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13 Transfer Claim Form-Nokia 2nd To Present

This document is a transfer claim form used to transfer an employee's PF account from a previous establishment to a present one. It contains sections for the employee's personal information, details of the previous PF account to be transferred including account number and employer details, and details of the present PF account and employer. The employee certifies the information is correct and the form can be attested by either the previous or present employer to help speed up the settlement process.

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Manas Kumar Mohapatra
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446 views2 pages

13 Transfer Claim Form-Nokia 2nd To Present

This document is a transfer claim form used to transfer an employee's PF account from a previous establishment to a present one. It contains sections for the employee's personal information, details of the previous PF account to be transferred including account number and employer details, and details of the present PF account and employer. The employee certifies the information is correct and the form can be attested by either the previous or present employer to help speed up the settlement process.

Uploaded by

Manas Kumar Mohapatra
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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TRANSFER CLAIM FORM CLAIM ID

FORM 13 (REVISED) (For EPFO Use only)

EMPLOYEES' PROVIDENT FUND SCHEME, 1952


(PARA 57)
[APPLICATION FOR THE TRANSFER OF EPF ACCOUNT FROM UNEXEMPTED ESTABLISHMENT TO
EXEMPTED OR UNEXEMPTED ESTABLISHMENT]

To, To,
The Regional P F Commissioner, Trust Name:
Office Name: _____________________ Trust Address:

Office Address:

(Please see instruction 3) (in case the PF A/C is with Exempted Establishment)

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 INFORMATION

1. *Name: MANAS KUMAR MOHAPATRA

2. *Father's/Husband's name: AJAY KUMAR MOHAPATRA

3. Mobile number: 9830554341 4. E-mail id: [email protected]

5. Bank A/C number: 5270231812 6. IFS code of Bank branch: CITI0000004

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

1. *PF Account No. : KN/23336/1120863


In case the previous establishment is exempted under Employees' Provident Fund Scheme,1952
Pension Fund Account No. : BG/BNG/23336/25138
*Name and Address of the previous establishment: NOKIA SOLUTIONS AND NETWORKS INDIA
PRIVATE LIMITED
1507, Regus Business Centre, Eros Corporate
Towers, Level 15Nehru Place, New Delhi - 110019

3. *PF Account is held by: (Name of EPF Office/ PF Trust) NOKIA SOLUTIONS AND NETWORKS EPF
TRUST

4. *Date of Birth: 03/02/1983 (dd/mm/yyyy) 5. *Date of joining : 9/11/2015 (dd/mm/yyyy)

6. *Date of leaving: 12/1/2017 (dd/mm/yyyy)

PART C: DETAILS OF PRESENT ACCOUNT


1. *PF Account No. : HR/GGN/26237/42189
In case the previous establishment is exempted under Employees' Provident Fund Scheme,1952
Pension Fund Account No. : HR/GGN/26237/X/124995

2. *Name and Address of the present establishment: Ericsson India Pvt. Limited
Ericsson Forum, DLF Cybercity, Sector – 25A,
Gurgaon – 122 022 Haryana

3. *Account is held by:(Name of EPF Office / PF Trust)- ERICSSON EMPLOYEES PROVIDENT FUND
4. *Date of joining : 14/01/2017 (dd/mm/yyyy)

5. #Name of Trust (to whom funds are to be paid in case of present establishment being exempted

under EPF Scheme, 1952) : ERICSSON EMPLOYEES PROVIDENT FUND

6. #Employee code under the Trust: ______________________________________________________

(* indicates mandatory fields) (# Strike off if not applicable)

I, Certify that all the information given above is true to the best of my knowledge and I have ensured
the correctness of my present and previous account numbers.

Signature of the Member


Date: ______________

IMPORTANT: Member has the option to get the claim form attested by present or previous employer.
In case of attestation by the previous employer, time taken in settlement will be relatively less.

Certified that I have verified the data in Part B in respect of the member mentioned in Part A of this
form and the signature of the member.

Signature of Previous Employer


Seal of the Establishment Date: ___________________
OR
Certified that I have verified the data in Part C in respect of the member mentioned in Part A of this
form.

Signature of Present Employer


Seal of the Establishment Date: ___________________

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