ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]
( Tracking ID: 10143369123405001 )
Claim Date : 17/12/2024
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,
MYSORE ROAD,
No.570, Raja Rajeshwari Regency, 26th Cross,I H Co-op Society Layout Bangalore
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 : NARESH D
2. Mobile Number : 9066446166
3. E-mail id : -
4. Bank Account Number : 1232500100861901
5. Bank IFSC : KARB0000123
PART B : DETAILS OF PREVIOUS PF ACCOUNTS (WHICH IS TO BE TRANSFERRED)
1. PF Account No. (with EPFO : BGMRD00574990000011165
2. Name of the Establishment : M/S LAKSHMI ENTERPRISES
3. Address of the Establishment : NO.1081, GOLDEN BLOSSOM, 18TH A MAIN, 5TH BLOCK, RAJAJINAGAR
BANGALORE 656
4. PF A/C No. held by : MYSORE ROAD
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 : NARESH D
10. Date of Birth : 10/04/1993
11. Father's/Spouse Name : SRIRAMULU
12. Relationship : FATHER
13. Date of joining : 01/01/2019
14. Date of leaving : 30/06/2021
PART C : DETAILS OF PRESENT PF
1. PF Account No. (with EPFO : BGMRD00417130000026114
2. Name of the Establishment : ASSOCIATED HUMAN RESOURCE SERVICE PRIVATE LIMITED
3. Address of the Establishment : NO.160, RAASHI COMPLEX, NAGARABHAVI 2ND STAGE,2ND BLOCK
BANGALORE BENGALURU (BANGALORE) URBAN
4. PF A/C No. held by : SRO MYSORE ROAD
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 : NARESH D
10. Date of Birth : 10/04/1993
11. Father's/Spouse Name : SRIRAMULU
12. Relationship : FATHER
13. Date of joining : 01/09/2023
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 Present
Establishment i.e. ASSOCIATED HUMAN RESOURCE SERVICE PRIVATE LIMITED
