PF closure Forms filling Guidelines

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PF CLOSURE GUIDELINES

Associates willing to close the Provident Fund from Cognizant have to fill PF settlement Form 19 & 10C,
(as well as two copies of form 15G - if less than 5 years of continuous membership with PF).

TIME DURATION FOR SETTLEMENT:

PF Closure forms will be processed only after 60 days from your Date of Release.
Post submission of forms to PF Office, it takes around 6 TO 9 Months for crediting the amount in
your Bank A/c.
You can check the status by logging on to http://www.epfochennai.tn.nic.in upon submission of
your forms to PF Office.

PLEASE READ THE INSTRUCTIONS BEFORE FILLING THE FORM

FAILURE TO COMPLY WITH THE INSTRUCTIONS WILL RESULT IN THE REJECTION OF YOUR
GUIDELINES TO FILL FORM 19,10C & 15G
PF CLAIM

Do not overwrite or use white ink or eraser for corrections

Please Do not fill those which are marked FOR OFFICE USE ONLY
Points mentioned below are Mandatory
Make sure you print the Form in back to back format
You need to sign under appropriate places in the Forms. In case of Signature missed out
the claim will be rejected.
Two copies of Form 15G must be filled manually and submitted along with two self-
attested PAN card copies.(Failing to furnish these will result in TDS being deducted
from your PF amount)
Copy of PASS PORT (or any Govt. ID proof) with Signature of the member. (Mandatory)
Proof for your Bank A/c. (Cancelled Cheque (or) Bank statement (or) Copy of Bank Pass
Book) (Mandatory)
Bank A/c Differs, Joint A/c, Member name differs, & A/c number not visible in the bank
proof will be rejected.
If the Associate is currently active or if a duplicate form is submitted, it will be
rejected.

A set of pre-filled forms have been attached for your reference, please refer the same prior
to filling your details.

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Page 1 of 5
PF closure Forms filling Guidelines
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FORM 19 Page 1

Please furnish your Associate ID., UAN, Aadhaar No., PAN No., & Contact No. on the top of
the form.
POINT NO. 1 - Your Name as per your PaySlip (IN BLOCK LETTERS)

POINT NO. 2 - Fathers Name (OR) Husbands Name in case of Married Woman

POINT NO. 3 - Name & Address of the Establishment

Cognizant Technology Solutions India Private Limited

New No 165, Old No 110,
Menon Eternity building, St. Marys Road, Alwarpet,
Chennai 600 018.

POINT NO. 4 - TN/MAS/31309/XXXXX (Please refer your Pay slip for PF no. (XXXXX))

POINT NO. 5 - Date of Release (Last Date in CTS)

POINT NO. 6 - Reason for Leaving Service- (Need to mention)

POINT NO. 7 - Your permanent address (Any further communication will be sent to
this address)

POINT NO. 8 - Mode of Remittance

You need to select (B) By Account Payee cheque sent for direct credit to
my account in the Scheduled Bank

S.B. Account No. - MANDATORY

Name of the Bank - MANDATORY
Branch - MANDATORY
IFS Code - MANDATORY
Full Address of the Bank - MANDATORY

Note:
Citi Bank accounts are not advisable.

Please attach a copy of cancelled Cheque Leaf / Bank Statement of the

given bank details.

You need to mention your DATE OF JOINING (dd/mm/yyyy) & DATE OF BIRTH (dd/mm/yyyy) under
CERTIFIED THAT THE PARTICULARS ARE TRUE TO THE BEST OF MY KNOWLEDGE.

You need to sign under Members Signature (X).

FORM 19 Page 2

Three signatures required in page - 2.

1. You need to sign under Signature of Left / Right hand thumb impression of the member.
2. You need to sign under Signature of Left / Right hand thumb impression of the member. (Given
in the section Declaration of non-employment) as well.

3. You need to affix a 1 Re. revenue stamp (postal stamp NOT accepted) & sign across in ADVANCE
STAMPED RECEIPT.

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Page 2 of 5
PF closure Forms filling Guidelines
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FORM 10 C Page 1

Please furnish your Associate ID., UAN, Aadhar No., PAN No., & Contact No. on the top of the
form.
POINT NO. 1 (a) - Your Name as per your PaySlip (IN BLOCK LETTERS)
POINT NO. 1 (b) - Name of the claimant(s) - Your Name

POINT NO. 2 - Date of Birth (dd/mm/yyyy)

POINT NO. 3 (a) - Fathers Name

POINT NO. 3 (b) - Husbands Name (If applicable)

POINT NO. 4 - Name & Address of the Establishment

Cognizant Technology Solutions India Private Limited

New No 165, Old No 110,
Menon Eternity building, St. Marys Road, Alwarpet,
Chennai 600 018.

POINT NO. 5 - Region/Off Code Esst. Code No. PF A/C No. (As per your Pay slip)
T N M A S 31309 XXXXXX

POINT NO. 6 - Date of joining (dd/mm/yyyy)

Reason for Leaving Service-(Need to mention)
Date of Leaving Service - (Last Date in CTS)

POINT NO. 7 - Your permanent address (Any further communication will be sent to
this address)

You need to sign under Signature or Left / Right hand thumb impression of the member(X)

FORM 10 C Page - 2

POINT NO. 8 - Are you willing to accept Scheme Certificate in lieu of Withdrawal
Benefit

If you select YES, you will be getting a Scheme Certificate.

If you select NO, you will be getting the Pension amount to Account.

Scheme Certificate is mandatory for an associate having continuous

service of more than 9 years 6 months.

If point-8 is Yes please fill in the nominee details in Point No. 9

POINT NO. 9 - If you select YES in POINT No. 8, you have to furnish Nominee Details
If you select NO in POINT No. 8, you need not fill any details here.

POINT NO. 10 - Need not fill any details here

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PF closure Forms filling Guidelines
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POINT NO. 11 - Mode of Remittance
You need to select (B) By Account Payee cheque sent for direct credit to
My account in the Scheduled Bank

S.B. Account No. - MANDATORY

Name of the Bank - MANDATORY
Branch - MANDATORY
IFS Code - MANDATORY
Full Address of the Bank - MANDATORY

Note:
Citi Bank accounts are not advisable.

Please attach a copy of cancelled Cheque Leaf / Bank Statement of the

given bank details.

POINT NO. 12 - Need not fill any details

Under the declaration Certified THAT THE PARTICULARS ARE TRUE TO THE BEST OF MY KNOWLEDGE
You need to sign above Signature of Left / Right hand thumb impression of the member(X).

FORM 10 C Page 3

Two signatures required in page - 3.

1. You need to sign under Signature of Left / Right hand thumb impression of the member.

2. You need to affix a 1 Re. revenue stamp (postal stamp NOT accepted) & sign across in ADVANCE
STAMPED RECEIPT.

Form No-15G (Two Copies of Filled Form 15G along with a PAN Card Copy)

As per the recent amendment in Income Tax Act, 1961, Income Tax shall be deducted at source (TDS) at
The following rates if at the time of payment of the accumulated PF balance is more than or equal to Rs.
30,000/-, with continuous membership with PF less than 5 years:-

TDS will be deducted @ maximum marginal rate (i.e. 34.608%) if a member fails to
submit PAN and Form No 15G or 15H (Senior Citizen).

TDS will be deducted @ 10% provided PAN is submitted.

No tax deduction if both PAN and Form 15G/H declared.

Form 15G and 15H may not be accepted if amount of withdrawal is more than
Rs. 2,50,000/- and Rs. 3,00,000/- respectively.

TDS shall not be deducted in respect of the following cases:-

Transfer of PF from one account to another PF account.

Termination of service due to ill health of member.

If employee withdraws PF after a period of five years of continuous membership,

including service with previous employer/s.
If PF payment is less than Rs. 30,000/- but the member has rendered service of less than
5 years.

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PF closure Forms filling Guidelines
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Documents to be enclosed along with the PF Closure Forms:

Proof for your Bank A/c. (Cancelled Cheque (or) Bank statement (or) Copy of Bank Pass Book)
(Mandatory). Account Number, Branch Address, IFSC Code are mandatory in (Cancelled Cheque
/Bank Pass Book / Bank statement). Printed Member Name required in Cheque Leaf if not
Member signature is required with name in BLOCK LETTER. Joint Account, NRI & NRO Not
Accepted, CITI Bank Account Not Advisable.

Two Copies of PAN & one copy of PASS PORT (or any Govt. ID proof) with Signature of the
member.

A letter addressed to The Regional Provident Fund Commissioner, Chennai - justifying the reason
for closing your PF A/c. (Mandatory)

Please send the forms through courier or in person as any other mode is not advisable.

Also furnish your email ID & contact no (refer page 1 of both forms right side top) for PF
Office to communicate further, if needed.

FOR ANY FURTHER QUERIES YOU CAN REACH:

Point Of Contact - Provident Fund Team

E-mail - hrss@cognizant.com

Address - Payroll & Benefits Shared Services:-

Cognizant Technology Solutions
DLF Info City, 1/124,
Sivaji Gardens
Block 9, B Wing,
11th Floor,
Mount P.H.Road
Manapakkam,
Chennai 600 089.

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Page 5 of 5
 Please align the form in below Order

Cheque Leaf

Name of the Member

Proof for your Bank A/c. (Copy of Bank Pass Book / Bank statement / Cancelled Cheque) (Mandatory)

Member Name Mandatory in Cheque Leaf

Joint Account, NRI & NRO Not Accepted

CITI Bank Account Not Advisable

 Form-19

UAN:

PAN:
Associate ID
Aadhar No:
XXXXXXXXX

TN/MAS/31309/XXXXX PF Account Number in the

Pay Slip
 Form-10C

UAN:

PAN:
Associate ID
Aadhar No:

XXXXXXXXX

XXXXX

PF Account Number in the

Pay Slip
Service more than 10 years with PF Account
(Previous organization transfer also included)
scheme certificate is mandatory. IF point-8 is
Yes please fill the nominee details.
PAN Card & Passport copy

Declaration Letter-1
Declaration Letter-2

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