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Joint Declaration Form

This document is a joint declaration from an employee and employer to the Regional Provident Fund Commissioner regarding corrections to the employee's PF/EPS account details. It provides the employee's name, father/husband's name, account number, date of birth, date of joining, date of leaving, gender, and title (Mr/Mrs/Ms). It also encloses an attested copy of the employee's ID proof for reference. The declaration requests the Commissioner to make any necessary changes to their records based on the correct details provided and notify the applicant of such changes.

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Hari Gopala
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2K views1 page

Joint Declaration Form

This document is a joint declaration from an employee and employer to the Regional Provident Fund Commissioner regarding corrections to the employee's PF/EPS account details. It provides the employee's name, father/husband's name, account number, date of birth, date of joining, date of leaving, gender, and title (Mr/Mrs/Ms). It also encloses an attested copy of the employee's ID proof for reference. The declaration requests the Commissioner to make any necessary changes to their records based on the correct details provided and notify the applicant of such changes.

Uploaded by

Hari Gopala
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Joint Declaration By the Member and The Employer

Date:

To

The Regional P F Commissioner,

No: 37, Royapettah High Road, Chennai – 600 014.

Sub: Joint declaration by the member and the employer

Dear Sir/ Madam,

I, am/ was an employee / ex employee of

furnishing below herewith correct details with

aforesaid establishment:-

Particulars Correct Particulars Wrong Particulars

Name

Father/ Husband Name

PF / EPS Account No.

Date of Birth (DD/MM/YYYY)

Date of Joining (DD/MM/YYYY)

Date of Leaving (DD/MM/YYYY)

Gender

Mr/Mrs/Ms

I am also enclosing herewith attested by authorized signatory, a copy of ID proof (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 :

Signature with Establishment Seal :

Encl.: As Above

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