Escolar Documentos
Profissional Documentos
Cultura Documentos
Form to be used by a member of the Provident Fund for claiming the Provident Fund dues
Name of Member
(block letter)
(Last) (First) (Middle)
Father’s Name ___________________________________
Emp ID :-
Provident Fund Account Number
PU/PUN/31643/EXEM/
Date of Joining Service ___________________________________
Mobile no:
E-mail id:
Signature of Member
CAPGEMINI INDIA PVT.LTD.
EMPLOYEES’
PROVIDENT FUND SEP- Plant
.2, Block C, Godrej IT Park, Godrej &
Boyce compound, LBS Marg
Vikhroli (West), Mumbai -
400079
Declaration of Non-Employment
I declare that I have not been employed in any factory / establishment to which the
Employee’s Provident Fund & Miscellaneous Provisions Act & Scheme, 1952 applies for
a continuous period not less than 2 months immediately preceding the date of my
application for final withdrawal of my Provident Fund money.
Date:
Signature of Member
account.
Affix Rs.1/-
Revenue
Stamp
Signature of Member
Instructions to follow:
An employee has to note that if he/she leaves organisation & join any next
organisation has to apply for the transfer of PF/Pension & not for withdrawal
of PF/Pension.
If member has not completed 5 yrs of Membership of PF Fund & opt for
withdrawal then entire PF withdrawal amount will be taxable.
PF No. : PU/PUN/EXEM/31643/ -
Reason of leaving service should be mentioned as follow :
o Resignation
o Higher Studies
o Going Abroad
For getting the PF settlement amount through NEFT employee have to
furnish the details of HDFC Saving Bank account. In case of bank details
other than HDFC, PF amount will be disbursed to employee by drawing a/c
payee cheque & same will be courier to address mentioned in PF withdrawal
form.
Employee has to sign advance receipt after affixing Rs. 1/- revenue stamp.
You do not have to fill any amount in Advance receipt.
PF Withdrawal forms have to submit after 60 days from last working day
along with Pension withdrawal Form 10C.
In case of retirement & Member going abroad, member can submit PF
withdrawal Form & Form 10C on last working day.
You can submit/courier PF Withdrawal form to below mentioned address:
1) Mandatory documents:
PF withdrawal Form.
Declaration of Non-Employment, as per s p e c i f i e d format.
Cancelled cheque.
Bank Statement or Bank Passbook copy
2) Additional Documents: