Account Details

Submitted online at UAN e-seva portal on ****-**-*6 08:06:35 www.epfindia.gov.in

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 UAN Portal and UAN has been activated.) Mobile Number / eksckby uacj - 783-***-****

1. I want to apply for PF Advance

2. Universal Account Number(UAN) / ;wfuolZy [kkrk la[;k 101********* 3. Name of the member VIKASH YADAV

4. Date of Joining 27-Jul-2019

5. Permanent Account number / LFkk;h [kkrk la[;k BAXPV1300C 6.a Purpose of Advance Natural Calamities

6.b Amount of Advance (In Rs) 6492

7 In case of Advance for purpose of Site/House/Flat Not Applicable 8 Bankers details for Electronic Payment (Only for the Advance if payable to third party)

Not Applicable

9. Payee Address House no 47-A gali no 2 kundan nagar near grovar hospital laxmi House no 47-A gali

no 2 kundan nagar near grovar hospital

* 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 UAN Portal and found all data including Form No.11

(New), bank account details and Aadhar Number to be correct Father/Husband/Spouse Name: MURARI LAL YADAV Date Of Birth: 15-Apr-1993 Bank Account Number 342********* Bank IFSC Code ICIC0003426 Bank Details ICICI BANK LIMITED,TAIMUR NAGAR

Aadhaar 79XXXXXXXX41

Member ID MRNOI00556280000014593

* —i;k ;w u-iksVZy ij n'kkZ, x, cSad [kkrs esa Hkqxrku djsaA

* Please make payment in the bank account mentioned in the UAN portal . UAN - 101********* Tracking ID - 10148798276506003

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