Date (DD-MM-YYYY):

To,
Manager,
E-tax Payments Operations,
HSBC India

Sub: Request letter for Providend Fund e-Payment

Dear Sir,

We request and authorize you to effect the electronic payment of our Providend Fund as per details
mentioned below:

Permanent Account Number (PAN)*

EPFO User ID*
EPFO Password*
Temporary Return Reference Number (TRRN)*
Wage Month (MM/YYYY)*
Total Amount*

Amount in Words*
(Note: All fields marked with * are mandatory)

To effect this payment please debit our account number

Thanking You,

(Signature & Name of Authorised Signatory)

For

(Company Name & Seal)

FF0000|PUBLIC|
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 _________________

ctronic payment of our Providend Fund as per details

FF0000|PUBLIC|
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