Employee ID: 2105610

Form 9 (Revised)
THE EMPLOYEES' PROVIDENT FUNDS SCHEME, 1952 (Paragraph 34)
AND
THE EMPLOYEES' PENSION SCHEME, 1995 (Paragraph 24)
Declaration by a person taking up employment in an establishment in which the Employees'
Provident Funds & Employees' Pension Scheme enforce

I, Muthukumaran S Son of Sh. Sivasubramanian Muthukumaran do hereby solemnly declare that:

(a) I was employed with Excel power switchgear Pvt Ltd, 286-1a, vazhuthalambedu main road thirumudivakkam
600044 with PF A/c Number TB/TAM/0060947000/000/0191 and left service on 16-Oct-2021 prior to that, I was employed in
null, null with PF A/c Number null from null to null.

(b) I am a member of the Pension Fund from 20-Nov-2014 to 16-Oct-2021 .

(c) I have not withdrawn the amount of my Provident Fund.

(d) I have not withdrawn the amount of my Pension Fund.

(e) I have not drawn any benefits under the Employees? Pension Scheme, 1995 in respect of my past service in any
establishment.

(j) I have not contributed to the social security programme in NA from NA to NA, which has not entered into a Social
Security Agreement with India.

(g) Do you have a Universal Account Number (UAN): Yes

Universal Account Number Aadhar NPR PAN

100689942502 520593085379 NA CYXPM1428D

(h) Bank Account Number Linked with UAN : Link UAN with TCS Salary Account

Bank Account Number IFSC Code

NA NA

Date : _____________________ Signature of employee

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(To be filled by the employer)

1) Shri/Smt/Kumari Muthukumaran S is appointed as ITA in Tata Consultancy Services Limited, with effect from 25-Oct-
2021 bearing Provident Fund Account Number: MH/BAN/48475/2105610
2) Declaration & Nomination in Form 2 is enclosed.

23-Nov-2021 Page 1 of 2
 Tata Consultancy Services Limited
10th Floor, Air India Building, Nariman Point,
Mumbai ? 400 021.

23-Nov-2021 Page 2 of 2