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Part A: Personal

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Part A: Personal

Uploaded by

UTILITY MECH
Copyright
© © All Rights Reserved
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Download as PDF, TXT or read online on Scribd
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ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]

( Tracking ID: 10017116702505001 )


Claim Date : 11/03/2024
EMPLOYEES' PROVIDENT FUND SCHEME, 1952
(PARA 57)

(This form has been printed on the basis of Online Transfer Claim Form filled up by the member under Unified Portal for submission to the
employer.)

To,
The Regional P.F. Commissioner,
CHANDIGARH,
S.C.O. 4-7, Sector 17-D, Chandigarh

Sir,
I request that my Provident Fund balance along with my Pension Service Details may please be transferred to my present
account under intimation to me. My details are as under :

PART A : PERSONAL

1. Name : JAI BHAGWAN

2. Mobile Number : 9569031946

3. E-mail id : [email protected]

4. Bank Account Number : 20135810173

5. Bank IFSC : SBIN0050022

PART B : DETAILS OF PREVIOUS PF ACCOUNTS (WHICH IS TO BE TRANSFERRED)

1. PF Account No. (with EPFO : PBCHD00201470000000762

2. Name of the Establishment : PARABOLIC DRUGS LIMITED

3. Address of the Establishment : VILL. SUNDRAN, DERA BASSI DERA BASSI 790

4. PF A/C No. held by : CHANDIGARH

5. Name of the Trust : NOT APPLICABLE

6. PF A/C No. in Trust : NOT APPLICABLE

7. Bank A/C No. of Trust : NOT APPLICABLE


8. IFS Code of the Bank Branch of
Trust where account is : NOT APPLICABLE

9. Member's Name : JAI BHAGWAN

10. Date of Birth : 20/05/1984

11. Father's/Spouse Name : RAM SARUP

12. Relationship : FATHER

13. Date of joining : 01/05/2008

14. Date of leaving : 20/09/2018


PART C : DETAILS OF PRESENT PF

1. PF Account No. (with EPFO : PBCHD00103870000013579

2. Name of the Establishment : STEEL STRIPS WHEELS LTD.

3. Address of the Establishment : 49-50, SECTOR 26 MADHYA MARG CHANDIGARH 147

4. PF A/C No. held by : RO CHANDIGARH

5. Name of the Trust : NOT APPLICABLE

6. PF A/C No. in Trust : NOT APPLICABLE

7. Bank A/C No. of Trust : NOT APPLICABLE


8. IFS Code of the Bank Branch of
Trust where account is : NOT APPLICABLE

9. Member's Name : JAI BHAGWAN

10. Date of Birth : 20/05/1984

11. Father's/Spouse Name : RAM SARUP

12. Relationship : FATHER

13. Date of joining : 20/02/2021

I, Certify that all the information given above are true to the best of my knowledge and I have ensured the correctness of
my present and previous account numbers.

Signature of the member

Note : Member should take a printout of this form and a signed copy of the same should be submitted to the Present
Establishment i.e. STEEL STRIPS WHEELS LTD.

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