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(FORM 2 REVISED) NOMINATION AND DECLARATION FORM …

( form 2 REVISED) NOMINATION AND DECLARATION form FOR UNEXEMPTED/EXEMPTED ESTABLISHMENTSD eclaration and NOMINATION form under the Employees Provident Funds and Employees Pension Schemes(Paragraph 33 and 61 (1) of the Employees Provident Fund Scheme 1952 and Paragraph 18 of the EmployeesPension Scheme 1995)1. Name (IN BLOCK LETTERS) : _____ Name Father s / Husband s Name Surname2. Date of Birth : _____ 3. Account No. _____4. *Sex : MALE/FEMALE: _____ 5. Marital Status _____6. Address Permanent / Temporary : _____ _____PART A (EPF)I hereby nominate the person(s)/cancel the NOMINATION made by me previously and nominate the person(s) mentioned belowto receive the amount standing to my credit in the Employees Provident Fu

Declaration and Nomination Form under the Employees Provident Funds and Employees Pension Schemes (Paragraph 33 and 61 (1) of the Employees Provident Fund Scheme 1952 and Paragraph 18 of the Employees Pension Scheme 1995) 1. Name (IN BLOCK LETTERS) : _____ Name Father’s / Husband’s Name Surname 2. Date of Birth : _____ 3. ...

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