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The document is an online submission for a PF Final Settlement application by a member named Abhishek Kumar Sharma, with UAN 101983935305. It includes personal details, dates of joining and leaving service, and bank account information for payment processing. The member certifies that all data in the Member Portal is correct and requests payment to the specified bank account.

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singhkhushi55796
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36 views2 pages

PDF Download

The document is an online submission for a PF Final Settlement application by a member named Abhishek Kumar Sharma, with UAN 101983935305. It includes personal details, dates of joining and leaving service, and bank account information for payment processing. The member certifies that all data in the Member Portal is correct and requests payment to the specified bank account.

Uploaded by

singhkhushi55796
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Submitted online at Member e-seva portal on 2025-04-03 17:55:36 (IP www.epfindia.gov.

in
Address:10.70.13.100)

deZpkjh Hkfo"; fuf/k ;kstuk] 1952


EMPLOYEES' PROVIDENT FUND SCHEME,1952
EMPLOYEES' Pension Scheme,1995
UAN Based Combined Claim Form 19/10C WB/31 for Advances/PF Final Settlement/Pension Fund Withdrawal
(mu ekeyksa esa ykxw tgka QkeZ 11(u;k)esa deZpkjh dk iwjk fooj.k] vk/kkj la[;k vkSj cSad [kkrk la[;k ;w-,-,u- iksVZy vkSj ij
miyC/k gS rFkk ;w-,-,u- esa lfØ; gSA)
(Applicable in cases where employee's complete details in Form 11(New),Aadhaar Number and Bank
Accounts details are available on Member Portal and UAN has been activated.)
Mobile Number / eksckby uacj - 9958493958
1. I want to apply for PF Final Settlement
2. Universal Account Number(UAN) / ;wfuolZy [kkrk la[;k 101983935305
3. Name of the member ABHISHEK KUMAR SHARMA

4. Date of Joining 21-Aug-2023


5. Date of Leaving Service/ NksM+us dk fnukad 22-Nov-2023
6. Reason of Leaving Service/ lsok NksM+us dk dkj.k CESSATION (SHORT SERVICE) - Any other
reason

7. Permanent Account number / LFkk;h [kkrk la[;k OHOPS3509H

8. Payee Address Kapashera Plot no 740,gali no 11,New


Delhi,SOUTH WEST,DELHI-110097

* eSa çekf.kr djrk gw¡ fd eSaus ;w , ,u iksVZy ij lhM MkVk dks Hkyh Hkk¡fr ns[k fy;k gS rFkk QkeZ u- 11( u;k ) cSad [kkrk fooj.k vkSj vk/kkj
la[;k lfgr lHkh MkVk lgh ik;k x;k gSA
* I certify that I have gone through the data seeded in Member Portal and found all data including Form
No.11 (New) , bank account details and Aadhar Number to be correct
Father/Husband/Spouse Name: OM PRAKASH THAKUR Date Of Birth: 05-Mar-2003
Bank Account Number 50100655056949 Bank IFSC Code HDFC0001670
Bank Details HDFC BANK,KAPASHERA
Aadhaar 24XXXXXXXX59
Member ID GNGGN00252970000364614
* —i;k ;w-,-,u-iksVZy ij n'kkZ, x, cSad [kkrs esa Hkqxrku djsaA
* Please make payment in the bank account mentioned in the Member portal .
UAN - 101983935305 Tracking ID - 10198393530501002

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