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OFFICE OF THE ACCOUNTANT GENERAL (A&E) II MAHARASHTRA, CIVIL LINES, NAGPUR 400 001. MOBILE NUMBER input form . MARKED COLUMNS ARE MANDATORY. GPF ACCOUNT SERIES. GPF ACCOUNT NUMBER. DATE OF BIRTH. NAME IN FULL (BEGINNING WITH SURNAME) LEAVE ONE BLOCK AFTER EACH WORD. OFFICE NAME AND POSTAL ADDRESS IN FULL (LEAVE ONE BLOCK AFTER EACH WORD). PARMANANT RESIDENTIAL ADDRESS OR ADDRESS FOR COMMUNICATION (LEAVE ONE BLOCK AFTER. EACH WORD). MOBILE PHONE NUMBER OF EMPLOYEE. RESIDENTIAL PHONE NUMBER OF EMPLOYEE IF ANY WITH STD CODE. STD CODE PHONE NUMBER. OFFICE PHONE NUMBER WITH STD CODE. STD CODE PHONE NUMBER. SIGNATURE OF EMPLOYEE. SIGNATURE OF HEAD OF OFFICE.

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1 OFFICE OF THE ACCOUNTANT GENERAL (A&E) II MAHARASHTRA, CIVIL LINES, NAGPUR 400 001. MOBILE NUMBER input form . MARKED COLUMNS ARE MANDATORY. GPF ACCOUNT SERIES. GPF ACCOUNT NUMBER. DATE OF BIRTH. NAME IN FULL (BEGINNING WITH SURNAME) LEAVE ONE BLOCK AFTER EACH WORD. OFFICE NAME AND POSTAL ADDRESS IN FULL (LEAVE ONE BLOCK AFTER EACH WORD). PARMANANT RESIDENTIAL ADDRESS OR ADDRESS FOR COMMUNICATION (LEAVE ONE BLOCK AFTER. EACH WORD). MOBILE PHONE NUMBER OF EMPLOYEE. RESIDENTIAL PHONE NUMBER OF EMPLOYEE IF ANY WITH STD CODE. STD CODE PHONE NUMBER. OFFICE PHONE NUMBER WITH STD CODE. STD CODE PHONE NUMBER. SIGNATURE OF EMPLOYEE. SIGNATURE OF HEAD OF OFFICE.

2 OR DDO WITH STAMPED SEAL. file:///C|/Documents%20and%20 Settings/Administrator/ [22/10/2010 14:21:08].