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santosh Duad PF final

The document is a UAN Based Combined Claim Form for PF Final Settlement submitted by Santosh Bajirao Daud, who is retiring on September 30, 2024. It includes personal details such as UAN, Aadhaar number, and bank account information for processing the claim. The claim is submitted through the Member e-seva portal on February 17, 2025.

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Ajit Karhale
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26 views2 pages

santosh Duad PF final

The document is a UAN Based Combined Claim Form for PF Final Settlement submitted by Santosh Bajirao Daud, who is retiring on September 30, 2024. It includes personal details such as UAN, Aadhaar number, and bank account information for processing the claim. The claim is submitted through the Member e-seva portal on February 17, 2025.

Uploaded by

Ajit Karhale
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Submitted online at Member e-seva portal on 2025-02-17 20:31:12 (IP www.epfindia.gov.

in
Address:182.64.171.179)

deZpkjh Hkfo"; fuf/k ;kstuk] 1952


EMPLOYEES' PROVIDENT FUND SCHEME,1952
EMPLOYEES' Pension Scheme,1995
UAN Based Combined Claim Form 19/10C WB/31 for Advances/PF Final Settlement/Pension Fund Withdrawal
(mu ekeyksa esa ykxw tgka QkeZ 11(u;k)esa deZpkjh dk iwjk fooj.k] vk/kkj la[;k vkSj cSad [kkrk la[;k ;w-,-,u- iksVZy vkSj ij
miyC/k gS rFkk ;w-,-,u- esa lfØ; gSA)
(Applicable in cases where employee's complete details in Form 11(New),Aadhaar Number and Bank
Accounts details are available on Member Portal and UAN has been activated.)
Mobile Number / eksckby uacj - 9096462498
1. I want to apply for PF Final Settlement
2. Universal Account Number(UAN) / ;wfuolZy [kkrk la[;k 100130516373
3. Name of the member SANTOSH BAJIRAO DAUD

4. Date of Joining 01-Apr-2010


5. Date of Leaving Service/ NksM+us dk fnukad 30-Sep-2024
6. Reason of Leaving Service/ lsok NksM+us dk dkj.k RETIREMENT

7. Permanent Account number / LFkk;h [kkrk la[;k ASUPD2806R

8. Payee Address c3
505,Aurangabad,AURANGABAD,MAHARAS
HTRA-431007

* eSa çekf.kr djrk gw¡ fd eSaus ;w , ,u iksVZy ij lhM MkVk dks Hkyh Hkk¡fr ns[k fy;k gS rFkk QkeZ u- 11( u;k ) cSad [kkrk fooj.k vkSj vk/kkj
la[;k lfgr lHkh MkVk lgh ik;k x;k gSA
* I certify that I have gone through the data seeded in Member Portal and found all data including Form
No.11 (New) , bank account details and Aadhar Number to be correct
Father/Husband/Spouse Name: BAJIRAO SHENPHAD DAUD Date Of Birth: 20-Jul-1980
Bank Account Number 910010018207876 Bank IFSC Code UTIB0001731
Bank Details AXIS BANK,GARKHEDA
Aadhaar 32XXXXXXXX03
Member ID GNGGN00266160000000127
* —i;k ;w-,-,u-iksVZy ij n'kkZ, x, cSad [kkrs esa Hkqxrku djsaA
* Please make payment in the bank account mentioned in the Member portal .
UAN - 100130516373 Tracking ID - 10013051637301001

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