Date:To,

The Regional PF Commissioner.

EMPLOYEE PROVIDENT FUND OFFICE
K R Puram, Bengaluru 560036.

Sub: Request for correction in the details of the employee / member.

Sir,
I, Mr. an employee/ex-employee of M/s. Tann Utility Services Pvt, Ltd., (Est, Id: )
wish to inform that the following is/are not correctly mentioned in the PF records and hence request you to
correct the same as furnished here under.

EPF Code: UAN No:

PARTICULARS AS PER PF RECORD TO BE CORRECTED AS
Name

Father’s /Spouse Name

UAN

PF / EPS Account No.

Date of Birth (DD/MM/YYYY)

Date of Joining (DD/MM/YYYY)

Date of leaving (DD/MM/YYYY)

Exit Reason
Aadhar Number

I am also enclosing herewith attested copy of ID proof (Any one PAN card/ Voters Identity Card/ Passport/
Driving License/School Certificate/Birth Certificate/Passport/ Aadhar Card/ medical Certificate from District
Civil Surgeon authorised by the competent authority concerned/ Wage register at the time of joining, etc) for
your ready reference. The documents are enclosed as per the Annexure-A.

“I hereby give my consent to share my Aadhar details/ Aadhar based authentication for the purpose of
establishing my identity and seeding it with UAN”.

All the documents (Xerox) enclosed are signed by me and attested by the employer.
Yours faithfully,

NAME AND SIGNATURE OF THE APPLICANT

Mobile no:

Certified that the above information is correct, and request as made by the applicant may please be accept
and necessary changes in your records may be made. We regret for the inconvenience caused, if any, in
this regard.

Encl: As above
Authorised Signatory
Seal and Signature