PF WITHDRAWAL

The procedure for withdrawal of PF is as follows. Both the Form nos. 19 and 10C are to be filled and sent.

Please find attached herewith the following documents.

1. Instructions (2 pages)
2. Form19 - PF Withdrawal Form (2 pages)
3. Form10C - Pension Fund Withdrawal form (4 pages)

Please read the instructions carefully (particularly the reason of leaving). Please do not mention the
following mentioned reasons.
• ‘joined other company’
• ‘better opportunities’
• ‘better prospects’
• ‘career opportunities’
• retrenched from service
• Discharged from service on receiving compensation under the Industrial Disputes Act, 1947’
• Resigned not employed in any factory to which the Employees’ Provident funds scheme applies

(Note: You can mention the reason (h) if the new employer where you are joining do not have the
Provident fund scheme)

The forms are to be taken print on the plain papers and send the duly filled Original forms by courier
to the Ohri towers address given below.

SCSL Payroll (PF section)

Satyam Computer Services Ltd
Ohri Towers, Plot No. 9-1-154,
Sebastian Road,
Secunderabad – 500 003

The PF withdrawal forms shall be processed after completion of full and final settlement from payroll
only.

Particulars for filling the PF withdrawal forms.

Please mention your ID number on the top of the form.

Form no.19 – Provident Fund withdrawal

1. Sl no. 1 – Name of the members in Block Letters – Write your Name (as appearing in Payslip)
2. Sl no. 2 – Father’s Name or (Husband’s Name in case of married woman) – Write the name
accordingly
3. Sl no. 3 – Name and address of the of the Factory / establishment in which the member
was employed
– Do not fill any
details
4. Sl no. 4 – Account no. – Please mention the PF account – AP/23034/ (see payslip and
write)
5. Sl no. 5 – Date of Leaving – Write the date of relieving (DD / MM / YYYY) (last working date)
6. Sl no. 6 – Reason for leaving – (Please see the instructions and mention accordingly)
7. Sl no. 7 – Full Postal address – Write your postal address of your residence with pin code and
telephone number (India and not any other country)
8. Sl no. 8 – Tick (b) and fill the Bank account details
• S.B. Account number – Write the Savings Bank account number
• Name of the Bank (India and not any other country)
• Postal address of the branch with pin code

9. Date of Joining of establishment – Write the Date of Joining Satyam (DD / MM / YYYY)
10. Date of Birth – Write your Date of Birth (DD / MM / YYYY)
11. Contribution for the current financial year – Do not fill any details
12. Signature of the member – Please sign and do not put thumb impression
13. Declaration of non-employment – If you are not employed, please sign
 14. Advance Stamped Receipt – Please affix Revenue stamp and sign across and do not fill any
details.
Form no.10C – Pension Fund withdrawal

1. Sl no. 1 – Name of the members in Block Letters – Write your Name (as appearing in Payslip)
2. Sl no. 2 – Date of Birth – Write your Date of Birth (DD / MM / YYYY)
3. Sl no. 3 – Father’s Name or (Husband’s Name in case of married woman) – Write the name
accordingly
4. Sl no. 4 – Name and address of the of the Factory / establishment in which the member was
employed - Do not fill any details
5. Sl no. 5 – Code no. & Account no. – Please mention the PF account
Region / SRO code - AP
Code no. - 23034
Account no. - (see Payslip)
6. Sl no. 6 – Reason for leaving – (Please see the instructions and mention accordingly)
Date of Leaving – Write the date of relieving (DD / MM / YYYY) (last working date)
7. Sl no. 7 – Full Postal address – Write your postal address of your residence with pin code
(India and not any other country)
8. Sl no. 8 – Are you willing to accept Scheme – Tick the box – No
9. Sl no. 9 – Particulars of Family – Please mention your Spouse or Father or Mother Name, Date
of Birth and Relationship
10. Sl no.10 – In case of death of member after attaining the age of 58 years – Not applicable
11. Sl no. 11 - Tick (b) and fill the Bank account details
• S.B. Account number – Write the Savings Bank account number
• Name of the Bank (India and not any other country)
• Postal address of the branch with pin code

12. Sl no. 12 – Are you availing pension under EPS-95 – No

13. Signature of the member – Please sign and do not put thumb impression
14. Advance Stamped Receipt – Please affix Revenue stamp and sign across and do not fill any
details.

NOTE:

Advance Stamped Receipt – Please affix Revenue stamp and sign across on both the forms and do
not fill any details. The PF authority has made mandatory to affix the revenue stamps and if not
affixed, the forms shall be rejected.

Bank account – The Savings bank account should on your name and not of your relatives. Do not
close the Bank account before the PF amount is credited into the Bank account.

The details of wages and period of non-contributory service - Do not fill any details

PROCESS OF PF WITHDRAWAL FORMS:

1. Please send the duly filled forms along with the self address envelope with pin code and the
telephone number (do not affix postage stamps) to the Ohri towers address. (SCSL Payroll - PF
section)
2. We shall process the withdrawal forms, enclose the Form no.3A / covering letter and courier back
to your residential address mentioned on the forms. (Please note that the previous years’ Form
no.3A, if any, will not be enclosed as the same was already submitted to the PF office by us).
3. Please see the remarks column of the covering letter and fill the pending details, if any.
4. Please retain the covering letter with you and submit the Original form nos. 19, 10C, 3A - either
personally or by registered post with acknowledgement due at the PF office at Hyderabad only after
two months from the date of relieving; they will directly credit the money into your bank account in a
month from the date of submission. If the amount is not credited to the bank account, write to the
PF office to know the status.

The address of the PF office is given below.

The Regional Provident Fund Commissioner

Regional office
3-4-763, Barkatpura,
Hyderabad - 500 027