Account C
Resume:
ONLINE TRANSFER CLAIM FORM [FORM ** (REVISED) ]
( Tracking ID: 10089682360305005 )
Claim Date : 21/05/2019
EMPLOYEES' PROVIDENT FUND SCHEME, 1952
(PARA 57)
:
Bank Account Number
PART A : PERSONAL
2.
Name
3.
Mobile Number
:
4.
Bank IFSC
E-mail id
SBIN0003351
VISWAKUMAR JAYAKUMAR
:
5.
1.
************@*****.***
The Regional P.F. Commissioner,
3, Rajaji Salai, Tambaram
(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.)
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 : TAMBARAM,
To,
Sir,
2.
:
Address of the Establishment
PART B : DETAILS OF PREVIOUS PF ACCOUNTS (WHICH IS TO BE TRANSFERRED) 3.
PF Account No. (with EPFO
:
Name of the Establishment
1. TBTAM00625640000016676
: HLF SERVICES LIMITED
27A, DEVELOPED INDUSTRIAL ESTATE GUINDY CHENNAI 685 4. PF A/C No. held by : TAMBARAM
5. NOT APPLICABLE
NOT APPLICABLE
:
PF A/C No. in Trust
Bank A/C No. of Trust :
:
7.
6.
Name of the Trust
NOT APPLICABLE
IFS Code of the Bank Branch of
Trust where account is
10.
Member's Name
16/03/1986
:
Date of Birth
: NOT APPLICABLE
8.
:
9. : VISWAKUMAR JAYAKUMAR
11.Father's/Spouse Name JAYAKUMAR
:
:
12. :
14. 18/04/2016
Relationship FATHER
13.
Date of leaving
Date of joining 01/06/2015
ORION EDUTECH PVT. LTD.
Father's/Spouse Name
:
Address of the Establishment
Member's Name
PF Account No. (with EPFO
Date of Birth
:
:
: 16/03/1986
:
5.
:
:
VISWAKUMAR JAYAKUMAR
Relationship
:
9.
1.
JAYAKUMAR
Name of the Establishment
12.
:
Name of the Trust
PF A/C No. in Trust NOT APPLICABLE
PART C : DETAILS OF PRESENT PF
6.
163/1, VIP ROAD, SCHEME-VIIM, KOLKATA 433
10.
3.
2.
NOT APPLICABLE
WBCAL00546520000028543
11.
FATHER
13. Date of joining : 01/02/2019
:
Bank A/C No. of Trust
8.
7. : NOT APPLICABLE
NOT APPLICABLE
IFS Code of the Bank Branch of
Trust where account is
4. PF A/C No. held by : RO KOLKATA
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. ORION EDUTECH PVT. LTD.
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.
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