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1 - 2 - Settlement - Application Form - Sample

This document is a PF Settlement Application form addressed to Tata Capital Limited Employees Provident Fund, requesting the withdrawal of Provident Fund accumulation. It includes personal details of the employee, employment history, and a declaration regarding employment status. Additionally, it mentions tax implications for settlements related to memberships of less than five years.

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215 views1 page

1 - 2 - Settlement - Application Form - Sample

This document is a PF Settlement Application form addressed to Tata Capital Limited Employees Provident Fund, requesting the withdrawal of Provident Fund accumulation. It includes personal details of the employee, employment history, and a declaration regarding employment status. Additionally, it mentions tax implications for settlements related to memberships of less than five years.

Uploaded by

m8971632739
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

PF Settlement Application form

To,
The Trustees,
Tata Capital Limited Employees Provident Fund
I-Think Techno Campus, A Wing Fourth Floor,
Off Pokhran Road No. 2
Thane (W) Mumbai 400607 Maharashtra

Subject : Application for Provident Fund Withdrawal for Emp. Code: {[Link]}

Dear Sir,

I would like to withdraw the Provident Fund accumulation in my PF account held by the Trust.
The brief particulars of my employment with the establishment are given below:

1. Employee Code
2. Name as per Aadhaar
3. Father/Husband Name
4. P.F. Number/UAN No
5. Date of Birth
6. PAN (Mandatory)
7. Address

8. Date of Joining
9. Date of Leaving
10. Reason of Leaving
11. Bank Account Number
12. Bank IFSC Code
13. Mobile Number
14. Email ID

I Declare that I have not been Employed in any factory or other establishment to which the Employees’ Provident
Funds and Miscellaneous Provident Fund Act 1952 applies for a continuous period of not less than 2 Months
immediately preceding the date of my application for Final withdrawal of my provident fund money

The above particulars are Correct. You can settle the Provident Fund account to the bank account number
mentioned in the cheque Copy/bank statement.

Date : {[Link]}

Place :
________________________
Member’s Signature

Note : 1. In case the member is migrated from India for permanent settlement/taking up employment abroad,
Please furnish a copy of Visa

2. Please note that as per the provisions of the fourth schedule of Income tax Act 1961, tax is to be deducted
on all PF settlement made for cases having membership less than five years (membership cumulative across
all employers). Tax at appropriate rate will be deducted from the settlement and deposited with the central
Government and a TDS certificate (Form 16) will be issued to you in said respect

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