Guidelines on PF & Pension claim

form

HR/SOP/PF/Con/01
Page:02
Revision:0

1. How to fill in form no. 19(PF withdrawal):

Form no 19 is to be submitted in original to your employer in order to withdraw

your accumulated provident fund from your PF account.

The duly completed form no 19 & 10-C will then by submitted by your employer
to provident fund office

Form should be written with proper care in legible & clear hand writing.

Name of the PF member to be written in Block letters. (members means the person
in whose name the PF is remitted)

Fathers name or husband name in case of married women.

Date of leaving service: Write last date of working in the establishment

Reason of leaving services: Be specific while writing reason of leaving services.

Kindly write resignation is only reason for separation:

Full Postal address: Kindly write complete postal address including PIN code. All
correspondence will be done by PF office on postal address given by the PF
member.

Mode of Remittance: You can chose two options of receiving payment a) Postal
money order 2) Direct payment to your saving Bank account

If you chose second option then, you have to write complete postal address of your
bank including PIN code and your savings bank account number, since fund
amount will directly get transferred to your savings Bank account. It is mandatory
for you to send one cancelled cheque leaf along with the claim form if the cheque is
not available then provide first two pages of Bank pass book where details of your
saving Accounts is mentioned and the same should be duly attested by the Bank.

Details of contribution for the current financial year: Kindly do not write anything
under this column as employer has to furnish this information.

Kindly inscribe your signature at three places in the form

1. Where it is specified that the applicant has signed/Thumb impressed before me

2. Declaration of non employment.
3. Advance Stamp receipt: Signature on advance stamp receipt must be done on
revenue stamp.

2. How to fill in form no. 10-C(Pension withdrawal):

Form no 10-C is to be submitted in order to withdraw your accumulated

pension fund from your pension account. However kindly note you are
eligible to withdraw pension only if you have completed continuous
services of 6 months in the establishment.

Form should be written with proper care in legible & clear hand
writing.

Name of the EPS member to be written in Block letters (Member means

the person in whose name the Pension is remitted)

Fathers Name or husbands name in case of Married women.

Date of leaving service: Write last date of working in the establishment

Reason of leaving services: Be specific while writing reason of leaving

services. Kindly write resignation is only reason for separation:

Full Postal address: Kindly write complete postal address including PIN
code. All correspondence will be done by PF office on postal address
given by the PF member.

Are your willing to accept scheme certificate in lieu of withdrawal

benefit?

You have to choose either Yes or NO

If you chose Yes: PF office will process for Pension Scheme Certificate
wherein they will issue a certificate to you describing the details of your
pension fund accumulation. You can submit this certificate to your existing
employer in order to merge you pension amount with that of your new
employer.
If you willing to accept scheme certificate then you have to submit attested
copies of birth certificate of your family members( i.e. your children &
spouse)
If you chose No.: PF office will process you pension amount and arrange to
credit the same to your saving Bank account.

Mode of Remittance: You can chose two options of receiving payment a)

Postal money order 2) Direct payment to your saving Bank account

If you choose second option then, you have to write complete postal address
of your bank including PIN code and your savings bank account number,
since fund amount will directly get transferred to your saving Bank account.
It is advisable to send one cancelled cheque leaf along with the claim form. It
is mandatory for you to send one cancelled cheque leaf along with the claim
form if the cheque is not available then provide first two pages of Bank pass
book where details of your saving Accounts is mentioned and the same should
be duly attested by the Bank.

Details of contribution for the current financial year: Kindly do not

write anything under this column as employer has to furnish this
information.

Kindly inscribe your signature at two places in the form

1) Where it is specified that
impressed before me

the applicant has signed/Thumb

2) Advance Stamp receipt: Signature on advance stamp receipt must

be done on revenue stamp.

Prepared By:

Approved By: