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Joint Declaration Formate

This document is a Joint Declaration Form submitted to the Regional Provident Fund Commissioner for correcting personal details of an employee's EPF account. It includes a request for changes in various personal particulars such as Aadhaar, name, date of birth, and marital status, along with a verification by the authorized signatory of the establishment. Both the employee and the employer declare the accuracy of the information provided and accept joint responsibility for any discrepancies resulting from the changes.

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Manikandan M
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9K views1 page

Joint Declaration Formate

This document is a Joint Declaration Form submitted to the Regional Provident Fund Commissioner for correcting personal details of an employee's EPF account. It includes a request for changes in various personal particulars such as Aadhaar, name, date of birth, and marital status, along with a verification by the authorized signatory of the establishment. Both the employee and the employer declare the accuracy of the information provided and accept joint responsibility for any discrepancies resulting from the changes.

Uploaded by

Manikandan M
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Date:

To

The Regional Provident Fund Commissioner,


Employees Provident Fund Organisation (Regional Office)
No. 37, Royapettah High Road, Opposite Swagat Hotel,
Chennai-600 014. Tamil Nadu.

Joint Declaration Form


I <Employee Name> having UAN <UAN NO> PF account <PF Number> and Aadhaar <Aadhar
Number> Is with establishment< Company Name and Address. The personal details furnished to EPFO
earlier were found to be incorrect and therefore request for change in the member profile as follows.

S.No Details/ Correct details Incorrect details


particulars
1 Aadhaar -- --
2 Name -- --
3 DOB -- --
4 Gender -- --
5 Fathers/Mother’s -- --
6 Relationship -- --
7 DOJ -- --
8 DOL -- --
9 Reason of leaving -- --
10 Marital Status -- --
11 Nationality -- --

I <DSC Holder Name> s/o, (), authorized signatory of the establishment, have verified the request, the
document attached and the records of the establishment and certify that the facts mentioned above are
correct. I am also enclosing my School Transfer Certificate, Aadhaar, Passport, Birth Certificate and
(documents of Establishment) in support of the request of the employee mentioned above.

We <Employee Name> (Employee) and <Employer Name> (Authorized Signatory) hereby declare we
have not concealed any facts and the above-mentioned facts are correct. We also indemnify that in case of
wrong payment/over payment/under payment because of the above furnished information shall be jointly
held responsible.

Authorized signatory Name of the


member

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