SPECIMEN SIGNATURE CARD FOR UPLOAD WITH THE ONLINE APPLICATION FOR REGISTRATION
WITH EMPLOYEES’ PROVIDENT FUND ORGANISATION
(This card is for the specimen signature of the employers of the establishment at the time of
registration of the establishment with the Employees’ P F Organization)
NAME OF ESTABLISHMENT MEDIATECHTEMPLE PRIVATE LIMITED
ADDRESS OF THE ESTABLISHMENT 57, Swran Jayanti Nagar, Bharatpur Rajasthan 321001
_____________________________________________________________________________
(Please upload for all employers and for Authorized Signatory if any)
Name of Employer 1: Name of Employer 2:
JAINENDRA AGRAWAL SAKSHI GOYAL
Designation Designation
Director Director
Signature Specimen Signature Specimen
1. 1.
2. 2.
3. 3.
Name of Employer 3: Name of Employer 4:
Designation Designation
Signature Specimen Signature Specimen
1. 1.
2. 2.
3. 3.
For P F Office Use: Code Number Allotted: