Please attach

recent passport
size photograph
ONBOARDING FORM
(Please fill all the details in
block letters)

Personal Details

Name as per Aadhaar: Devashish Kanade

Father's Name: Bhagwanji Kanade
Mother's Name: Kala Kanade
Gender: Male
Date of Birth(DD/MMIYYYY): 6/4/2000
Marital Status: Single :ed

Religion:

63
Adrash Nagar
Permanent Address:
Lal Chouki
Khandwa Madhya Pradesh 450001

Personal Email id: \

devashishkanade8@gmail.com �
Mobile No: 9111393256\ \
Alternate No: 8770912209\
Emergency Contact Details
\ J
Emergency Contact No: 8770912209 \ I
Emergency Contact Person: Chetan Kanade \ ___/
--�
Relationship: Sibling \.--
DECLARATION:

I, declare that the information given, herein above, is true & correct to the best of my knowledge & belief & nothing has
been concealed. I understand that if the above information is found to be false or incorrect, at any time during the course
of my employment, my services will be terminated, forthwith without any notice or compensation.

Place:
Date: Signature:

Devashish Kanade (Jan 25, 2022 11:29 GMT+5.5)

 www.epfindia.gov.in
Composite Declaration Form-11
(To be retained by the employer for future reference)
EMPLOYEES’ PROVIDENT FUND ORGANISATION
Employees’ Provident Funds Scheme, 1952 (Paragraph 34 & 57) &
Employees’ Pension Scheme, 1995 (Paragraph 24)
(Declaration by a person taking up employment in any establishment on which EPF Scheme, 1952 and / or EPS, 1995 is applicable)

1 Name Devashish Kanade

Father's Name Bhagwanji Kanade
2
Spouse's Name
3 Date of Birth :(DD/MM/YYYY) 6/4/2000
4 Gender :(Male/Female/Transgender) Male
Marital Status
5 Single
:(Married/Unmarried/Widow/Divorcee)
(a) Qualification : BBA
6 (b) Email ID :
(c) Mobile No : 9111393256
Present employment details:
7 Date of joining in the current 25/01/2022
establishment(DD/MM/YYYY)
KYC Details: (attach self-attested copies of following KYC's)
a) Bank Account No. : 20480612303
IFSC Code of the branch : SBIN0012159
8 Employee Name as per Bank : DEVASHISH KANADE
b) AADHAR Number 651100870558
Employee Name as per Aadhar : Devashish Kanade
c) Permanent Account Number (PAN), if available HFVPK6035J
Employee Name as per PAN :
Whether earlier a member of Employee’s Provident
9
Fund Scheme, 1952 No
Whether earlier a member of employee’s Pension
10
Scheme, 1995
No
Previous employment details: [if Yes to 9 AND/OR 10 above] -- Un-exempted

Establishment Universal EPF Account Date of Date of Whether Scheme PPO Non
Name & Account Number Joining : Exit Withdrawn Certificate Number Contributory
Address Number (DD/MM/ :(DD/MM/ EPF & EPS No. (if issued) (if issued) Period (NCP)
YYYY) YYYY) Amount Days

11

Previous employment details: [if Yes to 9 AND/OR 10 above] – For Exempted Trusts

Name & Address Member EPS A/c Date of Date of Exit Whether Scheme Non
of the Trust UAN Number Joining (DD/MM/Y Withdrawn PF Certificate Contributory
(DD/MM/Y YYY) Amount No. (if issued) Period (NCP)
YYY) Days
12

13 a) International Worker No
b) If Yes, state country of origin (India / Name of the Country
c) Passport No.
d) Validity of Passport [(DD/MM/YYYY) to (DD/MM/YYYY)]

Devashish Kanade (Jan 25, 2022 11:29 GMT+5.5)

 UNDERTAKING

1.Certified that the particulars are true to the best of my knowledge.

2.I authorize EPFO to use my Adhar for verification/authentication/e-KYC purpose for service delivery.
3.Kindly transfer the funds and service details, if applicable, from the previous PF account as declared above to the
present P.F. Account as I am Aadhar verified employee in my previous PF Account.
4.In case of changes in above details, the same will be intimated to employer at the earliest.

Date : Signature of Member

Place :
Devashish Kanade
DECLARATION BY PRESENT EMPLOYER

Devashish Kanade 25/01/2022

A. The member Mr/Ms/Mrs ………………………………………………………. has joined on …………………………………. and has been
allotted PF No. ……………………………………………………………..and UAN…………………………………………………………………………..

B. In case the person was earlier not a member of EPF Scheme, 1952 and EPS, 1995:

• Please Tick the Appropriate Option:

The KYC details of the above member in the UAN database
Have not been uploaded
Have been uploaded but not approved
Have been uploaded and approved with DSC/e-Sign
C. In case the person was earlier not a member of EPF Scheme, 1952 and EPS, 1995:

• Please Tick the Appropriate Option:

The KYC details of the above member in the UAN database have been approved with E-
Sign/Digital Signature Certificate and tranfer request has been genereated on portal.

The previous Account of the member is not Aadhar Verified and hence physical trasnfer form
shall be intiatied.

Date : Signature of Employer with Seal of the

Establishment

*Auto transfer of previous PF account would be possible in respect of Aadhar verified employees only. Other employees
are requested to file physical claim (Form-13) for transfer of account from the previous establishment.

Devashish Kanade (Jan 25, 2022 11:29 GMT+5.5)

Devashish Kanade (Jan 25, 2022 11:29 GMT+5.5)
Devashish Kanade (Jan 25, 2022 11:29 GMT+5.5)
Devashish Kanade (Jan 25, 2022 11:29 GMT+5.5)
 नामांकन म/ Enrolment No.: 2090/71443/64595
To
देवािशष कानड़े
Devashish Kanade
S/O: Bhagwan Ji Kanade
63 adrsh nagar lal choki moght marg khandwa
khandwa
Khandwa
East Nimar Madhya Pradesh - 450001
9424025971

Signature Not Verified

Digitally signed by DS
UNIQUE IDENTIFICATION
AUTHORITY OF INDIA 04
Date: 2022.01.23 14:24:20
UTC

6511 0087 0558

VID : 9 1 7 5 9 7 8 4 8 2 5 0 1 3 9 2

पता:
देवािशष कानड़े S/O: भगवान जी कानडे, 63 आदश नगर लाल चोकी
Download Date: 23/01/2022

Devashish Kanade मोघट माग ख डवा, ख डवा, ख डवा, ई ट िनमाड,

Issue Date: 24/02/2013

ज म ितिथ/DOB: 06/04/2000 म य पदेश - 450001

पु ष/ MALE Addr ess:
S/O: Bhagwan Ji Kanade, 63 adrsh nagar lal
choki moght marg khandwa, khandwa,
Khandwa, East Nimar,
Madhya Pradesh - 450001

6511 0087 0558 6511 0087 0558

VID : 9 1 7 5 9 7 8 4 8 2 5 0 1 3 9 2 VID : 9 1 7 5 9 7 8 4 8 2 5 0 1 3 9 2

Devashish Kanade (Jan 25, 2022 11:29 GMT+5.5)

Devashish Kanade (Jan 25, 2022 11:29 GMT+5.5)
Devashish Kanade (Jan 25, 2022 11:29 GMT+5.5)
Devashish Kanade (Jan 25, 2022 11:29 GMT+5.5)
Devashish Kanade (Jan 25, 2022 11:29 GMT+5.5)
Devashish Kanade (Jan 25, 2022 11:29 GMT+5.5)
Devashish Kanade (Jan 25, 2022 11:29 GMT+5.5)
Devashish Kanade (Jan 25, 2022 11:29 GMT+5.5)
Byjus Onboarding Document_devashishkanade
8@gmail.com_ 25th January 2022 (Alka Mishra)
Final Audit Report 2022-01-25

Created: 2022-01-25

By: Onboarding Team (onboarding@byjus.com)

Status: Signed

Transaction ID: CBJCHBCAABAAighu5fDbYjf7lzIr5pbZ9VcTEMdh5m37

"Byjus Onboarding Document_devashishkanade8@gmail.com_

25th January 2022 (Alka Mishra)" History
Document created by Onboarding Team (onboarding@byjus.com)
2022-01-25 - 5:18:19 AM GMT- IP address: 106.222.141.17

Document emailed to Devashish Kanade (devashishkanade8@gmail.com) for signature

2022-01-25 - 5:20:06 AM GMT

Email viewed by Devashish Kanade (devashishkanade8@gmail.com)

2022-01-25 - 5:30:04 AM GMT- IP address: 66.249.84.48

Document e-signed by Devashish Kanade (devashishkanade8@gmail.com)

Signature Date: 2022-01-25 - 5:59:42 AM GMT - Time Source: server- IP address: 106.208.178.171

Agreement completed.
2022-01-25 - 5:59:42 AM GMT