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Part A: Personal

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33 views2 pages

Part A: Personal

Uploaded by

Ram King3110
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]

( Tracking ID: 10191019777705001 )


Claim Date : 22/01/2024
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,
AHMEDABAD,
Bhavishyanidhi Bhawan, Near Income Tax Circle,Ashram Road Ahmedabad

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 : GOBI

2. Mobile Number : 7598504212

3. E-mail id : -

4. Bank Account Number : 1790108017665

5. Bank IFSC : CNRB0001790

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

1. PF Account No. (with EPFO : GJAHD10678070000114200

2. Name of the Establishment : REDEX ENTERPRISE

3. Address of the Establishment : B-813,814, SIVANTA-1,NR. KOTHAWALA FLATE, ASHRAM ROAD, PALDI
AHMEDABAD AHMEDABAD AHMEDABAD
4. PF A/C No. held by : AHMEDABAD

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 : GOBI

10. Date of Birth : 24/11/2002

11. Father's/Spouse Name : SIVAPERUMAL

12. Relationship : FATHER

13. Date of joining : 21/01/2023

14. Date of leaving : 18/03/2023


PART C : DETAILS OF PRESENT PF

1. PF Account No. (with EPFO : PYBOM19849350000122714

2. Name of the Establishment : SPNN BUSINESS SERVICES PRIVATE LIMITED

3. Address of the Establishment : NO 1178 2ND FLOOR SECTOR 7 HSR LAYOUT BANGALORE
BENGALURU (BANGALORE) URBAN
4. PF A/C No. held by : SRO BOMMASANDRA

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 : GOBI

10. Date of Birth : 24/11/2002

11. Father's/Spouse Name : SIVAPERUMAL

12. Relationship : FATHER

13. Date of joining : 19/04/2023

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. SPNN BUSINESS SERVICES PRIVATE LIMITED

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