Part A: Personal

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ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]

( Tracking ID: 10029016103705006 )


Claim Date : 08/04/2024
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,
HYDERABAD,
Bhavishyanidhi Bhawan, No. 3-4-763, Barkatpura Chaman, Hyderabad

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 : AITIPAMULA RAGHAVA

2. Mobile Number : 8185891667

3. E-mail id : raghu.master1990@gmail.com

4. Bank Account Number : 006901555663

5. Bank IFSC : ICIC0000069

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

1. PF Account No. (with EPFO : APHYD11963080000010106

2. Name of the Establishment : TECHSTAR SOFTWARE DEVELOPMENT INDIA PRIVATE LIMITED

3. Address of the Establishment : 82684/ J/7A BHAVANI NAGAR ROAD NO12 BANJARA HILLS HYDERABAD
617
4. PF A/C No. held by : HYDERABAD

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 : AITIPAMULA RAGHAVA

10. Date of Birth : 01/05/1990

11. Father's/Spouse Name : A SEETHARAMULU

12. Relationship : FATHER

13. Date of joining : 15/05/2018

14. Date of leaving : 28/02/2019


PART C : DETAILS OF PRESENT PF

1. PF Account No. (with EPFO : PYBOM00113940001587440

2. Name of the Establishment : WIPRO LIMITED - TECHNOLOGIES GROUP

3. Address of the Establishment : WIVIDUS - EC 1, 2ND, 3RD & 5TH FLR, TOWER 4, NO. 72, KEONICS, E.
CITY, BANGALORE 656
4. PF A/C No. held by : TRUST

5. Name of the Trust : WIPRO SYSTEMS LIMITED EMPLOYEES' PROVIDENT FUND TRUST

6. PF A/C No. in Trust : 00113941587440

7. Bank A/C No. of Trust : 9513836380


8. IFS Code of the Bank Branch of
Trust where account is : KKBK0008107

9. Member's Name : AITIPAMULA RAGHAVA

10. Date of Birth : 01/05/1990

11. Father's/Spouse Name : A SEETHARAMULU

12. Relationship : FATHER

13. Date of joining : 25/07/2019

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. WIPRO LIMITED - TECHNOLOGIES GROUP

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