Joint Declaration of EPF by the Member & Employer

Date:
To
The Regional PF Commissioner,
No.13, Bhavishya Nidhi Bhavan,
Raja Ram Mohan Roy Road,
Bengaluru – 560 025

Subject: Joint Declaration by the Member & Employer

Dear Sir,
I, ………………………………….., an employee of Karnataka State Tourism Development Corporation,
Yeshwanthpura, Bangalore, furnishing below herewith correct details with aforesaid establishment:-

Establishment Code: ……………………………

Particulars Correct Wrong Entry in my A/C

Name
Father/Husband Name
EPF/EPS Account No.
UAN Number
Date of Birth (DD/MM/YYYY)
Date of Joining (DD/MM/YYYY)
Education Qualification

I also have enclosed herewith the self attested copy of ID proof (Any one- PAN Card, Voter ID Card, Passport,
Driving License, Adhaar Card) for your ready reference.

Therefore, you are requested to make the necessary changes in your records (if required) under information to me.
An early action in this regard will be highly appreciated.
Encl.: As above

Yours faithfully,

Name & Signature of the applicant:

Signature of with Establishment Seal: