PWWF-TS-Certificate From Head of Administration of Employer

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Employment Certificate (Talent Scholarship)

Full Name of Worker


(Block Letter)
C.N.I.C No. - - Date of Birth - -
Full Name of Student
(Block Letter)
C.N.I.C No. - - Date of Birth - -
Or B-Form No.
1) Certified that the below mentioned particulars of the worker of our Establishment / Industrial Unit (Complete Name)
are correct. It is further certified that:-
i) He / She falls within the definition of “Worker” as defined in Punjab Industrial Relations Act (PIRA), 2010.
ii) He / She joined this Establishment as (Designation) on and is working till date
i.e. as (Designation)
iii) He / She died during service on and has been paid death grant of PWWF.
iv) He / She retired from service on :-
a) due to disability (disability proof through a legal medical board constituted for the
b) on attaining the age of superannuation.
OR
v) He / She was laid off due to closing / nonfunctional / inoperative industry / mining units.
2) Certified that worker is registered with:-
i) Employees Old Age Benefits Institution (EOBI) EOBI Card Number _
ii) Punjab Employees Social Security Institution (PESSI) PESSI R-5 Card Number
3)
i) Factories Act, 1934. Factory Registration Number
OR
ii) Punjab Mining Concession Rules, 2002. Mines Registration Number
OR
iii) is paying 2% contribution under Punjab Workers Welfare Fund Act, 2019
OR
iv) is paying 5% left out contribution under Companies Profits (Workers' Participation) (Amendment) Act 2021

(Attestation by the Employer)

Name Signature of designated officer

with date

Designation Stamp
Mobile No. Email

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