FORMS FOR CLAIMING BENEFITS UNDER THE EMPLOYEES' PROVIDENT FUND SCHEME FORM NO.

PURPOSE For transferring the Provident Fund account of a member from one establishment to another establishment covered under the act / scheme. To be submitted by a member to withdraw his Provident Fund dues on leaving service/retirement/termination. In the event of death of member, this form is to be used by a nominee / family member to claim the member's Provident Fund accumilation. For the use of Provident Fund members to avail advances / withdrawals as provided in the scheme.

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FORMS FOR CLAIMING BENEFITS UNDER THE EMPLOYEES' PENSION SCHEME '95 FORM NO. PURPOSE For claiming : - Refund of Employer share. - Withdrawl benefit - Scheme certificate for retention of membership To be submitted by the first claimant i.e. - member or - widow/widower or - orphan or

10-C

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10-D

- nominee as the case may be

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FORMS FOR WITHDRAWAL OF INSURANCE FUNDS BENEFITS UNDER EMPLOYEES' DEPOSIT LINKED INSURANCE SCHEME, 1976 FORM NO. PURPOSE

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To be preferred by the person eligible to receive the Employees' Provident Fund dues of the deceased member who died while in services.

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FORMS FOR New Joinee FORM NO. 2 PURPOSE Nomination Form to be filled by employee on joining. SSN form to be filled by employee on joining. If he had filled the same in his previous organization. He has to provide the SSN / acknowledgement copy of SSN.

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SSN

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