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Joint Declaration New

The document is a joint declaration from an employee and employer regarding corrections needed in the employee's EPF account details. It provides the employee's name, EPF account number, and UAN. It lists fields like name, gender, father's name, date of birth, date of joining, date of leaving, and Aadhar card where the correct details differ from what is in the EPF records. Both the employee and authorized employer representative sign to take responsibility for any wrong payments due to the corrections and certify that no one else will claim the PF account in future. Required documents like Aadhar card, marriage certificate, birth certificate, forms, and certificates are also listed.

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sarvang shah
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1K views

Joint Declaration New

The document is a joint declaration from an employee and employer regarding corrections needed in the employee's EPF account details. It provides the employee's name, EPF account number, and UAN. It lists fields like name, gender, father's name, date of birth, date of joining, date of leaving, and Aadhar card where the correct details differ from what is in the EPF records. Both the employee and authorized employer representative sign to take responsibility for any wrong payments due to the corrections and certify that no one else will claim the PF account in future. Required documents like Aadhar card, marriage certificate, birth certificate, forms, and certificates are also listed.

Uploaded by

sarvang shah
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Date: - 21st July’2022

To,
The Regional P F Commissioner
EPFO, Regional Office
Vadodara,
// Joint Declaration / Undertaking//
Subject: - Correction in Name of Member /Father /Spouse/ date of joining /Date of Leaving/ Other of Member
bearing EPF Account No. VD/BRD/ /000(UAN: - ). reg.

Dear Sir,
I ---------------employeeof M/S ----------------- Ltdbearing member id VD/BRD/0000/00000 (UAN: - ) furnishing
below herewith correct details during my service with aforesaid.
Establishment.
Particular Correct Details Details in EPF Record
Name
Gender
Father’

Date of Birth(DD/MM/YYYY)
Date of Joining
Date of Leaving
Aadhar card
Other
Details in this columns tobe filled as appearing in unified as appearing Employer Portal / unified Member portal

we both undertake all the responsibilities if any wrong payment made due to correction/change in name
of the Member/ Spouse/ Date of Birth/ Date of Joining/Date of Leaving /Other of the member and it is certifying
that nobody will claim of the same PF account Number in future.

______________________ ___________________________________
(Member Signature) (Signature of the Employer/Authorised person
With Name and Designation)
Document Enclosed (Please tick Appropriate)
Aadhar card (mandatory) Passport
y Pancard (mandatory) Marriage Certificate for Post marriage name correction
Birth Certificate School Leaving Certificate /Education Certificate for DOB
Form 5 for DOJ correction Certificate of Medical Board for date of Birth
Form 10 for DOL correction Indemnity Bond/Affidavit for father name Correction

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