purpose of PF PART Withdrawal: (Tick V whichever appicabie) SH rose oP Pa Wome —[ 2») Amount (aR: 1 | she LoenfPuchase of sea rBE Anouk os) —] |" |oriter Consiucnovaaiten, stsanen tt ©) Fo pose of Ste/Housa/at Construction through "ageny"or | | | exsing hosefRepaymort ot asing an fapaymart of Housing Loan or LG ndcate cheque to be own | |__| (rare as/enboeaney “infor and payee’ adress Tsou o cosa of tac ara) [ness of member famiy (Para 65) [Mariage of sli/son/caughter/oraha7 ster (Para 684) [Post Maticuation education of chiaren (Para 656) Natural clarity (Para 680) ‘Gut in electrity in establishment (Para 68h. Purchasing equipment — By physicaly handicappes (Para 68N) ‘One year before retirement (Para GN) Tnvestment in Varistha Pension ima¥ojana (Para 6BNNN) Fa) ae] Date af eaving sence: (oot required Wapping for PF Pak Withrawaly

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