()Emaa iD (©) Mooae No Marta 1208 Marea omen erica WidowhidomeuiDioon °) [Present emg Pasa 7 wercow enka nage a 0” [V6 Otte: enaoree Pet atlested copies of elowng ya) ae (®) FS Cove of the branch Mesto (©) AADHAR Num pene ver | ta) Permanent: asia ) ‘Account Number (PAN), i avallane Ee Whathor earter a member of Employee's Prova Fund 5: > ot Fr Scheneat ; 11 [Previous employment aon loyment deta yes to 9 AND OR 10 above] “onesenpice Geena Fstablishmont Name & Address Account | Pree |foonner | (Bausuest [Caste na PPO Mee“ Cones Numoer | Namaer | Doammvyy)| (oonaneryys| erica nay og | Pe C=) I. 2 ‘Taner oo NovELry cLorng vate res fr sucezuea | sn0nzoz | = some | cota ember EPS NC| Date otjoning | Date of Ext | congentone, | Ce, Name & Adress of the Trust AN Wear | (Oona | oar) aay | PLN | tn vay vernal rte orn ntry of origin (IndkarName of oh (b) yes . State Country of org fc) Passport No. DO MRAYYYY) 10 (DOM YY (a) Vakdity of aassport KC [eoe wee 1) Certtiog tate pariculas are We o best of my enowtadge 2)! eArer'z@ EPFO to use my Anchor or veritcaonautenicaonlsKYC purpose lor seree delivery 3) Kindy transfor the funds and service details, # appeal. om the previous PF account ‘my perwous PE Account © ecard above oo ‘4)1n caso of changes i above deta, the same wit be intimated oerployr at he eaiest ate Proce Sopot tarcer DECELARATION BY PRESENT EMPLOYER has edt on ae na be aed PF Ne. ‘and VAN, 8 In case the person was eartor nota membot of EPF acho, 1982 and EPS, 1006 Please Tick he approprate option: A. The member Meats, ‘The KYC dota of he above momber nthe UAN database ‘ave nt bean uploaded. ave bean uploaded bul net approved ‘been uploaded and approved wih OSCle-gn In caso the person was carer a momber of CPF scheme, 1952 and EPS, 1995 Picase Tick the appropnate option 7 The KYC cotats of th above member in the UAN dalstine nave been approved wth E-ign Dl Sigatie Cece nt ante request has bean gonarates on peta 71 The prowious Account af the member is nat Aatharveriod and hence physi wane form shall nite, oa¥ Slqnatre of Employer wi Soa of Estabishmart fe of pravious PF tbe possible n respect of Anda veri employees ony Other employees ae ecues + Auto transfer of previous PF accoul would be et an a ‘yal elim (Pom-13) for transl of account from the prev estab