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Form11 1633872532769

Pratham Nishad has declared that: - He was previously employed by NA with PF account number NA and left on NA, and was previously employed by NA with PF account number NA from NA to NA. - He is/was a member of the Pension Fund from NA to NA. - He has withdrawn amounts from his Provident Fund and Pension Fund. - He has not contributed to any social security programs in NA from NA to NA, which do not have a Social Security Agreement with India. - He does not have a Universal Account Number but provides his Aadhaar and PAN numbers. - He is appointed as an Assistant System Engineer-

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133 views2 pages

Form11 1633872532769

Pratham Nishad has declared that: - He was previously employed by NA with PF account number NA and left on NA, and was previously employed by NA with PF account number NA from NA to NA. - He is/was a member of the Pension Fund from NA to NA. - He has withdrawn amounts from his Provident Fund and Pension Fund. - He has not contributed to any social security programs in NA from NA to NA, which do not have a Social Security Agreement with India. - He does not have a Universal Account Number but provides his Aadhaar and PAN numbers. - He is appointed as an Assistant System Engineer-

Uploaded by

Pratham Nishad
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Applicant ID: 1426968

Form 9 (Revised)
THE EMPLOYEES' PROVIDENT FUNDS SCHEME, 1952 (Paragraph 34)
AND
THE EMPLOYEES' PENSION SCHEME, 1995 (Paragraph 24)
Declaration by a person taking up employment in an establishment in which the Employees'
Provident Funds & Employees' Pension Scheme enforce

I, Pratham Nishad Son of Sh. Laxmi Kant Nishad do hereby solemnly declare that:

(a) I was employed with NA, NA with PF A/c Number NA and left service on NA prior to that, I was employed in NA, NA with
PF A/c Number NA from NA to NA.

(b) I am a member of the Pension Fund from NA to NA .

(c) I have withdrawn the amount of my Provident Fund. - NA

(d) I have withdrawn the amount of my Pension Fund. - NA

(e) I have drawn any benefits under the Employees Pension Scheme, 1995 in respect of my past service in any
establishment. - NA

(j) I have not contributed to the social security programme in NA from NA to NA, which has not entered into a Social
Security Agreement with India.

(g) Do you have a Universal Account Number (UAN): No

Universal Account Number Aadhar NPR PAN

NA 5512-1176-4895 NA CEPPN9430J
(h) Bank Account Number Linked with UAN : NA

Bank Account Number IFSC Code

NA NA

Date : _____________________ Signature of employee


---------------------------------------------------------------------------------------------------------------------------------------------------------

(To be filled by the employer)

1) Shri/Smt/Kumari Pratham Nishad is appointed as Assistant System Engineer-Trainee in Tata Consultancy Services
Limited, with effect from 07-OCT-2021 bearing Provident Fund Account Number: MH/BAN/48475/000/ ________________

10-Oct-2021 Page 1 of 2
Tata Consultancy Services Limited
10th Floor, Air India Building, Nariman Point,
Mumbai 400 021.

10-Oct-2021 Page 2 of 2

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