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eksckby la-@ Mobile Number

Form 10C ( ) Page 1 of 4 eksckby la-@ Mobile Number dsoy dk;kZYk; ds iz;ksxkFkZ @ For Office Use Only nkok la[;k@Clam .. fudklh ifjYkkHk@;kstuk ds nkos gsrq iz;ksx fd;k tkus okyk izi= 10 lh FORM 10C FOR CLAIMING WITHDRAWAL BENEFIT/SCHEME CERTIFICATE deZpkjh isa ku ;kstuk] 1995 EMPLOYEES PENSION SCHEME, 1995 izi= Hkjus ls igys funsZ kksa dks i<sa+@(Read the instructions before filing up this form) ;fn lnL;rk 180 fnu xSj va knk;h lsok dks NksM+ dj ] ls de dh gS rks izR; ykHk ns; ugh gSaA WITHDRAWAL BENEFIT IS NOT ADMISSIBLE IF MEMBERSHIP IS LESS THAN 180 DAYS EXCLUDING NON CONTRIBUTING PERIOD 1.

¼[k½ nkosnkjks ds uke@rFkk lnL; ls mldk laca/k@Name of the Claminant(s)/and relationship with the member 11. /kuis’k.k dk ek/;e ¼fodfYir fof/k ds vuqlkj lacaf/kr dks’Vd e fVd djsa½ Mode of remittance (put a tick in the box against the one opted) ¼d½ en la- …

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