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PF Transfer Form

This document is an Online Transfer Claim Form for the transfer of Provident Fund balance and Pension Service Details for the member Surekha Roy. It includes personal details, previous and present PF account information, and certification of the accuracy of the provided information. The form is to be submitted to the previous establishment for processing.

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Surekha Roy
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15 views2 pages

PF Transfer Form

This document is an Online Transfer Claim Form for the transfer of Provident Fund balance and Pension Service Details for the member Surekha Roy. It includes personal details, previous and present PF account information, and certification of the accuracy of the provided information. The form is to be submitted to the previous establishment for processing.

Uploaded by

Surekha Roy
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

ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]

( Tracking ID: 10037278061305001 )


Claim Date : 08/12/2022
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 : SUREKHA ROY

2. Mobile Number : 9916951682

3. E-mail id : [email protected]

4. Bank Account Number : 50100033806279

5. Bank IFSC : HDFC0001268

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

1. PF Account No. (with EPFO : GJAHD14478000000000022

2. Name of the Establishment : MAX PUBLICITY & COMMUNICATION PRIVATE LIMITED

3. Address of the Establishment : MUDRA TOWER, SHANTI SADAN SOCIETY, OFF C.G. ROAD,
ELLISBRIDGE, AHMEDABAD 554
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 : SUREKHA ROY

10. Date of Birth : 06/01/1987

11. Father's/Spouse Name : MR SUDHIR ROY

12. Relationship : FATHER

13. Date of joining : 01/03/2016

14. Date of leaving : 31/03/2022


PART C : DETAILS OF PRESENT PF

1. PF Account No. (with EPFO : GJAHD14478000000010332

2. Name of the Establishment : MAX PUBLICITY & COMMUNICATION PRIVATE LIMITED

3. Address of the Establishment : MUDRA TOWER, SHANTI SADAN SOCIETY, OFF C.G. ROAD,
ELLISBRIDGE, AHMEDABAD 554
4. PF A/C No. held by : RO 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 : SUREKHA ROY

10. Date of Birth : 06/01/1987

11. Father's/Spouse Name : MR SUDHIR ROY

12. Relationship : FATHER

13. Date of joining : 01/10/2022

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 Previous
Establishment i.e. MAX PUBLICITY & COMMUNICATION PRIVATE LIMITED

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