FORM 13 ( Revised) - SSSomega
For Office Use Only(Inward No. & Date :ToThe Commissioner,Employees' provident FundsSir,12345678Date : Signature / Left Hand Thumb impression of the memberTO BE FILLED BY THE PRESENT EMPLOYER910111214Date : Signature Employer / Authorized official with SealInwhosefavourtransferiftobeeffectedi spayee'sdetailsBy whom the PF account of the present estt. Is kept(2) By Sub Regional office at :(1) By Regional office at : (1) By Regional office at : (2) By Sub Regional office at (1) By exempted PF Trust, Viz : (2) By private PF Not covered under the Act, Viz :Being an unexempted establishmentBeing an exempted Account Number alloted to the member seperately, if anyBy whom the PF account of the present estt. Is keptName and address of the factory/Establishment Account Number alloted to the Account Number with the previous Account Number with the previous employerDate of Joining the present employerDate of leaving Service with previous employerFORM 13 ( Revised) EMPLOYEES' provident fund SCHEME, 1952Name of the MemberFather's/ Husband's NameIRequestthatmyProvidentFundbalanceal ongwithmembershipdetailsinFamilyPensionF undsmayPleasebetransferredto my present account under intimation to me.)
For Office Use Only (Inward No. & Date : To The Commissioner, Employees’ Provident Funds Sir, 1 2 3 4 5 6 7 8 Date : S ig na tu re/L fH dT h mbp s o TO BE FILLED BY THE PRESENT EMPLOYER
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