Joint Declaration By the Member and The Employer

Date: 18.11.2020

To

The Regional PF Commissioner

Royapettah

Sub: Joint declaration by the member and the employer

Dear Sir,

I, Ranjith am/ was an employee / ex employee of

Xeniaa Hospitality Private Limited furnishing below herewith correct details with

aforesaid establishment:

Particulars Correct Wrong

Name RANJITH BABU

Father/ Husband Name BABU C

PF / UAN Account No. 101127021978

Date of Birth (DD/MM/YYYY) 10/07/1996

Date of joining (DD/MM/YYYY) 01/03/2019 01/02/2019

Date of leaving (DD/MM/YYYY) 31/05/2020

I am also enclosing herewith self attested copy of ID proof (Any one PAN card/ Voters’ Identity Card/
Passport/ Driving License/Aadhar Card) for your ready reference.
Therefore, you are requested to make necessary changes in your records (if required) under intimation to
me. An early action in this regard will be highly appreciated.

Yours Faithfully

Name & Signature of Applicant :

Name of Authorized Signatory : B P Vignesh

Signature with Establishment Seal :

Encl.: As Above