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EPFO Declaration

This document is a Declaration Form for employees joining establishments under the Employees’ Provident Fund Scheme, 1952 and Employees’ Pension Scheme, 1995. It collects personal information, previous employment details, and KYC details necessary for EPF and EPS membership. The form also includes sections for employer verification and transfer of previous PF account details if applicable.

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74 views3 pages

EPFO Declaration

This document is a Declaration Form for employees joining establishments under the Employees’ Provident Fund Scheme, 1952 and Employees’ Pension Scheme, 1995. It collects personal information, previous employment details, and KYC details necessary for EPF and EPS membership. The form also includes sections for employer verification and transfer of previous PF account details if applicable.

Uploaded by

dusxtilldawn
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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1 (To be retai New Form No 11 ~ Declaration Form ined by the employer for future reference) EMPLOYEES’ PROVIDENT FUND ORGANISATION Employees’ Provident Fund Scheme, 1952 (Paragraph 34 & 57) & Employees’ Pension Scheme, 1995 (Paragraph 24) (Declaration by a person taking up employment in any establishment on which EPF ‘Scheme, 1952 and EPS, 1995 is applicable) [Name of the Member : | Fathers’ Name | Spouse's NameL] | (Please tick whichever is applicable). | Date of Birth (0D/MM/YYYY) | Gender (Male/Female/Transgender) | Marital Status (Married/Unmarried/Widow/ Widower/Divorcee) Abdul Sarnad Choudhavi | Mohammad Umar Chadhari 13/64/2001 ae Unmasried (@) Email ID (6) Mobile No Samadchoudhary 2Bgres! Lon 455266 994 F Whether earlier a member of | EPF Scheme, 1952 Whether earlier a member of EPS Scheme, 1995 (yes ONo Oves ONo Previous employment details: If Yes to 7 and/or 8 above] ) Universal Account Number: b) Previous PF Account Number: 102091830816 GIAHD00261720000051208 ¢) Date of exit previous employment: (DD/MM/

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