Microsoft Word - GPF Part Final
Microsoft Word - GPF Part Final
Microsoft Word - GPF Part Final
Form of application for part-final withdrawal of money from the Provident Fund for House
Building, Purchase or Redemption of Houses and House-sites, Higher Education purposes or
Marriage of Medical expenses
3 Pay :
4 Name of the Provident Fund A/c. No :
5 (a) Balance at the credit of the subscriber on :
the date of application.
NOTE: In the case of part-final withdrawal for house building and marriage purposes as well as purchase
of house/house site, the total balance at the credit o all the Provident Funds should be taken into
account, if the subscriber subscribes to more than one Provident Fund.
(b) If it is a second Part-final withdrawal for the purpose of :
carrying out additions and alterations to or reconstruction
of a house acquired with the help of withdrawal already --
made or which may be made in future from the Provident
Fund.
i) Amount of part-final withdrawal already taken : --
ii) The specific course taken by the person and the name & : --
place of the institution.
iii) Whether the course is for more than three years and beyond : --
the High School stage.
iv) Whether this is the first or the second withdrawal for the : --
current year
v) The rate of previous withdrawal of advance, if any, taken : --
for this purpose.
C. If it is for Marriage or Betrothal ceremony expenses :
i) Whether for the Marriage or Betrothal ceremony of the : --
subscriber’s daughter/son or for any other female relation
dependent on the subscriber who has no daughter.
ii) Whether any advance under ordinary rules has been drawn : --
iii) Actual date fixed for celebration of the betrothal ceremony : --
or marriage.
8. i) Total service including broken periods, if any :
Recommended/Not recommended
Note: Delete the certificates not applicable, (Certificates in items (ii), (iii) & (iv) above are
not necessary if the part-final withdrawal is for higher education or for betrothal ceremony of
marriage purpose).
Signature :
Designation:
Date:
No.
Signature :
Designation :
Forwarded to :