‘Adecco Stating = ARIS Form PP Photograph fame feds ws franersispouseName:§ [ =| ee fat ot Btn C an ane See ey pan Ee Maria! Status: — sans Date frtzon Satay TE pon rm == = Present Aderess _choemanent Agar [em a iat oo =——— Pi nore iti —— feats Sa re morgoncy Contact No Tua Years of Experence: [| beevious Experience ‘SKS Name othe span Di ‘Sapaien | — tose seseatone! Ontatoneumes nm nai very Soo! "Year of Passg Durston [ois 7a noe ee Ga i (ee nda Fai coe utero ny aac Foe) ‘The Abr omaton gun ein Wan Caet x vn ieditesemesereeeearnaets | [—_Sionaiure of associateEPF Form (orurexamotaitxemptas extsbishmens) {aragron S861) he Employee's roitert Finds Schoo, 1952 and Paragraph 18 he ployee Penton Tt. Name (Block Loters) [a Fathers Husbands Name 3. Date faim 48x 5. moral Satie ath [eeniemn) pez) ~T. Adress (Permanent) (omporary) Date of oinng Pr es. PasafePey ‘nareby nominate tle parsonsicancel i Gominaton mada by me prvbus'y and nominate, he otsons} marine below resowe the amountetending to my creat rte Employee's Provident nd, nthe event! my dats ‘Name ana | Nominee's | Oateorsinn | Total amountof "1 ihe Nominee isa ‘adress of | tolationehip share ot ‘minor, nar and {ho Nominoa/| eth to sonumulaone ‘eleterap and Nominees | mamber inProment Sesress ofthe Fund bepaldto | feceve to amount ch nmin {rng the minoety Stoning o 2 z z = 41. Certo nat nave no family as dened in Para 2(6) of tho Employou's Provident Funds ‘Scheme 1852 and should acqure afarly hereafter tne above nomination shoud be deemed as canoole 2.“ Coranod nat my amermamer sare dependent upon me. + Stk cut whisnever snot appeabn. EIST a a na aT x “hha morognensany nner mods cn ‘monoge shal te ore oe Sigratref tum igre of he startercae pa PS) Para FB) | Thereby nie boon parlours of ie mamas of Tari whe WOU Ba sigh) recat wdenichlren pension in the event of my death. ae oe Far anos wer [= REF Taasose [pate or im | palatenshie o ® @ @ o ‘Cariad tat Ihave no arly ab defined in pare 2s of Employer's Pension Sehmom, 1905 and shou! acquire afamiy here: shal fumishparteularsthoreon the above fomm "hereby nminats the ftoning person for reeving the monthly widow pansion ae irra sete loncon, SEN | ws ate: x se Sibi verb cite ‘Slanature or thumb impression Ske out whichever is not appicabio eo ue in (CERTIFIED BY EMPLOYER) Carib nat tne above dectaraion and nominaton as been signedehumb impressed before me by Sw/Smt/ Kumar ‘employe in my establishment afar labo has ead he ensTeias have Been read ‘overtime by me and gat conformed by hime Place: x ‘Signature of Employr ‘or Authorised officer of the Estaishment Designation Date Name and address ofthe Fatorstabishmont or Rusbor Stamp Threon|Ce este ay nen nee UUSIRS TUNES TET Tobe Meo eolye ats eta nent 2 Poca Se septa ached wh be «9 emcee ‘® Rawet ee Sf SES mene SET nee oo renee [Sate a [Slee fee = ee =e apres fel pre a Ss ecoooo | S=ceocoo| §Sconooo | §Soccooo Laeteares [eh etary eee = in etn esate SS WT Pps eT AER a a nana Geom a rl & tee — (Soeeeg Pee SET eregrew eter ne nope semen rosagani n — oes ere gem se ease ene owe ae (Sindy rtaaow erase a = ere freee ere Cee aw terete 15 Caper mony ny Cot ars onan esd See RR ae oe sexs Tecome my omni ES eare Tocris ome = a Pops age avg wet ‘Syste ree ¢ ee ae Sawa sencaetesage mstRUCTIONS [BEL me Ren ere or, tse a 11 rs Re ere Stam «Fos a gory opaon 1&2 6 (Gree Rete, ape fe see a & Rea wi sre it a afte Fore (0) Pelee) gen ee efi aw ey eee ST RR, EEA Mo er ‘Saree we str Feo 0) Rw a ween ov at ey Se OE AEN, Cu ye Sah stig ro ene ma ee re sae er Saree er airy 6) ati sete (er eye, ee, te OMe a “Fan meu ay eo ine 2 aud Poran nl ares sees ‘oo Coi hen arte, satpbe-aaholnceinantactanstekanchsodertal {Se ny Cod be tepotnaeEmpoyrtannh Marup weedy et ne nee gee HA Mae, Oe, sou reat & ner IGh aTich AHA By ‘Samra tae orate sacs pe elon Unde Sn ES! Ae Ea fh fh oy a ar FS ee aN ar ae ey en afr Peet Rete dP og om aed SH Se Swe ‘ayn ces Dae Oma 17a on Eo ey ep tts 8 tae ee eee heres ere wet at Bh ene rem) et ‘rae (ster ey es) eet ee ere abt ee (3) ghee Ee Asan Paro pron you ana you Sopa oe se tb tf ar Wn ge bee ch ‘ete 0) Sena Dart eroory Obssaner val | Pano Sohne Bou Coma bon ‘ois Money ora ee ean eros naea ware sy cnr ts sai RR ge ee mee Ta ace eres @ He hs ‘Foror cls aan eon weet ESIC awe ay hitachi. “Ee ara ree # ree Fer Banh Ono Use ny Lr ten ta 2. seu ere oa 8 te 5 ghee eer: ae Mo ery 4s ore fe sees apr a x a at "Wraer mcoc Mda sreganerts he Fen, pn ne ra rows & re Sato rh are Seen exw OCF) 18) i LER A HERIE CF THE OWGTEET PROUDENT FO SHOE, 157? sete 9) Were UALR AMER OF HE ELE PSION SEE, BS? fasten {Tr assronse ro aN Of BOTH OF (8) & (9) ABOVEIS VE THEN HAMDATORILY FIL UP THE PREVIOUS EMPLOVMENT DEALS, srqoaies2).x Prevout anomie pers “10) te ETAL OF ne Uva, AOU Nave (VAN) RENO PF evn 1: ww CTT Err rt tt on F ee Oo anus PF Meme D sce [erm aaa tn pweoromrranenas [TOT RT HTT aE] Neots oanerTy | ey. perc comme sup et mena omonen,nen tee corcre yee %2) (B.S 0) neon mes Gong Hon PPO MME 12) remus won e cs foe “eye nny v0 (33) atove 5 5 eh TER THE BETAS 4 13(), 1368) 8.2360: ya) com of orem (Heats Te -__{aecienae |17) kycomnns [COREE TE SCOR |e iw aan Pressanraccont | — ween (PAN) Pon T DG T aren EATON [sito 1 Mandatory Fea (ane ave AGeouNT NUMBER (owe wi FFSCcoD8) 1S ANOATORY. OI et nonees NOSES Te Des RYE COSMAS AADAD. ET ODN ASTI TOMBOHTORY KYCS [ia te stom. Seu-ArestenpuovOcoPntSOPTHE OOCUMENTS = ATA WHT FO, Incase eaniens nnn or EP See, 1952 n0/ oR £5, 1995, {3 trove eine me conacnts ofr UAN) Pevous PF MOWERID iso a TEATEO As HY REQUEST FON RANGER OF PONDS AND SERVICE DTA 1F APPLICABLE POM acount: CWE TRANSFER WOULD BE PSST ‘mn en er eo reas move as BH vena “gs pdtoere™ ‘Somarune oF Monae 5 MED OF 190 Hs DU ALOT PF ERD ee ees Us oy Ans Soe 1952 ano EPS, 1995: ‘codes foes Resse te nornoreare Ort TWEKY® OFTAILS OF THE ABOVE MEMBER OW THE UAN CATABASE ee reese ee , Se ew nee mes “re op Te me As eo (A) AOE TMS BEN TAGGED WT wR AN REINS ove Yn + PueseTio 8 OPTION serie IVE trate oF We AEOVe MEMEER IN THE UAN DHTASE WAVE BEN APRENED wT DIOTAL Sout GHTIRCATE ie TeverR RCE PAS BEN GENERATED OM PTA 1b Ame DSC Esme BR NT RESTEED yt CFO, THE MbacR HAS EE ECR TOPE ‘re. ano Fone 3) on TRANSFER oF NES ROM HS REELS STALE ure: SroxsTuns oF EnPiover rn Sta oF ESTABLISHMENTFORM NO. 128 Form for furnishing details of ir nd eocton 192(2) for th ding 31st March, ‘orm for furnishing details of income under section the year en t March, Kamas vitro se6ye8 oe Decl) healt ete et eee Pamanea acct earec iste Fen ss, | nameans | tavere | Pemanrt S| MESES | areola irpayee) | ‘msn | Nora | mo" | "Sree + Wh effect fom 1-4-1991, section 80 has been replaced by secon 88 Vertcation ‘Signature ofthe employee \ “donereby docare that whats stated above ste tothe best of my knowledge and belt Verio tay, e_______ayat Place x ANNEXURE ‘Signature of he employee Printed trom wow.texmann.com[Soecolunn 8 of Fo No. 128) Particulars of value of pe-quisites and amount of accretion to employee's provident fund account Printed trom wirwtaxmann.comPrinted fom wwr.taxman.com