TRANSFER CLAIM FORM

CLAIM

ID___________________________

(For EPFO Use only)

FORM 13 (REVISED)

EMPLOYEES PROVIDENT FUND SCHEME, 1952

(PARA 57)

[APPLICATION FOR THE TRANSFER OF EPF ACCOUNT FROM UNEXEMPTED

EXEMPTED OR UNEXEMPTED ESTABLISHMENT]

To,

To,

The Regional P F Commissioner,

Trust Name: ___________________________________

Office Name: _____________________

Trust Address: _________________________________

Office Address: ___________________

_____________________________________________

________________________________

_____________________________________________

(Please see instruction 3)

(in case the PF A/C is with Exempted

Sir,

I request that my provident fund balance along with my pension service

PART A: PERSONAL INFORMATION

1. *Name:
____________________________________________________________________________

2. *Fathers/Husbands
____________________________________________________________

name:

3. Mobile number:
______________________

4. E-mail id:
___________________________________

5. Bank A/C number:

6. IFS code of Bank branch:

PART B: DETAILS OF PREVIOUS ACCOUNT (WHICH IS TO BE

1. *PF
Account
No.
____________________________________________________________________

In case the previous establishment is exempted under Employees Provident Fund

Pension
Fund
Account
:____________________________________________________________

2. *Name
and
Address
of
_________________________________________

the

No.

previous

establishment:

__________________________________________________________________________________

3. *PF
Account
is
held
by:
(Name
______________________________________

of

EPF

Office/

PF

Trust)

4. *Date of Birth: ______________ (dd/mm/yyyy) 5. *Date of joining

6. *Date of leaving: _____________ (dd/mm/yyyy)

PART C: DETAILS OF PRESENT ACCOUNT

1. *PF Account No. :_____________________________________________________________________

In case the previous establishment is exempted under Employees Provident Fund

Pension
Fund
Account
:____________________________________________________________

2. *Name
and
Address
of
__________________________________________

the

present

No.

establishment:

_________________________________________________________________________________
_

3. *Account
is
held
by:
(Name
________________________________________

of

EPF

Office

PF

Trust)

4. *Date of joining :___________________(dd/mm/yyyy)

5. #Name of Trust (to whom funds are to be paid in case of present establishment
being

exempted

under

EPF

Scheme,

1952)

:_____________________________________________________________

6. #Employee
code
under
_______________________________________________________

(* indicates mandatory fields)

the

Trust:

(# Strike off if not applicable)

I, Certify that all the information given above is true to the best of my
knowledge and I have ensured the correctness of my present and previous
account numbers.

Signature of the Member

Date:
________________

IMPORTANT: Member has the option to get the claim form attested by
present or previous employer. In case of attestation by the previous
employer, time taken in settlement will be relatively less.

Certified that I have verified the data in Part B in respect of the member mentioned
in Part A of this form and the signature of the member.

Signature of Previous
Employer Seal of the Establishment Date: _____________________

OR

Certified that I have verified the data in Part C in respect of the member mentioned
in Part A of this form.

Signature of Present
Employer Seal of the Establishment Date: _____________________

INSTRUCTIONS AND GUIDELINES

1. The Bank A/C details are for verification purpose even if the Fund is transferred
to the EPFO Office/Trust maintaining the present account number.

2. In case the Previous Account was maintained by PF Trust of the exempted

3. The Form should be submitted to that PF Office under which previous or the
present account is maintained, depending upon as to which employer has
attested the claim. (In case the claim is attested by the present employer, claim
should be submitted with the PF Office under which the present account is
maintained, and so on).

4. The mobile number (wherever provided) of the member would be used for
sending an SMS alert informing him/her the processing of his/her claim and is
non-mandatory for Physical form.