PF Transfer Request - 2

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ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]

( Tracking ID: 10039249495305002 )


Claim Date : 16/10/2020
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,
BANGALORE,
Bhavishyanidhi Bhavan, No. 13, Raja Ram Mohan Roy Road, 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 : TUHIN HARIPADA CHAKRABORTY

2. Mobile Number : 7760000343

3. E-mail id : [email protected]

4. Bank Account Number : 146301500404

5. Bank IFSC : ICIC0001463

PART B : DETAILS OF PREVIOUS PF ACCOUNTS (WHICH IS TO BE TRANSFERRED)

1. PF Account No. (with EPFO : BGBNG00233360001272434

2. Name of the Establishment : NOKIA SOLUTIONS AND NETWORKS INDIA PRIVATE LIMITED

3. Address of the Establishment : L-5, MANYATA EMBASSY PARK, OUTER RING ROAD, NAGAVARA
BANGALORE 656
4. PF A/C No. held by : TRUST

5. Name of the Trust : Siemens Public Communicartion Networks Pvt Ltd Employees

6. PF A/C No. in Trust : BGBNG00233360001272434

7. Bank A/C No. of Trust : 00761110000502


8. IFS Code of the Bank Branch of
Trust where account is : HDFC0000076

9. Member's Name : TUHIN HARIPADA CHAKRABORTY

10. Date of Birth : 27/04/1986

11. Father's/Spouse Name : HARIPADA CHAKRABORTY

12. Relationship : FATHER

13. Date of joining : 22/05/2017

14. Date of leaving : 31/07/2019


PART C : DETAILS OF PRESENT PF

1. PF Account No. (with EPFO : GNGGN16437810000014027

2. Name of the Establishment : ERICSSON INDIA GLOBAL SERVICES PRIVATE LIMITED

3. Address of the Establishment : BLOCK A,KING CANYON ASF INSIGNIA GURGAON FARIDABAD
ROAD,GAWAL PAHARI GURGAON 179
4. PF A/C No. held by : TRUST

5. Name of the Trust : Ericsson Employees Provident Fund

6. PF A/C No. in Trust : 51126

7. Bank A/C No. of Trust : 00031110001294


8. IFS Code of the Bank Branch of
Trust where account is : HDFC0000003

9. Member's Name : TUHIN HARIPADA CHAKRABORTY

10. Date of Birth : 27/04/1986

11. Father's/Spouse Name : HARIPADA CHAKRABORTY

12. Relationship : FATHER

13. Date of joining : 05/08/2019

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 Previous
Establishment i.e. NOKIA SOLUTIONS AND NETWORKS INDIA PRIVATE LIMITED

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