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This document is an Online Transfer Claim Form for transferring Provident Fund details from a previous account to a current account. The claimant, Pooja Rani, provides personal information, previous and current PF account details, and certifies the accuracy of the information. The form is to be submitted to the current employer, NISA Industrial Services P. Ltd.

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2 views

1

This document is an Online Transfer Claim Form for transferring Provident Fund details from a previous account to a current account. The claimant, Pooja Rani, provides personal information, previous and current PF account details, and certifies the accuracy of the information. The form is to be submitted to the current employer, NISA Industrial Services P. Ltd.

Uploaded by

rc301806
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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ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]

( Tracking ID: 10163287871105001 )


Claim Date : 25/02/2024
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,
DEHRADUN,
Bhavishyanidhi Bhawan, Vyomprasth, GMS Road, Dehradun

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 : POOJA RANI

2. Mobile Number : 8077672290

3. E-mail id : [email protected]

4. Bank Account Number : 765310510002028

5. Bank IFSC : BKID0007653

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

1. PF Account No. (with EPFO : UKDDN14247860000012729

2. Name of the Establishment : DEEWAN ASSOCIATES

3. Address of the Establishment : A-2 NEAR RAM MANDIR TEHRI VISTHAPIT NULL HARIDWAR 161

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

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 : POOJA RANI

10. Date of Birth : 02/10/1995

11. Father's/Spouse Name : RAJAT KUMAR

12. Relationship : HUSBAND

13. Date of joining : 21/11/2020

14. Date of leaving : 31/12/2020


PART C : DETAILS OF PRESENT PF

1. PF Account No. (with EPFO : MHBAN00469340000233718

2. Name of the Establishment : NISA INDUSTRIAL SERVICES P. LTD

3. Address of the Establishment : 211 SAI COMMERCIAL CENTRE 504 LINKING ROAD KHAR (W) MUMBAI
598
4. PF A/C No. held by : RO BANDRA(MUMBAI-I)

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 : POOJA RANI

10. Date of Birth : 02/10/1995

11. Father's/Spouse Name : RAJAT KUMAR

12. Relationship : HUSBAND

13. Date of joining : 31/12/2021

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. NISA INDUSTRIAL SERVICES P. LTD

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