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  • Form 3 A

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    Yogesh Devkare
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    This document is a contribution card for an employee of Vasantdada Shetkari Sahakari Sakhar Karkhan Ltd Sangli for the period of April 2004 to March 2005. It details the employee's name, account number, monthly wages, and provident fund contributions from both the employee and employer that have been remitted in full each month. It also notes that in November 2005, the employee left the organization due to resignation.

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    (Form-3-A)

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    This document is a contribution card for an employee of Vasantdada Shetkari Sahakari Sakhar Karkhan Ltd Sangli for the period of April 2004 to March 2005. It details the employee's name, account number, monthly wages, and provident fund contributions from both the employee and employer that have been remitted in full each month. It also notes that in November 2005, the employee left the organization due to resignation.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    3 views7 pages

    Form 3 A

    Uploaded by

    Yogesh Devkare
    This document is a contribution card for an employee of Vasantdada Shetkari Sahakari Sakhar Karkhan Ltd Sangli for the period of April 2004 to March 2005. It details the employee's name, account number, monthly wages, and provident fund contributions from both the employee and employer that have been remitted in full each month. It also notes that in November 2005, the employee left the organization due to resignation.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 7

    FORM - 3A

    (Unexempted Establishment Only)


    THE EMPLOYEE'S PROVIDENT FUND SCHEME, 1952
    (Paras 35 and 42) and
    THE EMPLOYEES PENSION SCHEME, 1995
    Para 20
    Contribution Card for the currency period from April 2004 to March 2005
    --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
    1. Account No. MH3746/2980 5. Statutoty Rate of Contribution : 12%
    UAN NO. 101696614009 6. Voluntary higher rate of Employees
    2. Name/Surname: PRAKASH MADHUKAR PATIL contribution, if any
    3. Father/Husband's Name: MADHUKAR
    4. Name & Address of the Establishment :
    VASANTDADA SHETKARI SAHAKARI SAKHAR KARKHAN LTD SANGLI
    SANGLI-MADHAVNAGAR ROAD
    SANGLI-416416
    Month Amount of CONTRIBUTIONS Refund of Non cont. Remarks
    Wages Worker's Share Employer Share Advances services
    Rs. from
    EPF EPF EPS TOTAL ---------
    a b c To---------
    1 2 3 4 5 6 7
    a) Date of Leaving service
    April 2004 6500 780 541 239 780 11/26/2005
    May 2004 6500 780 541 239 780
    June 2004 6500 780 541 239 780 b) Reason for leaving service
    July 2004 6500 780 541 239 780 Resignation
    August 2004 0 0 0 0 0 c) Certified that the total amount of
    September 2004 0 0 0 0 0 contribution indicated in this card

    October 2004 0 0 0 0 0 i.e. Rs.


    November 2004 0 0 0 0 0
    December 2004 0 0 0 0 0 Col 3+Col4 ( c ) has already been
    January 2005 0 0 0 0 0 remitted in full in EPF A/c No 1
    February 2005 0 0 0 0 0 ( Provident Fund contribution A/c)
    and in A/c no. 10 ( Pension
    March 2005 0 0 0 0 0 Fund Contribution account vide
    0 0 0 0 note below )
    26000 3120 2166 954 3120

    Certified That the difference between the total of the contribution shown under the columns (3) & (4)
    of the above table and that arrived at on the total Wages shown in Column (2) at the Prescribed rate
    is solely due to the rounding off of the contributions to the nearest rupee under the rule.

    Signature of Employer
    Date : (Office Seal)

    Note: 1 ) In respect of the Form (3A) sent to the Regional office during the course of the currency
    period for the purpose of final settlement of the accounts of the members who had left service
    details of date and reasons for leaving service and also certificate as shown in the Remarks
    Column should be added.
    Note: 2 ) If there is no period of NCS, the word "NIL" to be mentioned against the total column.
    Note: 3 ) Wherever no wages are shown against any month the period should be shown as NCS
    Under Col. 6.
    FORM - 3A
    (Unexempted Establishment Only)
    THE EMPLOYEE'S PROVIDENT FUND SCHEME, 1952
    (Paras 35 and 42) and
    THE EMPLOYEES PENSION SCHEME, 1995
    Para 20
    Contribution Card for the currency period from April 2003 to March 2004
    ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
    1. Account No. MH3746/2980 5. Statutoty Rate of Contribution : 12%
    UAN NO. 101696614009 6. Voluntary higher rate of Employees
    2. Name/Surname: PRAKASH MADHUKAR PATIL contribution, if any
    3. Father/Husband's Name: MADHUKAR
    4. Name & Address of the Establishment :
    VASANTDADA SHETKARI SAHAKARI SAKHAR KARKHAN LTD SANGLI
    SANGLI-MADHAVNAGAR ROAD
    SANGLI-416416
    Month Amount of CONTRIBUTIONS Refund of Non cont. Remarks
    Wages Worker's Share Employer Share Advances services
    Rs. from
    EPF EPF EPS TOTAL ---------
    a b c To---------
    1 2 3 4 5 6 7
    a) Date of Leaving service
    April 2003 6416 770 534 235 770 11/26/2005
    May 2003 6300 756 525 231 756
    June 2003 6500 780 541 239 780 b) Reason for leaving service
    July 2003 6500 780 541 239 780 Resignation
    August 2003 6500 780 541 239 780 c) Certified that the total amount of
    contribution indicated in this card
    September 2003 1729 207 144 63 207
    October 2003 6206 745 517 228 745 i.e. Rs.
    November 2003 6500 780 541 239 780
    December 2003 6500 780 541 239 780 Col 3+Col4 ( c ) has already been
    January 2004 6500 780 541 239 780 remitted in full in EPF A/c No 1
    February 2004 6500 780 541 239 780 ( Provident Fund contribution A/c)
    and in A/c no. 10 ( Pension
    March 2004 6500 780 541 239 780 Fund Contribution account vide
    0 0 0 0 note below )
    72651 8718 6052 2666 8718

    Certified That the difference between the total of the contribution shown under the columns (3) & (4)
    of the above table and that arrived at on the total Wages shown in Column (2) at the Prescribed rate
    is solely due to the rounding off of the contributions to the nearest rupee under the rule.

    Signature of Employer
    Date : (Office Seal)

    Note: 1 ) In respect of the Form (3A) sent to the Regional office during the course of the currency
    period for the purpose of final settlement of the accounts of the members who had left service
    details of date and reasons for leaving service and also certificate as shown in the Remarks
    Column should be added.
    Note: 2 ) If there is no period of NCS, the word "NIL" to be mentioned against the total column.
    Note: 3 ) Wherever no wages are shown against any month the period should be shown as NCS
    Under Col. 6.
    FORM - 3A
    (Unexempted Establishment Only)
    THE EMPLOYEE'S PROVIDENT FUND SCHEME, 1952
    (Paras 35 and 42) and
    THE EMPLOYEES PENSION SCHEME, 1995
    Para 20
    Contribution Card for the currency period from April 2002 to March 2003
    -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
    1. Account No. MH3746/2980
    UAN NO. 101696614009 5. Statutoty Rate of Contribution : 12%
    2. Name/Surname: PRAKASH MADHUKAR PATIL 6. Voluntary higher rate of Employees
    3. Father/Husband's Name: MADHUKAR contribution, if any
    4. Name & Address of the Establishment :
    VASANTDADA SHETKARI SAHAKARI SAKHAR KARKHAN LTD SANGLI
    SANGLI-MADHAVNAGAR ROAD
    SANGLI-416416

    Month Amount of CONTRIBUTIONS Refund of Non cont. Remarks


    Wages Worker's Share Employer Share Advances services
    Rs. from
    EPF EPF EPS TOTAL ---------
    a b c To---------

    1 2 3 4 5 6 7
    a) Date of Leaving service
    April 2002 6274 753 523 230 753 11/26/2005
    May 2002 6274 753 523 230 753
    June 2002 6274 753 523 230 753 b) Reason for leaving service
    July 2002 6258 751 521 230 751 Resignation
    August 2002 6258 751 521 230 751 c) Certified that the total amount of
    contribution indicated in this card
    September 2002 6258 751 521 230 751
    October 2002 6346 762 529 233 762 i.e. Rs.
    November 2002 6346 762 529 233 762
    December 2002 6346 762 529 233 762 Col 3+Col4 ( c ) has already been
    January 2003 6416 770 534 235 770 remitted in full in EPF A/c No 1
    ( Provident Fund contribution A/c)
    February 2003 6416 770 534 235 770 and in A/c no. 10 ( Pension
    March 2003 6416 770 534 235 770 Fund Contribution account vide
    note below )
    0 0 0 0
    75882 9106 6321 2785 9106

    Certified That the difference between the total of the contribution shown under the columns (3) & (4)
    of the above table and that arrived at on the total Wages shown in Column (2) at the Prescribed rate
    is solely due to the rounding off of the contributions to the nearest rupee under the rule.

    Signature of Employer
    Date : (Office Seal)

    Note: 1 ) In respect of the Form (3A) sent to the Regional office during the course of the currency
    period for the purpose of final settlement of the accounts of the members who had left service
    details of date and reasons for leaving service and also certificate as shown in the Remarks
    Column should be added.
    Note: 2 ) If there is no period of NCS, the word "NIL" to be mentioned against the total column.
    Note: 3 ) Wherever no wages are shown against any month the period should be shown as NCS
    Under Col. 6.
    FORM - 3A
    (Unexempted Establishment Only)
    THE EMPLOYEE'S PROVIDENT FUND SCHEME, 1952
    (Paras 35 and 42) and
    THE EMPLOYEES PENSION SCHEME, 1995
    Para 20
    Contribution Card for the currency period from April 2005 to November 2005
    -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
    1. Account No. MH3746/2980
    UAN NO. 101696614009 5. Statutoty Rate of Contribution : 12%
    2. Name/Surname: PRAKASH MADHUKAR PATIL 6. Voluntary higher rate of Employees
    3. Father/Husband's Name: MADHUKAR contribution, if any
    4. Name & Address of the Establishment :
    VASANTDADA SHETKARI SAHAKARI SAKHAR KARKHAN LTD SANGLI
    SANGLI-MADHAVNAGAR ROAD
    SANGLI-416416

    Month Amount of CONTRIBUTIONS Refund of Non cont. Remarks


    Wages Worker's Share Employer Share Advances services
    Rs. from
    EPF EPF EPS TOTAL ---------
    a b c To---------

    1 2 3 4 5 6 7
    a) Date of Leaving service
    April 2005 0 0 0 0 0 11/26/2005
    May 2005 0 0 0 0 0
    June 2005 0 0 0 0 0 b) Reason for leaving service
    July 2005 0 0 0 0 0 Resignation
    August 2005 0 0 0 0 0 c) Certified that the total amount of
    contribution indicated in this card
    September 2005 0 0 0 0 0
    October 2005 0 0 0 0 0 i.e. Rs.
    November 2005 0 0 0 0 0
    Col 3+Col4 ( c ) has already been
    remitted in full in EPF A/c No 1
    ( Provident Fund contribution A/c)
    and in A/c no. 10 ( Pension
    Fund Contribution account vide
    note below )

    0 0 0 0 0

    Certified That the difference between the total of the contribution shown under the columns (3) & (4)
    of the above table and that arrived at on the total Wages shown in Column (2) at the Prescribed rate
    is solely due to the rounding off of the contributions to the nearest rupee under the rule.

    Signature of Employer
    Date : (Office Seal)

    Note: 1 ) In respect of the Form (3A) sent to the Regional office during the course of the currency
    period for the purpose of final settlement of the accounts of the members who had left service
    details of date and reasons for leaving service and also certificate as shown in the Remarks
    Column should be added.
    Note: 2 ) If there is no period of NCS, the word "NIL" to be mentioned against the total column.
    Note: 3 ) Wherever no wages are shown against any month the period should be shown as NCS
    Under Col. 6.

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