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~" ~~<f; ~~ (ForOfficeuse only)GTCIT~ ~~~~.1952 EMPLOYEES'PROVIDENTFUNDSSCHEME,19521 WlI~20 FORMNO-20>r<fJT~~\iIlo/TTFormto be used:-1. ~/~~~<f; ~emBy the guardianof minor/lunaticmember2. ~~<f; ~/ ~~emBy a nomineeor legalheir of the ~/~~~m '3'i1~I~CIlI~<f; ~em~'1'fCIl-~<Ilt ~~ ~ c:W <f; ~By guardianof the minor/lunaticnomineeor heir for claimingthe ProvidentFundaccumulationof the minordeceasedmember~: ~ >r<fJTq;T 'i"f m <f m ~ ~~ I Note:Readthe "Instruction"Carefullybeforecompletingthe form.~1 IiT flIlftIrr/Particularsof the member(1)~1l>T'W{~31effl-<1)/ Nameof the member(Inblockletters)(2) fllin/'lfct1l>T 'W{/Father's/Husband'sName(3) ~/~q;r '{1l'I Cl" l !T ftR:IlI~3fflmm <i>TI!q;; IfI!UI Name& Addressof the Factory/Establishmentinwhichthe memberwaslast employed(4) <IDOT"ffi.}}}
supported and looked for bymyself and the Family Pension Fund benefit received on behalf ofminor Iunatic will be spent inhislher best interests & benefits. 1f "EI'Ifur ~ t f<I;~ ~ fil>flt ~ ~/~ if \iI5i f<I;~ ~ ~ aft<~ ~ ~ ~ ~ ~
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