Deposite No

_____________________ Provident Fund_____________________.

Subscriber’s Nomination

When the Subscriber has no family and wishes to nominate more than one person.
I having no family as defined in rule 2 of the____________________________________________________
Provident fund ____________________ * Rules_______________________ here by nominate the person (s)
mentioned below to receive the amount that may should to my credit in the fund in the event of my death before
that amount has become payable, or having become payable has not been paid, and direct that the said amount
shall be distributed among the persons I the manner shown below against their names:-

Name & Address of Nominees Relationship with Age Amount or share of

Subscriber Accumulation to be paid
to each

N.B- The subscriber should draw lines across the blank space below last entry to prevent the insertion of any
names after he has signed.
Dated this______________________ day of _________________________________201 at
Two witness to

1.

2.
Signature of Subscriber

Here insert the words necessary to complete the name of the Fund concerned ---General Provident
Fund (Central Service). Contributory Provident Fund (Pakistan), Defense Saving Provident Fund, etc as the case
may be.

This column should be filled in so as to cover the whole amount that may stand to the credit of the
subscriber in the fund at any time.