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PF Ready Reckoner

2012

Employees’ Provident Fund and Misc. Provisions Act, 1952 Ready Reckoner

Written by M Ravi Shankar, mravimtnl@gmail.com

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PF Ready Reckoner

Written by M Ravi Shankar
Dedicate to all the unknown gurus on Internet who helped me in learning various subjects.

Written by M Ravi Shankar, mravimtnl@gmail.com

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PF Ready Reckoner
Index
1 2 3 4 5 6 Introduction Enrollment Compliances EPF Calculations/benefits EPS Calculation/benefits Withdrawal/Advances

Written by M Ravi Shankar, mravimtnl@gmail.com

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PF Ready Reckoner Introduction
The Employees' Provident Fund & MP Act,1952 is an important piece of Labour Welfare legislation enacted by the Parliament to provide social security benefits to the workers . At present , the Act and the Schemes framed there under provides for three types of benefits -Contributory Provident Fund , Pensionary benefits to the employees/ family members and the insurance cover to the members of the Provident Fund. The object of the Act in 1952 was to institute the compulsory contributory Provident Fund to the employees to which both the employee and the employer would contribute. The Employees' Provident Fund Scheme was accordingly framed under the Act and it came into effect from 1-11-1952. On a review of the working of the scheme over the years by EPFO, it was found that in the event of the premature death of the employees the accumulation in the Provident Fund were too meagre to the family of the deceased .Thus another social security benefit of providing Family Pension through the Employees' Family Pension Fund Scheme , 1971 was introduced by amending the Act . At this stage, the Act was renamed as "The Employees' Provident Fund & Family Pension Act, 1952" and the Employees' Family Pension Scheme came into force on 1-3-1971. The Act was further amended in the year 1976 to introduce another social security benefit to provide an insurance cover to the members of the Provident Fund in covered establishment. The Employees' Deposit Linked Insurance Scheme, 1976 came into force from 1-8-1976. The name of the Act was then changed to the present one i.e. 'The Employees' Provident Fund & MP Act, 1952‟. From 16-111995, the Employees' Pension Scheme has come into force which provides pension to retiring employees on reaching 50/58 years of age, widow pension, children pension and nominee pension on death of the member to his eligible family members. This replaces the Employees' Family Pension Scheme 1971.

Employee Provident Fund Organization is the nodal agency for administration of the fund as well as statutory authority under the Act to ensure Compliances. EPFO had Launched online receipt of Electronic Challan cum Return (ECR) from the Month of April 2012 (March paid in April. Through, this portal registered employer can upload the Electronic Return and the uploaded return data will be displayed through a digitally signed copy in PDF format. The employer may choose to make the payment through internet banking of SBI or take a print out of the Challan and pay at any designated branch of State Bank of India (SBI). The Benefits of this portal are as follows::  No paper returns to be prepared and submitted to EPFO.  No need to submit other returns viz Form 5/10/12A,3A and 6A  Employers will get the confirmation of payment through SMS instantly.

Written by M Ravi Shankar, mravimtnl@gmail.com

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procedures on how to fill the form. mravimtnl@gmail. Though the EPFO has provided many features in its portal.  For earlier years employers can request for the annual slips through this portal. the relevant provisions pertaining to the form are explained. in the subsequent chapters of this book.  Employers can view the annual accounts slip for accounting year 2011-12 online.com Page 5 . Written by M Ravi Shankar. claiming benefits under EPF Act is not yet made online. Further. still the employers have to preserve Physical Copies of Forms Such as Form 2 (Nomination form) Form 5/10 (to be provided to members after joining/ leaving the service) and Form 3/3A (to be used for filling Form 10 C /D or Form 19 for withdrawal of Pension).PF Ready Reckoner  The contribution will be credited to the members' account on monthly basis. Therefore. The second part deals with benefits and withdrawals. The First part of book deals with the compliances that are required to be made by the employer.

PF Ready Reckoner Enrollment The EPFO Act is applicable to a factory or establishments engaging more than 20 workmen. Bank a/c existing Certificate 6. The Concerned enforcement Officer will visit the establishment for verifying the Original records 3. DD/Cheque for One month advance contribution 9. mravimtnl@gmail. Memorandum & Articles of Association with Certificate of Incorporation/Partnership Deed as applicable. Illustrative Form The Illustrative sheet given in the Next page pertains to ABC Company with employee strength of 20 workmen Proforma for Coverage Written by M Ravi Shankar.com Page 6 . Proof of Residence: rent agreement/Electricity Bill etc Procedure 1. 4. Copy of Work Orders 3. Labor License 4. First Sales Invoice/ Commencement of Business Certificate issued by the Registrar of Companies. Balance sheet is to be attached to determine actual date of coverage. 3. Copy of Factory/Shop & Comm. If workmen are more than twenty. the Contractor shall submit an application to PF office in the Form for Proforma of coverage (Template given in Next page): Attachments Required along with Proforma of Coverage: 1. In order to obtain coverage under EPFO Act. Point to be noted before submission of Form 1. Copy of Company PAN 5. Est Registration 8. Thereafter EPF will assign the code. Date of Incorporation will be in Certificate of Incorporation 4. Copy of VAT/ST Registration 7. 2. The form to be submitted to PF office 2. As proof of date of commencement 11. Advance Contribution for two months is required to be paid for coverage. Copy of Trade license 10. 2. a separate sheet should be attached along with the form.

6. Income Tax Permanent A/c. 2.2010 one of the documents mentioned overleaf in support of the proof of date of set up of the The date of est. CHEMBUR. No. Details of Code No. 5. CHEMBUR MUMABI AABPS1205E. Designation and Addresses of Managing Director. Details of Bankers: (Including Bank Branches & Account Number (s).) 11. Date of Incorporation/Set up (Please furnish any 05. P H Patil 804. Wages disbursed for the month 10. mravimtnl@gmail. Directors. VASHINAKA./factory) incorporation will be in the Certificate of Incorporation Employment Strength 20 At present : (ii)Month wise employment strength from the date of set up may be furnished in separate statement : Nature of business activity/ manufacturing Construction/Civil activity : Details of legal set up of the establishment Private (Please mention whether it is an incorporated Private or Public Limited Company. SAI KRUPA BUILDING. VASHINAKA.PF Ready Reckoner Performa for Coverage ( to be submitted by an employer along with one or more of the documents mentioned below for obtaining Code Number) 1. Partners.06. MUMBAI-400074 MH/19116 This field need not be filled for first time registration of Company 3. 7. Details of the employers/ownership particulars etc. MUMBAI-400074 July 2012 SBI. Secretary etc. Written by M Ravi Shankar. Name of the establishment/factory and address. Partnership or Proprietary concern) : 8. CHEMBUR.com Page 7 . (Names. 4. Society. Details of Head Office and branches with address. if any allotted to the Head Office. to be furnished) : 9. MAHUL. ABC Company Limited 804. SAI KRUPA BUILDING.

) 12. 2. Name SBI. 3. 7. (signature) Employer. It is clearly understood that we are liable for coverage from a date antecedent to the date of set up furnished above in the event of furnishing of false information.PF Ready Reckoner Sl.15% towards Amount:99840 administrative charges VERIFICATION The details furnished above are correct to the best of our knowledge and belief. mravimtnl@gmail. 6. Details of bank draft amounting to the contribution. contribution and 1.D.com Page 8 . 8. 9 10 11 12 13 14 15 16 17 18 19 20 Chhya R Dagde Eknath K Jore Madhav Manikar Nenu N Bagv Nitin Suravanshi Poonam Munde Rajkumar N Kagda Sanjay B ukande Santosh J shirke Vijay D Wagmare Vilas B sable Yogesh S Salve Prashant A Bhilarew Anil Y Mihsra Basavaraj k himatre G Krishan Naidu Vemal R Bhale rao Chinta Appa Rao Dianmaran C Hanumanta Mudakappa Eknath R Dagde Nitin K Jore Cheyya Manikar Madhav N Bagv Nitin Suravanshi Ashok Munde Vijay N Kagda Sunil B ukande Sanjay J shirke Vilas D Wagmare vinod B sable Bhaskar S Salve Prateek t A Bhilarew Ajay Y Mihsra Dinesh k himatre G Appala Naidu Ajayl R Bhale rao Chinta Sanjeev Rao Dinakaran C Vinay Mudakappa 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 05/04/2010 Fill the detail of Workmen engaged by the company Fill the details of DD Number and Amount (In case you have more than 21 employees the above information in respect of the other employees may be added in a separate sheet of paper in the same format continuing the serial number. Name of the employee Father‟s Name Date of Joining Wages (basic +DA & Cash value of Food Concession) 6500 5500 6500 4500 6500 6500 3500 6500 6500 6500 8500 6500 6500 9000 6500 6800 6500 6500 6500 6500 1. 4.I.5% DD No:33675 towards E. 5. (Rate of Contribution at Branch present is12% by employer and employees+ 0. Mahul of the Bank Branch & And administrative charges paid in Chembur respect of the above employees.N o.L. Sign of Employer Required Written by M Ravi Shankar.

First table (Part A) should be filled with the details of either parents or Spouse. whether married or unmarried. A member can distribute the amount in his nomination form 2. 3. 1995. her dependent parents. Nomination Form under Para 33 & 61(1) of EPF Scheme 1952 and paragraph 18 of Employees‟ Pension Scheme. Nominees under Employees Provident Fund Scheme Male Members : his wife. her deceased son‟s widow and children. Written by M Ravi Shankar. dependent parents. Table 3 Illustrative Form The illustrative form given in the next page is of a married person wherein he has distributed EPF benefits among his dependent parents and EPS benefit to his wife. Fill in the required details in the fileds from 1 to 7. Second table (Part B) should be filled only if employee is not married else empty. the nomination shall be in favour of one or more persons belonging to his family.Table 2 c. Any nomination made by such member in favour of a person not belonging to his family shall be invalid. his children. .PF Ready Reckoner Enrolment of Employees After registration under EPF Act. Third table (Part B) should be filled only if employee is married else empty. b. Nominees under Employees’ Pension Scheme Male Members : his wife.. except 6. (If married).e. Sons & Daughters (includes legally adopted) ** Dependent parents cannot be made as dependent in EPS scheme Point to be noted before submission of Form 1. If a member has a family at the time of making a nomination. mravimtnl@gmail. his dependent parents and his deceased son's widow and children Female Members: her husband. her husband's. her children. Sons & Daughters (includes legally adopted) Female Members: her husband. the employee should be enrolled under the EPF/EPS/EDLI scheme by submitting Form 2 i. In total there are three tables/ schedules in each form: a.com Page 9 .

Sadgur Apratm ent. and should I acquire a family hereafter. mravimtnl@gmail. name and relationship and address of the guardian who may receive the amount during the minority of nominee (1) Laxman Munda Shleke Block No. * Certified that I have no family as defined in para 2(g) of the Employees’ Provident Funds Scheme. * Certified that my father/mother is/are dependent upon me. Devalali . (PF/EPS Number) Address (Residential) : : : : : : : Eknath Ram Shelke Laxman untru shelke 15/4/1988 Male Married MH/19116/809 Permanent Block No.04. 1995) 1 2 3 4 5 6 7 Name (in Block Letters) Father‟s/Husband‟s Name Date of birth Sex Marital Status Account No.04. Vashinak Chembur PART A (EPF) I hereby nominate the person(s)/cancel the nomination made by me previously and nominate. 1952 and paragraph 18 of the Employees’ Pension Scheme. in the event of my death: Name and Address of the nominee/ nominees Address Nominee’s relationship with the member Date of Birth Total amount or share of accumulatio ns in Provident Fund to be paid to each nominee (%) If the nominee is a minor.PF Ready Reckoner (For Unexempted /Exempted Establishments) NOMINATION AND DECLARATION FORM FORM 2 (Declaration and Nomination Form under the Employees‟ Provident Funds and Employees‟ Pension Scheme) (Paragraphs 33 & 61 (1) of the Employees’ Provident Funds Scheme.com Page 10 . the above nomination should be deemed as cancelled. Thane Temporary Sai Darpar Apartment. Thane Mother (2) (3) (4) 01/05/196 50% 8 (5) NA Put Cross Mark at point 1 if you have a family and Point 2 if your parents are dependent 100% 1  2 3. the person(s) mentioned below to receive the amount standing to my credit in the Employees‟ Provident Fund. * Strike out whichever is not applicable. 1952. Devalali. Written by M Ravi Shankar. Sadgur Apratment.

Page No. Place: ___________________ Dated the __________________ …………………………………………………………. I hereby nominate the following persons for receiving the monthly widow pension (admissible under para 16 2(a) (i) and (ii) of Employees‟ Pension Scheme. as defined in para 2(vii) of Employees‟ Pension Scheme. mravimtnl@gmail. I hereby furnish below particulars of the members of my family who would be eligible to receive widow/children pension in the event of my death. Brother. 1995 and should I acquire a family hereafter I shall furnish particulars thereon in the above form. Name and Address of the Nominee (1) Sumanta Shelke Dated the :______________ **Strike out whichever is not applicable. 1995 in the event of my death without leaving any eligible family member for receiving Pension. deceased son‟s widow and children.com Page 11 .No. If unmarried then Parents. Sl. Sister or any other person(s). his/her dependent parents. Children (married or unmarried)./KumariEknath Ram Shelke_employed in my establishment after he/she has read the entries/the entries have been read over to him/her by me and got confirmed by him/her. Signature of the Employer or other authorised Officer of the establishment Designation……………………………………….A Fresh nomination shall be made by the member on his marriage and any nomination made before such marriage shall be deemed to be invalid # If Married –> Spouse.PF Ready Reckoner Remember to take sign of the Subscriber ---------------------------------------------------------------------Signature or thumb impression of the subscriber Note: . – 1 Please fill details of parents Part B (EPS) (Para 18) $ if not married. Date of Birth (2) 15/4/1989 Relationship with the member (3) Wife Signature / thumb impression of the subscriber CERTIFICATE BY EMPLOYER Remember to take sign of the Subscriber Certified that the above declaration and nomination has been signed/thumb impressed before me by Shri/Smt. Name and address of the family members Date of Birth Relationship with the member (1) (2) (3) (4) 15/4/1989 Wife 1 Sumanta Shelke ** Certified that I have no family. Name and address of the Factory/Establishment or rubber stamp thereof Written by M Ravi Shankar.

he never had a PF account number. Therefore all fields are kept blank except 1 (e) which is tick marked Written by M Ravi Shankar. furnish to him for communication to the Commissioner. the employer should insist the member to submit the details of his previous account and fill the same in Form No 11.com Page 12 . require such person to furnish and such person shall.11: Declaration on EPF Subscription: Form 11 under EPF scheme pertains to information provided by an employee while joining a new employer. ask for the Account Number and/or the name and particulars of the last employer. EPF inspector while inspecting records of an establishment may ask for these forms to check the eligibility criteria. Point (e) in the form 11 is required to be filed only in the case the member is not enrolled earlier in the PF Scheme.PF Ready Reckoner Form No. The EPFO has introduced this form in order to stop the system of having multiple numbers of one employee. ask him to state in writing whether or not he is a member of the Fund and if he is. In this form a new joinee also declares that whether he was previously a member of EPF scheme or not. The Form 11 of EPF is a declaration by the employee for certifying that wherever has worked/or not worked. In case an employee is already member of phased out Family pension scheme 1971. particulars regarding himself and his nominee required for the Declaration Form. Declaration by persons taking up employment after the Fund has been established The employer in relation to a [factory or other establishment] shall. This form is to be kept by an employer and not to be deposited with Sub/Regional commissioner. Illustrative form: The form given in the next page is of a new entrant who wan not a member of PF Scheme earlier. Points (a) to (d) in the form 11 are required to be filled in case the employee is earlier member of the scheme 2. As per Paragraph 34 of EPF Scheme. Duties of Employer 34. the details of same are also required to be furnished Point to be noted before submission of Form 1. 1971. he shall. mravimtnl@gmail. on demand. If the employee is previously enrolled. about his previous employments with name and address of employers along with duration of service. before taking any person into employment. If he is unable to furnish the Account Number. Such employer shall enter the particulars in the Declaration Form and obtain the signature or thumb impression of the person concerned: Provided that in the case of any such employee who has become a member of the Family Pension Fund under the Employees’ Family Pension Scheme. the aforesaid Declaration Form shall also contain such particulars as are necessary to comply with the requirements of that Scheme. Employer shall take an undertaking from the member in Form 11 that employee was not enrolled earlier in the scheme.

(For Unexempted Establishment only) Contract Total No.2010 No.com Page 13 .2010(Date of appointment) Date of completion of 120 actual working days in a period of 6 months or less or six months* continuous service or date of confirmation whichever is earliest.2010 to 01. (d) I have/have not drawn any superannuation benefits in respect of my past service from any employer. N. Date …………………………… ** Strike out whichever is not applicable. Date Signature or **right/left hand thumb impression of the employee. of Subscribers Rest Total Written by M Ravi Shankar. of days worked Account No.05.PF Ready Reckoner FORM-11 (For unexempted Establishment only) Paragraph 34 of the Employees‟ Provident Funds Scheme.05.11. Date of admission as member of Employees‟ Provident Fund From 01.  (e) I have never been a member of any Provident Fund and/or Family Pension Scheme. mravimtnl@gmail. of Employees Total No. – The principal employer should have filled it up also in respect of employees to be employed by or through a contractor. Put a Tick Mark in case employee is not a member earlier in this scheme (To be filled in by the employer only when the person employed had not already been a member of the Employees‟ Provident Fund) Shri Vikas Praksh Ghodke (name) is appointed as Rigger (Designation) in ABC Company(Name of the Factory/Establishment) with effect from 01. Signature of the Employer or Manager or other Authorised Officer. 1952 Declaration by a person taking up employment in an establishment in which the Employees’ Provident Fund and Family Pension Fund Scheme are in force : I Vikas Praksh Ghodke (Name) ** son/wife/daughter of Prakash B Ghodke do hereby solemnly declare that – (a) I was last employed in________Company left service on 1/5/2010 (Prior to that I was employee of from to date (b) I was a member of of the Family Pension Fund from / / Provident Fund and also/but not and my account number(s) was/were to (c) I have /have not withdrawn the amount of any Provident fund/Family Pnsion Scheme.B.

retaining allowance and the employee contribution shall be equal to employer‟s contribution. the Scheme may provide for rounding off of such fraction to the nearest rupee. at both the places where they occur. mravimtnl@gmail. the words ―12 percent‖ shall be substituted: Provided further that where the amount of any contribution payable under this Act involves a fraction of a rupee. Interpretation The PF Contributions payable shall be paid by the employer to the fund shall be ten/twelve percent of basic wages. be an amount exceeding ten percent of his basic wages. dearness allowance including cash value of food concession. 6-A & 6-B of the EPFO Act. Relevant provision Section 6: Contributions and matters which may be provided for in Schemes. dearness allowance and retaining allowance if any. and the employee’s contribution shall be equal to the contribution payable by the employer in respect of him and may. after making such inquiry as it deems fit. ―retaining allowance‖ means allowance payable for the time being to an employee of any factory or other establishment during any period in which the establishment is not working. Of the basic wages. if any employee so desires. this section shall be subject to the modification that for the words ―ten percent‖. Written by M Ravi Shankar.com Page 14 . by notification in the Official Gazette specify. – The contribution which shall be paid by the employer to the Fund shall be ten percent. dearness allowance and retaining allowance. – For the purposes of this section. if any. may. or quarter of a rupee. subject to the condition that the employer shall not be under an obligation to pay any contribution over and above his contribution payable under this section: Provided that in its application to any establishment or class of establishments which the Central Government. for the time being payable to each of the employees whether employed by him directly or by or through a contractor. for retaining his services. Explanation II. Explanation I – For the purposes of this section dearness allowance shall be deemed to include also the cash value of any food concession allowed to the employee.PF Ready Reckoner Contributions The Contribution payable by employer and employee is provided in Section 6. half of a rupee.

30 X 26 days) Contribution Towards EPF Employees share EPS Employer share EPF employer share EDLI charges payable by employer EPF Admin charges payable by employer EDLI Admin charges payable by employer Calculation 6149 x 12% 6149 x 8.1% 6500 x 0.5% 6149 x 1.01% 13. Para #(2) of EPS Scheme and Para 7 of EDLI Scheme.5% 1. the salary of employee is more than Rs 6500 then the PF Contribution payable by employer is only limited to Rs 6500/. Consider an employee getting a basic salary of 7500/Contribution Towards EPF Employees share EPS Employer share EPF employer share EDLI charges EPF Admin charges EDLI Admin charges Calculation 7500 x 12% 6500 x 8.33% 6500 x 3.30 per day. The wages payable for a month will be Rs 6149 (236.01% Amount 738 512 226 31 68 .33% 0.61 In case.1% 6149 x 0.61% Calculation of Contribution Let us calculate the contribution of an workman who is getting a minimum wage of Rs 236.65 ( Round up to Rs 1/-) Written by M Ravi Shankar. mravimtnl@gmail.only as per Para 2 6 A (2) of PF Scheme.67% 6149 x 0.33% 6149 x 3.67% 8.PF Ready Reckoner The Amount of Contribution is divided in to three schemes as follows: Scheme Name Employee provident fund Employees‟ Pension scheme Employees Deposit linked insurance EPF Administrative charges EDLIS Administrative charges Total Employee contribution 12% 0 0 0 0 12% Employer contribution 3.67% 6500 x 0.5% 6500 x 1.com Page 15 .1% 0. In such a scenario the following method may be adopted to pay their contributions.01% Amount 900 541 239 33 72 0.

33% Total employer contribution* 1.10% Employer contribution @ 0. by 15 th of the following month of payment of salary Written by M Ravi Shankar.com Page 16 . The ECR consists of the following fields: : Contribution Towards Establishment Code Account Group A/c 1 A/c 10 A/c 2 A/c 21 A/c22 Details of Account Code/Number allotted by department to your Company Payment towards Provident fund Contributions Payment towards Pension Admin charger for PF and And Pension for all employees Payment towards EDLI Admin charges for EDLi Calculation PF Employer 3.5% (Basic +Da) A/c21 *0.e. The Contributions of employee as well as employer shall be remitted in State Bank of India thru cheque or DD drawn in favor of EPFO along with Electronic Chalaln Cum.PF Ready Reckoner Points to be noted:  The employee has option to join or not to join PF Scheme in case his salary is more than Rs 6500  The minimum wages and special allowances notified by appropriate government can not be further bifurcated for payment of PF Contributions . mravimtnl@gmail.5% The remittance shall be made within 15 days of close of every month i. Mode of Payment An Electronic Challan Cum Return should be generated in the esewa portal of EPFO for payment of Contribution Amount.67% and Employee 12% Employer *8.

PF Ready Reckoner Compliance Form 5: Para 36 (2) (a) of EPF Scheme: (2) Every employer shall send to the Commissioner within fifteen days of the close of each month a return(a) in Form 5.4. VASHINAKA.81 Date of birth Sex Date of Joining of the fund Total period of previous service as on the date of joining the Fund (Enclose Scheme certificate if applicable SL No Rem arks MH/19116/23 POONAM MUNDE GUDDI MUNDE M 10. Employees Pension Fund & Employees‟ Deposit Linked Insurance Fund for the first time during the month of July 2012 (To be sent to the Commissioner with Form 2 (EPF & EPS) Name and Address of the Factory/Establishment: ABC COMPANY LIMITED. of Factory/Establishment: MH/19116 Account No Name of Employees in Block Letters Father‟s name (or Husband‟s name in case of married woman) 12. Employees Provident Fund Scheme Form 5 [Paragraph 36(2)(a) of the Employees‟ Provident Funds Scheme. 1952 and Para 20(4) of the Employees‟ Pension Scheme.. and (c) provided further that a copy of the forms mentioned in clause (a) and (b) above shall be provided by the employer to concerned employees immediately after joining of the service or at the time of leaving of the service as the case may be (7)Every employer shall send to the Commissioner such returns in electronic format also. Written by M Ravi Shankar. However. Such Form 5 shall consist information of the new employees who have joined the scheme.4.com Stamp of the Factory/Establishment Page 17 . Form 5 shall be submitted electronically (ie in ECR text file Form 5 is getting submitted). a physical copy should be provided to the employee. SAI KRUPA BUILDING. of the employees qualifying to become members of the Fund for the first time during the preceding month together with the declarations in Form 2 furnished by such qualifying employees. Vide Notification date 4th May 2012. 804. in such manner and form as may be specified by the commissioner Interpretation: By 15th of every Month Form 5 along with form 2 shall be submitted. CHEMBUR Code No. 1995] Return of Employees qualifying for membership of the Employees‟ Provident Fund.2010 Signature of the Employer or other authorized officer of the Factory/Establishment Date ……………. mravimtnl@gmail.

Vide Notification date 4th May 2012.. Form 5 shall be submitted electronically (i. of the employees leaving service of the employer during the preceding month: Provided that if there is no employee qualifying to become a member of the Fund for the first time or there is no employee leaving service of the employer during the preceding month.. ( c) provided further that a copy of the forms mentioned in clause (a) and (b) above shall be provided by the employer to concerned employees immediately after joining of the service or at the time of leaving of the service as the case may be (7)Every employer shall send to the Commissioner such returns in electronic format also.PF Ready Reckoner Compliance-II :Form-10 Para 36 of EPF Scheme: (2)Every employer shall send to the Commissioner within fifteen days of the close of each month a return-: (b) [in such form as the Commissioner may specify]. the employer shall send a ‘NIL’ return. a physical copy should be provided to the employee. in ECR text file form 10 is getting submitted).com Page 18 . Employees Provident Fund Scheme Form 10 Paragraph 36(2)(a) & (b) of the Employees‟ Provident Funds Scheme. Such Form 10 shall consist information of the employees who have left the scheme. However. 1952 Return of Members leaving service during the month of Name and address of the Factory/Estt. SL No Account No. Name of Father’s Name (or member (in husband’s name in block letters) case of married woman) 3 4 Nitin S Vanshi Vijay K Gaikwad Ravindran K Mahesh Suray Vanshi Prakash K Gaikwad Padmanabhan K Code No Date of leaving service 5 10/4/2010 15/4/2010 18/4/10 *Reasons for leaving service 6 Attained age of 58 yrs Dismissed Resigned Remarks 1 1 2 3 2 MH/19116/ 12 MH/19116/ 14 MH/19116/ 20 7 Signature of the employer or other authorised officer Date : ……………………. Stamp of the Factory/Estt. in such manner and form as may be specified by the commissioner Interpretation: By 15th of every Month Form 10 shall be submitted. Written by M Ravi Shankar. mravimtnl@gmail.e.

in different [factories and other establishments] as may be decided by the Commissioner from time to time: Provided further that the cards issued— a.2 Shri Vijay K Gaikwad was dismissed from the service for willful misconduct. or b. (c) retrenchment. I recommend that the employer's contribution for Rs 5326 should be forfeited from his account in the fund. Currency of Contribution Cards The contribution cards issued under this Scheme shall be current for one year: Provided that the said period of one year may commence and terminate at such different times. The amounts recovered shall be entered in Form 3/3-A 41. in respect of the first contribution period.PF Ready Reckoner *Please state whether the member is (a) retiring according to Para 69 (1)(A) OR (B) of the scheme. the following certificate should be filled. (b) leaving India for permanent settlement abroad. (cc) part of a total disablement due to employment injury. Shri was paid/ unpaid retrenchment compensation of Rs under the Industrial Disputes Act. A copy of order of dismissal is enclosed (2) In case of discharge from service. Interpretation: The Contribution card will be FORM 3/3-A. No. Certified that the member mentioned in Sr. (d) ordinarily dismissed for serious and wilful misconduct.com Page 19 . in respect of the contribution period immediately preceding the date from which the establishment is notified as an annually posted establishment. (I) attained the age of 58 years. A request for deduction from the account of a member dismissed for serious and willful misconduct should be reported by the following “Certified that the member mentioned at Sr. 1947 Signature of the Employer Compliance-III :Form-3A & 6A Relevant Provisions 40. Written by M Ravi Shankar. No. Contributions to be entered in the contribution card The amount recovered every month from the wages of an employee as well as the contribution made by the employer in respect of each such employee shall be entered by the employer every month in the contribution card opened in the name of each member under this Scheme. (The name and address of the Employers should be stated) (h) Death. (g) taking up employment elsewhere. mravimtnl@gmail. (f) resigning from or leaving service. (e) discharged. may be for a period which may be less or more than a year.

If any person joins in between the year his card can be maintained from such month till end of March 42. However. 1971.e. for the next period of currency: Provided that in the case of any such employee who has become a member of the Family Pension Fund under the Employees’ Family Pension Scheme. Written by M Ravi Shankar.e starting from April to March. Interpretation: Fresh Form3/3-A shall be prepared after expiration of each year for every member. then Form 3/3A shall be submitted within 20 of the following month of leaving. Renewal of contribution cards An employer shall.com Page 20 . the aforesaid Form shall also contain such particulars as are necessary to comply with the requirements of that Scheme. after launch of e-sewa portal Form 3/3A is not required to be submitted in commissioner’s office 44. send the contribution cards to the Commissioner together with a statement in Form 6: Provided that where a member leaves service. If an employee leaves in between the year. the aforesaid Form shall also contain such particulars as are necessary to comply with the requirements of the Scheme. 1971. In other words Form3/3A is valid for one year only. April 30th is the last date for submission of Form3/3A along with Form 6/6A to RPFC. Interpretation: Form 3/3A shall be submitted to RPFC within one month of expiration of currency period i. mravimtnl@gmail. prepare in respect of each member employed by him a card [in Form 3] [or Form 3A] as may be appropriate. 43. the employer shall send the contribution card in respect of such members before the twentieth day of the month following that in which the members left the service: Provided further that in the case of any such employee who has become a member of the Family Pension Fund under the Employees’ Family Pension Scheme.PF Ready Reckoner Interpretation: Form 3/3-A shall be maintained generally for accounting year i. Custody of contribution cards The employer shall retain in his custody the contribution cards in respect of each member employed by him and shall take every precaution against loss or damage of the contribution cards Interpretation: The employer shall keep the FORM 3/3A in his safe custody. on or before the expiration of the period of currency of the contribution card. Submission of contribution cards to the Commissioner Every employer shall within one month from the date of expiration of the period of currency of the contribution cards in respect of members employed by him.

Interpretation: Form 6A shall be submitted before 30th April of every year.PF Ready Reckoner Para 38 (3) of EPF Scheme: The employer shall send to the Commissioner within one month of the close of the period of currency. a consolidated annual Contribution Statement in Form 6-A. The employer shall maintain on his record duplicate copies of the aforesaid monthly abstract and consolidated annual contribution statement for production at the time of inspection by the Inspector. There is no requirement of Physical submission of the Annual Returns Written by M Ravi Shankar.com Page 21 . showing the total amount of recoveries made during the period of currency from the wages of each member and the total amount contributed by the employer in respect of each such member for the said period. Now Form 3/3A/6/6A will be generated electronically. mravimtnl@gmail.

If there is any deficiency in the claim. duly filled in and attested. for any reason whatsoever. it shall be the duty of the Commissioner to make prompt payment as provided in this scheme (5)(a) Every employer shall. complete in all respects submitted along with the requisite documents shall be settled and benefit amount paid to the beneficiaries within 30 days from the date of its receipt by the Commissioner.25% p. at the time when a member of the Fund leaves the service. and to give the said application to the member. Written by M Ravi Shankar. The interest rate for the year 2011-12 is 8. the same shall be recorded in writing and communicated to the applicant within 30 days from the date of receipt of such application. be required to get the claim application.PF Ready Reckoner Withdrawals & Benefits Interest: Relevant Provision 60. the Commissioner or any other officer authorised by him in this behalf may forward such application to the employer and the employer shall be required. of paragraph 69. for payment of provident fund in cases specified in clauses (a) to (dd) of sub-paragraph (1). . to the Commissioner or any other officer authorised by him in this behalf. and to forward the said application [within five days of its receipt] to the Commissioner or any other officer authorised by him in this behalf. Claiming of Provident Fund 72. and wherever necessary. he may forward it to the Commissioner or any other officer authorised by him in this behalf. (7) The claims. [provided the member continues to remain unemployed in a factory or other establishment to which the Act applies] either through post or in person with proper identification. duly filled in and attested. forward forthwith [but not later than five days of its receipt] the said application to the Commissioner or any other officer authorised by him in this behalf. the Commissioner shall be liable for the delay beyond the said period and penal interest at the rate of 12% per annum may be charged on the benefit amount and the same may be deducted from the salary of the Commissioner. on completion of the period specified in sub-paragraph (2) of paragraph 69.a. (b) Every employer shall. (c) Every employer shall. at the time when a member of the Fund leaves the service. be required to get the claim application. on the death of the member and on receipt of an application for receiving the amount standing to the credit of such member. for submission. Payment of Provident Fund (1) When the amount standing to the credit of a member. Interest (1) The Commissioner shall credit to the account of each member interest at such rate as may be determined by the Central Government in consultation with the Central Board. becomes payable. mravimtnl@gmail. Meaning The interest will be decided by Central Board of trustees the Apex Body of EPFO currently chaired by Labor and Employment Minister Mallikarjun Kharge. for payment of provident fund in cases specified in clause (e) of sub-paragraph (1). (d) If the applicant is unable to send the claim application through the employer or duly attested by him.com Page 22 . to return it within five days of its receipt. and in subparagraph (2) of paragraph 69. In case the Commissioner fails without sufficient cause to settle a claim complete in all respects within 30 days.

Sl. Particulars Instructions for furnishing the particulars in form 19 1 Reason for Leaving Service From the following please Indicate the reason applicable to you: 1. mravimtnl@gmail.com . So. the specimen signature of the attesting official should have been already furnished to the EPFO. the claim should be submitted by the member only after two months from the Date of Leaving Service It is safer to have the payment through cheque. Wherever payment is sought through account payee cheque. The authorized official of the establishment should attest the claim under the seal of his designation. It should be ensured. The example given below is of a resigned employee in Form 19. Employer shall send duly filled in withdrawal form to the PF Commissioner while a member leaves service 2. It is the duty of the commissioner to ensure that claim gets settled within 30 days from date of receipt Instructions: Form 19 should be filled for withdrawal of provident fund except for death. Employer shall send duly filled in withdrawal form to the PF Commissioner within 5 days of receipt in case of death 3. Under Voluntary Retirement Scheme 4. Page 23 2 Mode of Remittance 4 5 Advance Stamped Receipt Written by M Ravi Shankar. Please furnish the Xerox copy of the First page of Saving Bank account pass book or monthly statement/Cancelled Cheque wherein the account number and address of the Bank is clearly visible. The fields of both the forms are almost similar except in form 20 the details of claimant and his bank account details needs to be filled and signed by claimant. contribution for the current financial year with wages should be furnished or Form 3/3A for the current financial year with attestation of the employer should be furnished. Account Payee cheque will be sent directly to the Scheduled bank / Coop Bank / Post Office in which Savings bank Account of the member is maintained.PF Ready Reckoner Interpretation 1. Migration to abroad on Permanent settlement 5. furnish correct SB account number with full address of the Branch of the Bank. Retired from Service after attaining 55 years 2. Resigned / Left Service * * For cases of Resignation / Left Service. The amount need not be filled in. the advance stamped receipt should be signed by the member duly affixing One Rupee Revenue Stamp. 3 Contribution for the current financial year Attestation by the Employer In the table provided in Page 3. wherever applicable furnish the MICR Number also. In case of Death Form 20 should be filled. Retired on Disability to the work 3. Retrenched from Service 6. which shall be filled in by the RPFC / OIC of the EPFO Office.

B. Vashinaka. 804. 7. (Tick here) (Advance Stamped Receipt furnished below) Certified that the particulars are true to the best of my knowledge. 5. Mumbai 8. Name of the member (in Block Letters) : Vikas Praksh Ghodke 2. Name and address of the Factory/Establishment in which the member was last employed …… ABC Company Limited.PF Ready Reckoner Employees Provident Fund Scheme Form 19 Paragraph 72(5) of Employees‟ Provident Funds Scheme./A/c (Scheduled Bank/P. in figure: 129000100241065 Name of the Bank: State Bank of India Branch: Chembur (Mumbai) Full Address: Nr Post Office. W/o: Prakash Bandhu Ghodke. BLG:7/A. VASHINAKA. 3. 1952 Form to be used by a Major Member of Employees’ Provident Funds Scheme. Mumbai. Chembur. mravimtnl@gmail. No: 501. Chembur. 4. Father‟s Name (or husband‟s name in the case of married woman) Prakash Bandhu Ghodke …………………………………………………………………………………………. A/c No.B. Date of Joining the Establishment : 5/12/2000 Date of Leaving Service:31/6/2010 Contribution for the current financial year Written by M Ravi Shankar. CHEMBUR. Mode of Remittance ………………………………………………………………… (a) by postal money order at my cost (b) by account payee cheque sent direct to credit to my S.) under intimation to me. Vishwa Shanti Bldg. 7 ( ) S. 6. 1952 for Claiming the Employees’ Provident Fund Dues : (Refer to Instructions) 1. Pin: 400074 Put a „tick‟ in the box against the one opted () ( ) to the address given against item No. Ashish Theatre.com Page 24 .O. MUMBAI-400074 Account No. : Vikas Praksh Ghodke S/o. MH/19916/38 Date of leaving service: 31/06/2010 Reason for leaving service Resigned Full Postal Address (in Block Letters) Shri/Smt/Kumar. SAI KRUPA BUILDING.

* The space should be left blank which shall be Provident fund Commissioner/Officer-in-charge Remember to take Sign of Member of the member filled in by Regional of S.(-) Pension Pension Fund Fund Cont. The applicant has signed/thumb impressed before me. mravimtnl@gmail. (Rupees*…………………………) From Regional Provident Fund Commissioner/Officer-in-Charge of Sub-Regional Office…………………………… deposit in my Savings Bank Account towards the settlement of Provident Fund Accout.PF Ready Reckoner Employees’ Share Month Amount of Wages E.O.F Employers’ Share EPF Cont.( if any) Total 744 744 744 744 744 744 744 744 744 744 744 744 8928 228 228 228 228 228 228 228 228 228 228 228 228 2736 516 516 516 516 516 516 516 516 516 516 516 516 6192 6200 6200 6200 6200 6200 6200 6200 6200 6200 6200 6200 74400 (Information tobe furnished by the employer if the claim form attested by the employer) Certified that the above contributions have been included in the regular monthly remittance. Period of Break Remarks March paid in April 6200 May June July August September October November December January February Feb.R.com Page 25 . Refund of Adv.P. paid in March Suppl. Affix 1 ruppes Revenue Stamps Signature of left/right hand thumb impression (For the use of Commissioner‟s Office) Written by M Ravi Shankar. ……………………………………………… Signature of the employer or authorised Official …………………………… Signature of left/right Thumb impression of the member Advance Stamped Receipt Remember to take ( Sign of Member Received a sum of Rs* ……………………….

H.PF Ready Reckoner A/c. …………………………. dt………………………. Date Office Seal……………………….. Commission If any) Net Amount to be paid by M.I. you may write to the complaints Officer. …………………………………………… …………………………………………… In case. …………………… in words) M.. 10 Debit Item No.O.. Written by M Ravi Shankar..C. mravimtnl@gmail. Account No.R. …………………………………….O.com Page 26 .) ……………………………… (M./Cheque)………………………………. no intimation is received within a Month. ………………………. ……………………………. ………………… (Section)……………………….. Paid by inclusion in Cheque No. ………………….O. Accounts Officer Date …………………………. Under Rs…………… Passed for Payment of Rs. EPFO Office of the RPFC/Officer-in Charge of Sub-Regional Office Acknowledgement Received the following claims. Remarks Acknowledgment Card AC/RC Account No. Clerk Head Clerk (P.O. settled in part/Full Entered in F-21-A/224/29 Withdrawal Register. EPF FPF IF Registration No. No. PIN……………………………… Employees‟ Provident fund Organisation Office of the Regional Provident Fund Commissioner/ S.. Vide Cash Book (Bank) Account No. Employees‟ Provident fund duly quoting the Registration Number and your Provident Fund Account Number Postcard Postage Prepaid …………………………………….

11. i.e. Calculation of pension (A) Those who joined service before 15.600.1995 Benefit in Rs. Z Rs.Rs.11.1995  Y : those who have attained 48 years but less that 53 years as on 16.1995.11.800.1995.1995  Z : those who have attained 53 years or more as on 16.1995: The formula for calculation of pension for employees who joined service before 15. if a PF member gets Rs. mravimtnl@gmail. 1000/.16% of wages..1995 is Past Service Benefit + Pensionable service benefit Proportionate reduction The employee who joined service before 15.11. upto 15.11.1995 and the service rendered.1995 as shown below: TABLE – A Past Service before 15.2500/80 85 95 105 135 170 Upto 11 years More than 11 years but upto 15 years More than 15 years but less than 20 120 years Beyond 20 years 150 The above amount is the benefit payable on completion of 58 years of age as on 16. Benefit in Rs. Rs. X . Written by M Ravi Shankar.11. Y . Wages as on Wages as on 15. Government also contributes to this Welfare Scheme at the rate of 1.as monthly wages and he and his employer contributes 12% each.PF Ready Reckoner Pension Benefit Funding of the Pension Scheme An amount equal to 8.11.11.Rs.1995 The minimum pension specified for each group i.e. The three groups are divide basis their as on 16.1995 is more Rs.com Page 27 .500.11.1995 are divide in to three groups. The pension payable is calculated as follows: Past Service Benefit: Past Service benefit depends upon the wage as on 15.11.1995 is upto 15. 83 goes to Pension Fund.11.11.  X : those who have not attained 48 years as on 16.33% of Wages is paid into the EPS from the Employer's contribution.2500/ than Rs.11.

390 2.11.396 1.720 2.049 1.com Page 28 .689 1.PF Ready Reckoner For the calculation of pension benefits before 58 years (if a member do not complete 58 years of age on 15.29 3. Pensionable Service benefit= Pensionable salary X Pensionable Service --------------------------------------70 The pensionable salary will be the last drawn salary (Basic+DA which is less than Rs 6500) and Pensionable is the total service. The pension payable is subject to minimum pension assured by EPF Suppose a workmen has service of 20years and his last drawn pensionable salary is 5000 (Basic+DA which is less than Rs 6500) then the pension benefit is as follows: Pension benefit = 5000 x 20 = 1428 p. Table B If Years to 58 of age from 15. 3.044 2.983 4. Proportionate reduction: arises if the past service is less than 24 years and aggregate pension calculated is less that Rs. The pension payable is Subject to minimum pension assured by EPF.761 8.819 5.1995 is: less than 1 year less than 2 years less than 3 years less than 4 years less than 5 years less than 6 years less than 7 years less than 8 years less than 9 years less than 10 years less than 11 years less than 12 years then factor is: 1.381 4.1995 is: less than 13 years less than 14 years less than 15 years less than 16 years less than 17 years less than 18 years less than 19 years less than 20 years less than 21 years less than 22 years less than 23 years less than 24 years then factor is: 3.858 2.992 If Years to 58 of age from 15.11.473 2.m 70 Written by M Ravi Shankar.500/(B) Pension Calculation for Employees who Joined Service after 15.414 7.1995.536 1.11. his past service benefit will be increased by the below factor .537 9.Early pension cases ) the above benefit is multiplied by the TABLE .154 1.B factor to arrive at the past service benefit.301 5.810 6.269 1. mravimtnl@gmail.1995: Pension benefit= Pensionable salary X Pensionable Service --------------------------------------70 The pensionable salary will be the last drawn salary and Pensionable is the total service.11.621 3.248 2.056 7.

Written by M Ravi Shankar.1 4.05 3. The below given form is an example of Form 10-d of a widower subsequent to her death orphan pension is being given to her children.7 9.PF Ready Reckoner Types of Pension: Type of Description Pension Superannuation If age is 58 years or more 20 years or more service Retirement If age is between 50 and 58 years 20 years or more service Short Service If service is more than 10 years (Cessation) Return of If Service is less than 10 years Contribution on exit from employment Calculation Formula As provided in the Formula above As provided in the Formula above As provided in the Formula above Return of contribution will be provided as per service i.88 Suppose last drawn salary is Rs 5000/- Widow/Child Pension Provided to widow and child Widow pension would be same as he would have received on members date of retirement.com Page 29 .28 Yrs of service 6 7 8 9 Return of Contribution 6.4 7.02 2.54 8.e Yrs of service 1 2 3 4 5 Return of Contribution 1. Disability Pension Certificate to the effect Would be same as he would have received of permanent and 100% disability on members date of retirement should be produced Commutation not applicable For withdrawal of pension for service less than 10years Form 10-C is required to be used where as for claim of monthly pension on superannuation/retirement/short service pension/disabled pension/widowed pension/children person/ orphan pension form 10 d should be used. mravimtnl@gmail.18 5. In addition to this child would receive 25% of widow pension as child pension.

documentary evidence such as Birth Certificate / School Certificate / Service records of the establishment duly attested by the employer should be furnished. If the member had attained age of 58 years and still continuing in service.PF Ready Reckoner Form 10-D The information you should know before you fill claim form seeking settlement under Employees Pension Scheme 1995. mravimtnl@gmail. it should tally with Date of birth furnished in Form 9 and other office records.com Page 30 . Date of joining in the Pension Scheme either old pension scheme or new pension scheme should be furnished Date of leaving service be furnished. The type of pension claimed is to be furnished For Example . If you want to correct the Date of birth now.Retirement pension or Reduced pension or Widow pension or Children / Orphan pension / Disability pension While furnishing Date of birth. If the member is claiming for Retirement / Reduced / Disablement pension. If you are a member of pension scheme and If you have less than 10 years contributing service and seek settlement of withdrawal benefit If you are applying for Superannuation pension / Reduced pension / Widow pension / Children / Orphan Pension / Permanent Disability pension If the claimant is minor Submit claim in Form 10-C Submit claim in Form 10-D The claim should be submitted by the Natural guardian / Guardian appointed by the Competent court How to fill Form 10-D claim application Sl. he should fill in his name. Date of attaining 58 years of age be furnished. 1 Instructions for furnishing the particulars Please fill the claimant‟s name. Member should mention the Date from which he opts to receive pension in case of reduced pension Reason for leaving service be furnished correctly as (1) Retirement or Superannuation or (3) Resigned / Retrenched or (4) Disablement or (5) Attained 58 years and continuing service (2) 2 3 (d) 6(a) 6(b) 6(c) 7 Written by M Ravi Shankar.

Birth certificates of the children be furnished. If the member is un. If the claimant is drawing pension under this Scheme. birth certificate and disability certificate from the competent medical officer should be furnished. Furnish Death Certificate in original. The documents enclosed with the claim form should be invariably mentioned individually. Details of Savings Bank account with branch address is furnished. the spouse and children only are family members. As per the pension scheme.PF Ready Reckoner 9 Facility of Commutation of pension and benefit of Return of Capital are withdrawn.com Page 31 . if children pension is claimed. Break-in-Service details for entire period of service be furnished along with the claim application. Descriptive role of the pensioner / claimant be filled correctly and attested by the employer If the establishment is closed. Keep Nil in case of no option Particulars of family of the member be furnished. 12 13 14 15 16 17 18 19 20 Written by M Ravi Shankar. i f necessary. pension payment order number and name of the office which issued the PPO be furnished. Furnish the control number of the Scheme Certificate. If the member is deceased. separate SB account number for each of the child. the claim may be attested by any one of the authorized official. the original Scheme Certificate should b e s u b m i t t e d r e t a i n i n g a P h o t o s t a t copy. parents name can be furnished. who is a minor maintained in the same bank branch of the widow / widower be furnished. mravimtnl@gmail. The enclosures should be attested by the employer / authorized official of the establishment Wages / Contribution be furnished for a period of 12 months preceding the Date of Leaving / Death. furnish the Date of Death as per the Death certificate. If the children pension claimed. If the applicant / claimant is in possession of Scheme Certificate. Please furnish the Photostat copy of the first page of pass book. If the child is disabled.married.

F. 4. mravimtnl@gmail.PF Ready Reckoner for Office Use Only Inward No. Vashinaka. Type of Pension Claimed. Account Number Members‟s Accounts No: PH/18116/3103 5. 8. (a) Member‟ Name (In Block Letters) (b) Sex (c) Marital Status (d) Date of Birth/Age (e) Parent/Spouse Name : DWARAK JADHAV : FEMALE : WIDOW : 42 : RAMESH : RO SRO Establishment Code No. Sai Krupa Building. Chembur. Mumbai Abc Company Limited. 6. PIN: 400074 9. Option for commutation of 1/3 of Quantum: Pension (If option is for lesser) commutation indicate the quantum Yes No Amount ----- ------ ----- Tick No as scheme is phased out Written by M Ravi Shankar. 1995 (Read INSTRUCTIONS before filling in this Form) 1. 804. Mumbai-400074 Name & Address of the establishment : in which the member was last employed Date of Leaving Service : Not Applicable Reason for leaving Service : Not Applicable Address for communication : Om ganesh Nagar Sainath seva Mandal Vaisnaka. Major Orphan Orphan Pension 3.P.com Page 32 . R C Marg Chmebur.By whom the pension is claimed? 2. 7. APPLICATION FOR MONTHLY PENSION FORM 10-D(EPS) EMPLOYEE’S PENSION SCHEME. E.

CHEMBUR. mravimtnl@gmail. indicate your choice of alternative Mention your Nominee for Return of Capital Name Relationship Date of Birth Address 12. Written by M Ravi Shankar.com Page 33 . Guardian (1) (2) SANAY R JADHAV (3) 22/11/1984 (4) (5) SON SON NA NA Relationship with Member (6) NA VIKRANT R JADHAV 20/11/1988 NA Note : If any child is physically handicapped.PF Ready Reckoner 10. 13. : : : : : Date of Birth/Age Relationship with Member Indicate against Minor Not Applicable SI. No. Date of death of Member (if applicable) Details of Saving Bank Account Opened Name of the Bank Name of the Branch Full Post all Address 31140646055 STATE BANK OF INDIA MAHUL ROAD. MUMBAI 17/11/2008 14. Option of Return of Capital (Please refer Serial Number 10 of INSTRUCTIONS) [Put a Tick ( )] If Yes. please indicate “DISABLED” below the name. Particulars of Family Name Yes No  1 : 2 3 Tick No as scheme is phased out 11.

indicate his/her (1) Name : (2) Relationship : with the deceased Member 15.PF Ready Reckoner SI. Details of Scheme Certificate Not Applicable Scheme Certificate received & enclosed Not Received Not Applicable NA NA NA Already in possession of the Member. 31140646055 31140646054 1 2 SANAY R JADHAV VIKRANT R JADHAV 14(A) If the claim is preferred by nominee. Authority who issued the Scheme certificate NA NA Written by M Ravi Shankar. No Scheme Certificate Control No. indicate: SI.com Page 34 .No Name of the Claimants(S) Saving Bank Accounts No. if any If received. mravimtnl@gmail.

mravimtnl@gmail. 10. issued by RO SRO 17.com Page 35 . 5.. 8.canclled cheque 4. 7. If Pension is being drawn Under E. 1995 PPO No. Documents enclosed (Indicate as per the Instructions) 1.pass book 3.PF Ready Reckoner 16.P. 9. Written by M Ravi Shankar.death certificate 2.S. 6.

(Only in the case of illiterate Claimant (Pensioner) Left Hand Finger Impression). THUMB INDEX MIDDLE RING SMALL Signature Name of attesting Authority Official Seal: Place : Date : Certified that: (i) (ii) I am not drawing Pension under Employees Pension Scheme.P. 4. 6. 2. Remember to take 3 specimen signatures Signature of the applicant / Left hand Thumb Impression Written by M Ravi Shankar. 3. Name of the Member E. mravimtnl@gmail. Black mark on head signatures 2…………………………………………….com Page 36 . 1…………………………………………… 2…………………………………………… 3…………………………………………… 10.F. Specimen signature of Pensioner : 10.PF Ready Reckoner TO BE SUBMITTED IN DUPLICATE IN RESPECT OF EACH PERSON ELIGIBLE FOR PENSION Descriptive of Pensioner and his/her Specimen Signature/Thumb impression 1. 1995: The particulars given in this application are true and correct. 7. Account Number Name of the Pensioner Father/Husband name Sex Nationality Religion Height Personal Marks of Identification : : : : : : : : : DWARAK R JADHAV MH/18116/3103 SANJAY RAMESH MALE INDIAN BUDDHA Remember to take 3 5 specimen 1. 5. 5 9.

If there is no such period. Form of descriptive roll and specimen signature. 2. Documents as given in the Instructions. indicate „Nil‟ Year No. the block of 12 months will commence backwards from the last drawn) Year Month Wages Pension (1) 2007 (2) Jan Feb Mar April May June July August September Ocober November No of Days (3) 19 Amount (4) 2682 (5) Details of period of noncontributory service. the particulars of Wages and Pension Contribution for the period of 12 months preceeding the date of leaving service are as under :(In case. the wages is not earned for all 12 months.PF Ready Reckoner (TO BE FILLED IN BY THE EMPLOYER / AUTHORISED OFFICER OF THE ESTABLISHMENT) Certified that: (i) (ii) the particulars of the member are correct.of days for which no wages were earned (6) (7) 223 265 154 Fill the details as mentioned in Form 3/3A 22 15 3182 2097 08 09 19 18 14 16 03 1157 1302 2748 2598 2021 2310 433 139 108 216 168 192 36 ------23 days------------131 days-------- Encls: 1.com Page 37 . Signature of Employer/ Authorised Official of The Establishment with Seal & Date Written by M Ravi Shankar. mravimtnl@gmail.

may be generated through Computer.P.O Date A. P.S date A. The Input Data Sheet is placed below for approval. CLERK date S. Master Ledger Card/Claim Inward Register Form 2(R) enclosed along with the documents furnished by the claimant. CLERK date S.C date Hindustan Petroleum Corporation Limited Page 38 .A.F.P.O.F.S Date A.(FOR OFFICE USE ONLY) (PENSION SECTION / ACCOUNTS SECTION) Certified that the particulars in the application have been verified with the relevant concerned documents.A.O Date A. The claimant is eligible for Pension.O Date A.O.P.C date FOR USE IN PENSION PRE-AUDIT CELL The Input data sheet verified with reference to the application and the documents enclosed and found correct.F.A.P.S date A.P. Entered in Form 9/Form 3(PS).C(Pension) date FOR USE IN PENSION DISBURSEMENT SECTION P. No Date of issue to the Bank Intimation sent to the Claimant and also to Accounts Branch on CLERK date S.

2000) * The purchase with interest should be in thereon favour of member or member & spouse.2000) with interest thereon The purchase of dwelling flat 36 months wages No. dwelling site or dwelling OR house/flat or the house under Member‟s own construction is free from share of encumberances and the same is contribution + under the title of the member or Company‟s share the spouse (notification dated of Contribution 25. Hindustan Petroleum Corporation Limited Page 39 .31 A declaration from the member (Basic & DA) that.31 A declaration from the member (Basic+DA) that.31 A declaration from the member membership of the (Basic+DA) that. The Construction 5 Years of of House membership of the Fund Eligible Amount Form Documentary Support 24 months wages No. Company‟s share the spouse (notification dated 1000/-) of contribution 25. Company‟s share the spouse (notification dated 1000/-) of contribution 25. 5 Year of 36 months wages No.2. dwelling site or dwelling OR house/flat or the house under Members own construction is free from (Minimum balance share of encumberances and the same is in member‟s a/c contribution + under the title of the member or should be Rs.PF Ready Reckoner Withdrawal/Advances Withdrawals: Types of Benefit The purchase of site for construction of house Eligibility 5 Years of membership of the Fund (Minimum balance in member‟s a/c should be Rs.2. dwelling site or dwelling Fund OR house/flat or the house under Members own construction is free from (Minimum balance share of encumberances and the same is in member‟s a/c contribution + under the title of the member or should be Rs. 1000/-) * The purchase should be in favour of member or member & spouse.2.2000) * The purchase with interest should be in thereon favour of member or member & spouse.

31 A certificate from the Medical Practitioner for hospitalisation or operation. 68 J : ADVANCE FROM FUND FOR ILLNESS Types of Benefit Advance from the fund for illness viz. hospitalisation for more than a month. major surgical operation or suffering from TB. Cancer. Eligibility 7 years membership of the fund & minimum balance in member‟s account should be Rs. Paralysis.31 Declaration by the member which is attested by the employer. 1000/Eligible Amount Form 50% of member‟s own share of contribution Documentary Support No.PF Ready Reckoner Additions. Alterations or improvements to the dwelling house 5 years from the 12 months basic date of completion or members own of dwelling house share of contribution with thereon. Advance from the fund for education of Son/Daughter 68L : ADVANCE IN ABNORMAL CONDITIONS Hindustan Petroleum Corporation Limited Page 40 .31 A certificate from the + DA) lending authority OR furnishing the details of Members own share of loan and outstanding Contribution + amount. 68 K : ADVANCE FROM THE FUND FOR MARRIAGE Types of Benefit Advance from the fund for Marriage of self/son/daughter/ sister/brother etc. Company‟s share of Contribution with interest thereon. Body Eligible Amount Form Documentary Support 36 month wages (Basic No. Leprosy. Heart ailment etc. No. Eligibility Stay in Hospital at least for a month Eligible Amount 6 moths wages (Basic + DA) Form Documentary Support No.31 Advance: 68 BB : REPAYMENT OF LOAN Types of Benefit Advance from the fund for repayment of loan Eligibility 10 years membership of the fund & member should have taken loan from Govt.

physically handicapped equipment which ever is least.31 l Certificate from the Appropriate Authority. damage from Natural calamities etc. appropriate authority. 68 M : ADVANCE TO MEMBER AFFECTED BY CUT IN THE SUPPLY OF ELECTRICITY Types of Benefit Grant of advance to members affected by cut in the supply of electricity Eligibility The advance may be granted only to a member whose total wages for any one month commencing from the month of January 1973 were 3/4th or less than 3/4th of wages for a month Eligible Documentary Form Amount Support Wages No.31 Certificate from State for a Govt.31 Certificate from the Handicapped member certificate from a for six months Medical practitioner to for purchase of an competent medical or own share of the effect that the equipment required to practitioner to the contribution with member is physically minimize the hardship effect that he is interest or cost of handicapped.. Form Grant of advance in Certificate of abnormal conditions. Types of Benefit Eligibility Eligible Amount Form Form No 31 shall be filled for withdrawal or taking advance from EPFO for any of the above reasons.or 50% of member‟s own share of contribution (To apply within 4 months) Documentary Support No. on account of handicap.300/- 68 N : GRANT OF ADVANCE TO MEMBERS WHO ARE PHYSICALLY HANDICAPPED Documentary Support To Physically Production of medical Basic wages+ DA No. Rs. regarding cut in month the supply of OR electricity. An illustrative form 31 is provided below.PF Ready Reckoner Types of Benefit Eligibility Eligible Amount Rs. 5000/. Hindustan Petroleum Corporation Limited Page 41 .

indicate (i) in whose favour the cheque is to be drawn ( ii ) Full address :In other cases. 3. put a tick ( ) against any one of the following : (b) (c) By account payee cheque through the employer (to the address given against Sl. Certificates/documents in support of my application is/are furnished/enclosed. Post Office. R C Marg.A. 1000 TOTAL 7500 4. 8/604.1952 FORM NO 31 APPLICATION FOR ADVANCE FROM THE FUND : Amount of advance required Rs 50. Om ganesh Nagar. (d) I declare that the above particulars are true to the best of my knowledge and I will abide by the conditions governing the grant of advance under the Scheme. Mahul. *I declare that the advance is required to meet the expenses in connection with my marriage / marriage of my son/daughter/brother/sister. By deposit in bank account no. Shri/Kumari Ms Lakshmi (Name) 21 (aged) to be celebrated on 10 Aug 2012 (date) at address 8/604. No. Indira Nagar. Full postal address of the member to which payment/intimation to be sent D.PF Ready Reckoner EMPLOYEES’ PROVIDENT FUNDS SCHEME. 2. No. PC Lane. Indira Nagar. Mumbai : PH/18116/05 : BASIC 6500 6. (a) MODE OF REMITTANCE : In case of advance for purchase of site/house/flat or construction through an ‘agency’-or repayment of housing loan. Govandi PIN:400074 7. Govandi. Chmebur. Sainath seva Mandal Vaisnaka. Name in full ( in block letters) Father’s/Husband’s Name Name of the factory/establishment in which employed and address Provident Fund Account No.000/-In Words fifty Purpose for which advance is thousand only Required: Marriage of Daughter 1. PC Lane.3. Date : Station : Signature/left /Right/hand thumb impression of the member Remember to take signature of * Delete if the advance applied for is not for marriage employee Hindustan Petroleum Corporation Limited Page 42 . Mumbai By money order at my cost to the address given against SL.31000059765(Name of the Bank) State Bank India located Govandi (Full postal address) opp Nr. Chembur. 5. 6. Monthly basic wages and DA : Raman Shelke : Laxman Shelke : ABC Company.

* (To be filled in by the EPF Office) Affix Re. to A. sign of Certified that the application has been signed by the member in my presence after he/she had read the employer contents/ the contents have been explained to him/her by me and that the information given in the application is correct. Date_______________ Designation of the signing official with Stamp of the Factory/establishment Encls.PF Ready Reckoner ADVANCE STAMPED RECEIPT [ To be furnished with reference to 7(a) or (b) or (c) above only] Received a sum of Rs. or member CBT/ Regional Committee. 7 ) M.P. Commission.L.O. Fifty thousand (Only) from the Regional Provident Fund Commissioner/Officer in –charge of Sub-Regional Office/Sub-Accounts Office. FOR USE IN CASH SECTION Paid by inclusion in Cheque No.____________________________________________________ Clerk Section Supervisor Assistant Commissioner REMARKS Hindustan Petroleum Corporation Limited Page 43 .______________ Rupees ________________________________________only Mode of remittance ( Refer S.A. 1/Revenue Stamp Signature of the member [ TO BE FURNISHED BY THE EMPLOYER] During closure/lock out of the factory/establishment by any Gazetted Officer or the Chief Executive/ Head of a local authority or M. 1 debit item No. A.l. Employees‟ ProvidentFund towards the grant of advance from my Employees‟ Provident Fund Account maintained by him.C._________________________________dated the ______________vide Cash Book Account No.F.O.C.:________________________ Signature of the employer or an authorised official of the factory/establishment FOR USE IN PROVIDENT FUND COMMISSIONER’S OFFICE Section _____________________________________ Account No.____________________ ( AUTHORITY FOR PAYMENT OF ADVANCE UNDER PARA 68 ) Passed for payment of Rs./A. if any Net amount to be paid by money order P. Required certificate(s) is/are enclosed.A. EPF.A. No.F. or M.O.No./A.P. Clerk : Section Supervisor Vide payment scroll P.P.C.

HOUSING BOARD.Approved Plan.While claiming the second and subsequent installments. “ Agency” referred to in 1 to 3 would above mean.estimated cost of construction. original title deed of the house ( for verification ). a Trust.) Hindustan Petroleum Corporation Limited Page 44 . MUNICIPAL CORPORATION OR A BODY SIMILAR TO DELHI DEVELOPMENT AUTHORITY. non-encumbrance certificate.PF Ready Reckoner INSTRUCTIONS A MEMBER OF THE FUND MAY AVAIL THE FOLLOWING WITHDRAWALS/ADVANCE 1. a certificate from the appropriate authority specifying the date of completion of the house). estimate of the work. ALTERATIONS OR IMPROVEMENT TO THE HOUSE OWNED BY MEMBER OR BY SPOUSE OR JOINTLY MEMBER AND SPOUSE: (Approval of the appropriate authority. 5. 4. REPAYMENT OF HOUSING TO LOAN TO STATE GOVT. PURCHASE OF DWELLING HOUSE/FLAT : ( From An “Agency”Original Allotment Order ) From an individual : Original title deed for (verification and return).non-encumbrance certificate . FOR THE REASONS OTHER THAN STRIKE : ( Furnish the Certificate “A” given overleaf ) NON RECEIPTS ON WAGES FOR 2 MONTHS FOR REASON OTHER THAN STRIKE: (Furnish Certificate “B” given overleaf. Note :. a Co-operative Society. a local body or a Housing Finance Corporation. direct to the “ Agency” concerned. an Institution. In case of Transactions through an agency the payment will be made only by Account payee cheque. the declaration/certificate as required by the Commissioner in his letter sanctioning the advance should be submitted along with the application. Central/ State Government. non -encumbrance certificate ( for verification and return ) agreement with the seller.: ( A certificate from the lending authority furnishing the details of loan and outstanding amount). 2. ADDITIONS. ON ATTAINMENT OF AGE OF 54 YEARS OR WITHIN ONE YEAR BEFORE RETIREMENT : (Date of birth/age of the member and due date of retirement should be furnished by the employer) CLOSURE /LOCKOUT OF THE FACTORY/ ESTABLISHMENT. CONSTRUCTION OF A HOUSE : Original Title Deed (for Verification and Return ). agreement with the seller. 3. PURCHASE OF A DWELLING SITE : ( From an “Agency” Original allotment order) From an individual : Original Title deed. non-encumbrance certificate .

4. 1.P./Smt. “In case the advance granted for the purpose at SL. AFFECTED BY CUT IN ELECTRICITY : ( Furnish the Certicate “E” given overleaf ) PURCHASE OF EQUIPMENT FOR PHYSICALLY HANDICAPPED MEMBERS : Furnish the Certificate “F” given overleaf NOTE :Such other documents.) ILLNESS OF MEMBER/FAMILY MEMBER : (Furnish Certificate “C” given overleaf.C. 2.PF Ready Reckoner DISCHARGE OR DIMISSAL OR RETRENCHMENT ARE CHALLENGED BY THE MEMBER-THE CASE IS PENDING IN THE COURT OF LAW ( A copy of the petition filed by the member in the court of law and certificate from the advocate that the case is pending in the Court of Law. should be furnished./officer in charge of SubRegional office. Signature of the Employer /Authorised Official With date & seal Hindustan Petroleum Corporation Limited Page 45 . through the establishment. Certified that no compensation was not paid to the member Sh/. NO. In case no intimation received within a month. Smt. 3. as may be required by the sanctioning authority are also required to be furnished.e. Signature of the Employer /Authorised Official With date & seal CERTIFICATE – B NON RECEIPTS ON WAGES FOR 2 MONTHS FOR REASON OTHER THAN STRIKE Certified that the member Sh.______________________________________has not received his wages for a continuous period 2 months or more i. In case of misuse of the advance granted for marriage the amount of advance will be recovered with penal interest.F. from _____________to_____________________for reasons other than strike.______________________________________________________for the period of Lock Out/Closure. Certificate etc. please write to R. CERTIFICATE – A CLOSURE /LOCKOUT OF THE FACTORY/ ESTABLISHMENT FOR THE REASONS OTHER THAN STRIKE Certified that the establishment has been closed down/locked up for reasons other than strike. 1 to 3 above is misused the amount of the advance granted will be recovered with penal interest and no further advance under the paragraph shall be granted for a period of three years from the date of grant of said advance.) MARRIAGE OF SELF/SON/DAUGHTER/SISTER BROTHER : ( Furnish a declaration in Form 31 ) POST MATRICULATION EDUCATION OF SON/DAUGHTER : ( Certificate from the institution regarding the course of study and anticipated expenditure ) DAMAGE TO THE PROPERTY DUE TO NATURAL CALAMITY(FLOOD/RIOT/EARTH QUAKE) : (Furnish the Certificate “D” given overleaf.

S.I.T. Signature of the Employer/ Authorised Official With date & seal MEDICAL CERTIFICATE TO BE ISSUED :1. /Regional Committee with seal and date CERTIFICATE . and date _________________ Signature of Employer/Revenue official/Gazetted Officer/ M. ( nature of handicap)_________________________ costing about Rs. ___________________________ has/ had been granted leave for a period of_______________________ from _____________to _________________ The E. Medical Practitioner._______________to minimise the hardship on account of handicap. 3.B/ Leprosy/ Paralysis or cancer By a Doctor of Govt. In case of Treatment of T./Smt.S.B./Private Hospital E. Certified that Shri/Smt. In case of major surgical operation or where the Hospitalisation for one month or more had or has become necessary the Doctor of the Govt. III. (Certificate from E./Kumari______________________S/o. *Delete if not applicable CERTIFICATE .______________________The State Govt.P./M./ Smt./ Private Hospital .D Signature of Doctor with dated Seal DAMAGE TO THE PROPERTY DUE TO NATURAL CALAMITY(FLOOD/RIOT/EARTH QUAKE) Certified that the movable/immovable property of Sh. has declared that calamity has effected the general public in the area in which the property of the member is/was located vide Notification/press release no. Certified ( i ) The member Sh.S.A. The estimated loss of property due to calamity is valued at Rs.PF Ready Reckoner CERTIFICATE – C ILLNESS OF MEMBER/FAMILY MEMBER I. In case of Treatment of heart ailment or mental derangement: By a specialist Doctor.I./or by a Regd. enclosed ) II. is suffering from T.L. is suffering from ____________________________________( disease)for which a major surgical operation /and hospitalisation for a period of ____________________day from ___________to___________________________has or had become necessary./Kumari______________________is due to power cut Signature of Employer/authorised official with dated seal CERTIFICATE – F PURCHASE OF EQUIPMENT FOR PHYSICALLY HANDICAPPED MEMBERS Medical Certificate from a competent Medical practitioner: Certified that Sh./Member of C.E CUT IN ELECTRICITY Certified that the fall in wages amounting to 25% more than 25% of wages in respect of Sh. facilities/Cash benefits are not actually available to the member/ the member has ceased to be eligible for cash benefits under E./Leprosy/Paralysis/Cancer/Mental Derangement/Heart ailment. Signature of the Doctor with Date and Seal Hindustan Petroleum Corporation Limited Page 46 .B.I. E. 2.D/o____________________________ I.S.S. is suffering from _____________________________and hospitalisation for a period of ________days from ________________________ to _____________________had or has become necessary._____________________________ situated at_______________________has been damaged due to ____________________________on date_______________________. II.I./Kumari__________________________________S/o/W/o/D/o____________________________is physically handicapped viz_____________________and requires the equipment viz./Smt .I.W/o.

PF Ready Reckoner Hindustan Petroleum Corporation Limited Page 47 .