Joint Declaration By the Member and The Employer
To
The Regional P F Commissioner,
Pune-
Sub: Correction in UAN Data-reg.
Dear Sir,
I, am/ was an employee / ex - employee of M/s.
Submitting here with details for correction in my PF Account bearing No-PUPUN/ / and
UAN No.
Particulars Incorrect Details Correct Details
Member Name
Father Name
Husband Name ( For Married
Member only)
Date of Birth (DD/MM/YYYY)
Date of joining (DD/MM/YYYY)
Date of Exit (DD/MM/YYYY)
Gender
Reason for Exit
I am also enclosing herewith copies of Aadhar, PAN Card, School Leaving, Marriage Certificate (for married women),
Passport, Employee Register, Appointment Letter, Pay Slip, Signatory/ employer, (As per EPFO H.O. Circular No.
WSU/KYC/Correction process (E- 15189)/2874 dated 12.02.2021)
You are requested to make necessary Changes as shown in “ Correct Details” column at the earliest.
Date-
Yours Faithfully
Name & Signature of Member/Applicant
Document required copy of : Aadhar card, PAN card, School Leaving certificate, Passport, Marriage Certificate,
Gazette, Appointment Order, Pay Slip, Increment order, and --------------------------------------
The, aforementioned information in this letter/Form is correct as per our office record. Person whose name shown in
Incorrect and Correct column are same. If any wrong/over/excess/payment done at the time of settlement of any
claim after requested correction by EPFC Office, in that case our Company/establishment will be held responsible
and will refund any such amount.
(Name & Signature of Authorized officer along with seal of establishment)
