To
‘The Regional P-F. Commissioner
EPFO..EPFO Complex
Regional Office Delhi (S)
Sub : Joint Declaration by the Member & Employer
am an employee/ex-employee of
comnuetne..Liioua...Bu7- L412 somishing below herewith
correct details
during my service with aforesaid establishment.
Particulars Correct [__Wrong
PAMIREDDYGART SURYA TsuRYA PAMIRCDDY GAR!
Name PRASAD peDoy |
é ISREE NIVAS REDDY
Father/Husband Name face carats PamikeDDyone!
PF/EPS Account No. _|
Date of Birth (DD/MM/YY)
Date of Joining (DD/MM/YY)
Date of Leaving (DD/MM/YY)
Tam also enclosing herewith self attested copy of ID proof for your ready reference.
‘Your ire requested to make the necessary changes in your records (if required) and settle my
PF/EPS claim at the earliest.
Ancarly action in this regard will be highly appreciated.
Please acknowledge the receipt.
‘Yours faithfully,
Employee Name PAN|REDDYGAR) SURYA Name of Authorized Signatory
PRASAD REDDY
Employee Signature Auayefuased Signature
Authorized Signatory . With establishment sealTo
‘The Regional P.F. Commissioner
EPFO.. EPFO Complex:
Regional Office Delhi (S)
Sub : Joint Declaration by the Member & Employer
am an employee/ex-employee of
:.0..Samishing below herewith
correct details
during my service with aforesaid establishment.
+
Particulars Correct ‘Wrong,
DRYA TRAD Ken PISURYA PamecDD yah)
Y
Name
Father/Husband Name
PF/EPS Account No.
Date of Birth (DD/MM/YY),
Date of Joining (DD/MM/YY)
Date of Leaving (DD/MM/YY)
Jam also enclosing herewith self attested copy of ID proof for your ready reference.
Your are requested to make the necessary changes in your records (if required) and settle my
PF/EPS claim at the earliest.
An carly action in this regard will be highly appreciated.
Please acknowledge the receipt.
Yours faithfully, 7
EmployeeName Surya leasapRecpy ? ‘Name of Authorized Signatory
Employee Signature Jusyeppored Signature
Authorized Signatory . With establishment seal[ee sation 978, 197A ap ae 290)
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eran eet witout deacon cn
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‘ecu caren {semua bye decreed yyy
soveoute
(0ets ofthe sums ent he decrant on
Tare and aera ofthe Anountot
persone whom the suns are | some een
(Grenonineren | oni
Date an whch the sum were ae
irerestedinm/)
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ua ts oe se
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aro ete acount under the natn ¢| ste onwnicntheseount | Theamount of
Poste whe Sas Shen eee
a epenet damm /yny)Wn do hereby decare that tothe best of yout newledge 2 ete what sata sbve correct comple anit stated. We