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  • Form10D 7

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    savap57140
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    This document appears to be a form for claiming savings bank account funds from a deceased member. It contains fields for the claimant's name and bank account number, as well as fields for details about the deceased member such as their name, membership number, and date of death. If the claimant is a nominee, they must provide their name and relationship to the deceased member. The form also has sections to provide details about any pension or scheme certificates already in the deceased member's possession.

    Original Description:

    RGF

    Original Title

    Form10D-7

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    This document appears to be a form for claiming savings bank account funds from a deceased member. It contains fields for the claimant's name and bank account number, as well as fields for details about the deceased member such as their name, membership number, and date of death. If the claimant is a nominee, they must provide their name and relationship to the deceased member. The form also has sections to provide details about any pension or scheme certificates already in the deceased member's possession.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    3 views1 page

    Form10D 7

    Uploaded by

    savap57140
    This document appears to be a form for claiming savings bank account funds from a deceased member. It contains fields for the claimant's name and bank account number, as well as fields for details about the deceased member such as their name, membership number, and date of death. If the claimant is a nominee, they must provide their name and relationship to the deceased member. The form also has sections to provide details about any pension or scheme certificates already in the deceased member's possession.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    'fi. ~. ~/~1'ffl"'Wf/ "ifim. tq; -mm ~.

    /
    SI No Name ofClaimant(s) Saving Bank Account Number

    14 . .A (c!i) ~ GT<IT fcIrn\ "'Ilf>rff <ZIfcltr "[RT ~ fclxrr 7J<IT ~ m~ ~


    (a) If the claim is preferred by nominee, indicate hislher.-- ---...,

    (1) 'Wf/ Name I


    L.. .,- -\

    (2) ~ ~ ct; ~ ~/ Relationship with deceased Member

    1'ffl"flm"ur ~ tr ~ ~ m'<f ~ fclxrr


    15. ~
    ~ ct; tjffi
    Wll"f
    cfflt m~
    Detail of Scheme Certificate already in
    Cffl ~
    m} Scheme Certificate received & enclosed
    "fiofr.f I

    D
    Possession of the Member, ifany m'<f -;ffi) / Not received
    D
    "ffil! ~ Not Applicable
    D
    ~"SIT'<! t en ~/ifReceived, Indicate:

    'fi. ~. ~.
    SI No Scheme Certificate Control No Authority who issued the Scheme Certificate

    16. ~ ~ q;. if. m.,


    1995 ct; 3Rf1fQ ~ \iIT 1(jft ~ l\l.l\l.31T:if. et. rvr. /\3'. et. <!iT. "[RT-;;ffi)
    Ifpension is being drawn under E.P.S, 1995 PPONo Issued by RO/SRO

    17. ~ ~ (~et; ~ ~/ Documents enclosed (Indicate as per the Instructions)

    4. _
    1.-------------
    2. _ 5. _

    3. _ 6. _

    ~ fiImr vmrr ~ I Certified that;


    0) i'f ~ m
    mwrr, 1995 et; ~ iWf ;ffil ~ W tl
    I am not drawing Pension under Employee's Pension Scheme, 1995.
    Qi) ~ ~ tf?[ "4 ~ flm"ur ~ ~ -mt t I
    The particulars given in this application are true and correct

    ~lDate
    ~lPlace ~ et; ~ <rn 6W <t'I 3t'!,OT f.mJ;ft
    Signature I Left Hand Thumb Impression ofthe applicant

    ~ ~ ~/SigDature of Employer ~ .•
    f.\1I)1ft!y/~ ~ um 'Rf 'GIRr t)

    Form IOD (www.epfindia.gov.in) Page 3 of6

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