Scribd
Upload
93 views1 page

Name Change Correction Form

The document is a joint declaration from an employee and employer correcting details in the employee's PF/EPS account like name, father/husband's name, account number, date of birth, date of joining, and date of leaving. It requests the PF commissioner to update records based on the enclosed ID proof.

Uploaded by

sastecosto1
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
93 views1 page

Name Change Correction Form

The document is a joint declaration from an employee and employer correcting details in the employee's PF/EPS account like name, father/husband's name, account number, date of birth, date of joining, and date of leaving. It requests the PF commissioner to update records based on the enclosed ID proof.

Uploaded by

sastecosto1
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
You are on page 1/ 1

Joint 

Declaration By the Member and The Employer 
 
Date: 

To 

The Regional P F Commissioner 
______________________________ 
 
Sub: Joint declaration by the member and the employer 
 
Dear Sir,  
 
I, _____________________________________________ am/ was an employee / ex employee of 

______________________________________________ furnishing below herewith correct deails with aforesaid 

establishment :­ 

Particulars  Correct   Wrong 

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)     
 
 
I am also enclosing herewith self attested copy of ID proof (​
Any one​
 ­ 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 

You might also like