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Epfo form

The document is a Transfer Claim Form for the Employees' Provident Fund Scheme, allowing members to request the transfer of their provident fund balance and pension service details from a previous establishment to a current one. It includes sections for personal information, details of the previous and present accounts, and requires verification by the previous or present employer. Mandatory fields are indicated, and the form must be signed by the member and the employer for processing.

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possworlduk
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8 views

Epfo form

The document is a Transfer Claim Form for the Employees' Provident Fund Scheme, allowing members to request the transfer of their provident fund balance and pension service details from a previous establishment to a current one. It includes sections for personal information, details of the previous and present accounts, and requires verification by the previous or present employer. Mandatory fields are indicated, and the form must be signed by the member and the employer for processing.

Uploaded by

possworlduk
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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TRANSFER CLAIM FORM CLAIM ID

FORM 13 (REVISED) (For EPFO Use only)

EMPLOYEES’ PROVIDENT FUND SCHEME, 1952


(PARA 57)
[APPLICATION FOR THE TRANSFER OF EPF ACCOUNT FROM UNEXEMPTED ESTABLISHMENT TO
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 Establishment)

Sir,
I request that my provident fund balance along with my pension service details may please be
transferred to my present account under intimation to me. My details are as under:

PART A: PERSONAL INFORMATION


1. *Name:
2. *Father’s/Husband’s 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 TRANSFERRED)

1. *PF Account No. :


In case the previous establishment is exempted under Employees’ Provident Fund Scheme,1952
Pension Fund Account No. :
2. *Name and Address of the 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 : (dd/mm/yyyy)
6. *Date of leaving: (dd/mm/yyyy)

PART C: DETAILS OF PRESENT ACCOUNT


1. *PF Account No. :
In case the present establishment is exempted under Employees’ Provident Fund Scheme,1952
Pension Fund Account No. :
2. *Name and Address of the present 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) :
Bank Name:
Trust Bank A/C No:
RTGS/NEFT IFSC:
FULL ADDRESS OF THE BANK:

6. #Employee code under the Trust:


(* indicates mandatory fields) (# 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:

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