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  • Death Claim Check List

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    Anand Khot
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    This document outlines 14 check points for a Form 10D, which is used to process pension claims. It lists requirements such as UAN and PF account numbers, claim forms attested by the employer, bank account details, passport photos attested by the employer, family member details attested by the employer, wage statements, declarations for name or date of birth changes, an employer undertaking, original scheme certificates, non-employment and non-pension declarations, and other service record forms. It specifies that if the establishment is closed, documents should be attested by a bank manager, postmaster, gazetted officer, MP, or MLA where the claimant has a bank account.

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    DEATH CLAIM CHECK LIST

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    This document outlines 14 check points for a Form 10D, which is used to process pension claims. It lists requirements such as UAN and PF account numbers, claim forms attested by the employer, bank account details, passport photos attested by the employer, family member details attested by the employer, wage statements, declarations for name or date of birth changes, an employer undertaking, original scheme certificates, non-employment and non-pension declarations, and other service record forms. It specifies that if the establishment is closed, documents should be attested by a bank manager, postmaster, gazetted officer, MP, or MLA where the claimant has a bank account.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    75 views1 page

    Death Claim Check List

    Uploaded by

    Anand Khot
    This document outlines 14 check points for a Form 10D, which is used to process pension claims. It lists requirements such as UAN and PF account numbers, claim forms attested by the employer, bank account details, passport photos attested by the employer, family member details attested by the employer, wage statements, declarations for name or date of birth changes, an employer undertaking, original scheme certificates, non-employment and non-pension declarations, and other service record forms. It specifies that if the establishment is closed, documents should be attested by a bank manager, postmaster, gazetted officer, MP, or MLA where the claimant has a bank account.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    GROUP NO :.

    KD/NSK/ I
    FORM l0 D CHECKINC POINTS F

    1) UAN & PF A/C NO.


    2) CTAIM & DESCRIPTIVE ROTL (lN DUPI.ICATE} TO BE ATTESTED BY EMPLOYER WITH
    ESTABLSHMINT SEAL.
    3l BANK ACCOUNT SHOULD BE ANY ON€ OF THE FOLIOW|NG BANKS r
    A) STATE BANX OF INDIA.
    B) PUNJAS NATIONAL BANK,
    c) BANK OF rNDtA.
    D) AX|S BANK,
    E) HDFC BANX LTD.
    F) rcrct BANX LTD.

    4) THREE PASSPORT SIZE IOINT PHOTO SHOUI.D BE ATTESTED BY EMPLOYER wlTH SEAL.

    5) XEROX COPY OF SCHOOL LEAVING CERTIFIATE AND AADHAR CARD COPY OF MEMBER,

    6) TAMILY MEMBERS PARTICULARS WITH AGE PROOF OULY ATTESTED BY EMPI.OYER I.T. SCHOOL

    I.EAVING CERTITICATE & AADHAR CARO DOCUMENTS.

    7l DAYWISE/MONTHwlSE/YEARWISE BRAEX STATEMENT SY EMPLOYER .

    8) lF ANY NAME OR DATE OF BIRTH CHANGE r JOINI DECLARATTON Sy MEMBER AND EMPIOYER

    WITH SUPPORTING DOCUMENTS.

    9 } UNDERTAKING BY EMPLOYERTHAT ESTABLISHMENT IS FULLY RESPOINSIBI.E FORANYWRONG

    OR OVERPAYMENT DUETO INCORRECT FURNISHING OF DATE OF BIRTH OFTHE MEMBER.

    !0) oRIGINALSCHEMECERTTFTCATE.

    11) NoN EMptoyEMENT & NoN GETTTNG pENStoN UNDER Eps -9s- owN DEcrARATtoN.
    12) FoRM 5/ 10, Form 4/ 5 pS 13) FORM 3 A,7 pS (1995/1996 & last Fiveyears),

    14) TerminalBenelit Certiricate & Retention Allowances Certifi.ate (lfany)From Employer

    AS PER SYSTEM AS PER FOR]II


    NANt I
    D.O.B
    D.O.J

    Form 10 D & all other supporting Xerox documents should be attested through the employer
    or.omptitant authorityor authorized signature.

    lf the ESTTAB|ISHMENT is closed then required all Xerox documentr and all lorms should be
    attested THROUGH BANK MANAGER where claimant having Bank Account Or Post
    Master Or Any Gazetted Officer Or Any M.P. Or Any M.L.A..

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