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Khajanchi

This document is an Online Transfer Claim Form for the Employees' Provident Fund Scheme, submitted by a member named Khazanchi to transfer their PF balance from Jindal Stainless Hisar Ltd to their current employer, Rajender Singh & Co. The form includes personal details, previous and present PF account information, and certifies the accuracy of the provided information. The member is required to print and submit a signed copy to the previous establishment.

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20 views2 pages

Khajanchi

This document is an Online Transfer Claim Form for the Employees' Provident Fund Scheme, submitted by a member named Khazanchi to transfer their PF balance from Jindal Stainless Hisar Ltd to their current employer, Rajender Singh & Co. The form includes personal details, previous and present PF account information, and certifies the accuracy of the provided information. The member is required to print and submit a signed copy to the previous establishment.

Uploaded by

smilyravi11
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
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ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]

( Tracking ID: 10189153574905001 )


Claim Date : 13/12/2024
EMPLOYEES' PROVIDENT FUND SCHEME, 1952
(PARA 57)

(This form has been printed on the basis of Online Transfer Claim Form filled up by the member under Unified Portal for submission to the
employer.)

To,
The Regional P.F. Commissioner,
ROHTAK,
Plot No.1, Institutional Area, Opp. Sh. Ram Global Sch.,Sec-3, Rohtak

Sir,
I request that my Provident Fund balance along with my Pension Service Details may please be transferred to my present
account under intimation to me. My details are as under :

PART A : PERSONAL

1. Name : KHAZANCHI

2. Mobile Number : 9138247677

3. E-mail id : -

4. Bank Account Number : 41511963546

5. Bank IFSC : SBIN0010318

PART B : DETAILS OF PREVIOUS PF ACCOUNTS (WHICH IS TO BE TRANSFERRED)

1. PF Account No. (with EPFO : GNRTK00008560000034843

2. Name of the Establishment : JINDAL STAINLESS HISAR LTD

3. Address of the Establishment : DELHI ROAD HISAR HISAR HISAR

4. PF A/C No. held by : ROHTAK

5. Name of the Trust : NOT APPLICABLE

6. PF A/C No. in Trust : NOT APPLICABLE

7. Bank A/C No. of Trust : NOT APPLICABLE


8. IFS Code of the Bank Branch of
Trust where account is : NOT APPLICABLE

9. Member's Name : KHAZANCHI

10. Date of Birth : 06/04/2002

11. Father's/Spouse Name : POLU RAM

12. Relationship : FATHER

13. Date of joining : 01/12/2022

14. Date of leaving : 31/10/2023


PART C : DETAILS OF PRESENT PF

1. PF Account No. (with EPFO : GNRTK31253420000010417

2. Name of the Establishment : RAJENDER SINGH & CO.

3. Address of the Establishment : 455 Gali No. 3 Shiv Colony Hisar HISAR

4. PF A/C No. held by : SRO ROHTAK

5. Name of the Trust : NOT APPLICABLE

6. PF A/C No. in Trust : NOT APPLICABLE

7. Bank A/C No. of Trust : NOT APPLICABLE


8. IFS Code of the Bank Branch of
Trust where account is : NOT APPLICABLE

9. Member's Name : KHAZANCHI

10. Date of Birth : 06/04/2002

11. Father's/Spouse Name : POLU RAM

12. Relationship : FATHER

13. Date of joining : 01/11/2023

I, Certify that all the information given above are true to the best of my knowledge and I have ensured the correctness of
my present and previous account numbers.

Signature of the member

Note : Member should take a printout of this form and a signed copy of the same should be submitted to the Previous
Establishment i.e. JINDAL STAINLESS HISAR LTD

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