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    PF Withdrawal Form

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    somb2.career

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    PF Withdrawal Form

    Uploaded by

    somb2.career
    9 views2 pages

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    Copyright:

    © All Rights Reserved
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    9 views2 pages

    PF Withdrawal Form

    Uploaded by

    somb2.career

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]

    ( Tracking ID: 10038388337505001 )


    Claim Date : 22/05/2021
    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,
    BANDRA(MUMBAI-I),
    341, Bhavishya Nidhi Bhawan Bandra (East), Mumbai

    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 : SOMOBRATA BALLABH

    2. Mobile Number : 9967959361

    3. E-mail id : -

    4. Bank Account Number : 20020567771

    5. Bank IFSC : SBIN0011372

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

    1. PF Account No. (with EPFO : MHBAN00432220000030822

    2. Name of the Establishment : KPMG PEAT MARWICK

    3. Address of the Establishment : LODHA EXCELUS IST FLR APOLLO MILLS COMPOUND N M JOSHI MARG
    MAHALAXMI 599
    4. PF A/C No. held by : BANDRA(MUMBAI-I)

    5. Name of the Trust : NOT APPLICABLE

    6. PF A/C No. in Trust : NOT APPLICABLE

    7. Bank A/C No. of Trust : NOT APPLICABLE


    8. IFS Code of the Bank Branch of
    Trust where account is : NOT APPLICABLE

    9. Member's Name : SOMOBRATA BALLABH

    10. Date of Birth : 23/07/1990

    11. Father's/Spouse Name : SHRI SUBRATA BALLABH

    12. Relationship : FATHER

    13. Date of joining : 08/05/2017

    14. Date of leaving : 26/11/2019


    PART C : DETAILS OF PRESENT PF

    1. PF Account No. (with EPFO : PYKRP00184530000054856

    2. Name of the Establishment : CAPGEMINI TECHNOLOGY SERVICES INDIA LIMITED

    3. Address of the Establishment : EPI PARK WHITEFIELD BANGALORE 656

    4. PF A/C No. held by : SRO K R PURAM (WHITEFIELD)

    5. Name of the Trust : NOT APPLICABLE

    6. PF A/C No. in Trust : NOT APPLICABLE

    7. Bank A/C No. of Trust : NOT APPLICABLE


    8. IFS Code of the Bank Branch of
    Trust where account is : NOT APPLICABLE

    9. Member's Name : SOMOBRATA BALLABH

    10. Date of Birth : 23/07/1990

    11. Father's/Spouse Name : SHRI SUBRATA BALLABH

    12. Relationship : FATHER

    13. Date of joining : 13/12/2019

    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 Present
    Establishment i.e. CAPGEMINI TECHNOLOGY SERVICES INDIA LIMITED

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