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  • Wipro in PF Settle Form

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    umesh
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    This document contains an application form for withdrawal of accumulated funds from a provident fund. It requests the full amount standing in the applicant's credit after applicable deductions. It collects information such as the applicant's name, employee number, account number, current and previous employment details, and reason for withdrawal. Supporting documents may be required depending on the reason for withdrawal, such as a medical certificate for permanent disability or passport details for emigrating abroad. The form must be signed by the applicant and authorized witness such as a gazetted officer or local official to certify the applicant is not currently employed under another provident fund.

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    wipro In Pf Settle Form

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    This document contains an application form for withdrawal of accumulated funds from a provident fund. It requests the full amount standing in the applicant's credit after applicable deductions. It collects information such as the applicant's name, employee number, account number, current and previous employment details, and reason for withdrawal. Supporting documents may be required depending on the reason for withdrawal, such as a medical certificate for permanent disability or passport details for emigrating abroad. The form must be signed by the applicant and authorized witness such as a gazetted officer or local official to certify the applicant is not currently employed under another provident fund.

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    © All Rights Reserved
    Descărcați ca PDF, TXT sau citiți online pe Scribd
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    1K vizualizări2 pagini

    Wipro in PF Settle Form

    Încărcat de

    umesh
    This document contains an application form for withdrawal of accumulated funds from a provident fund. It requests the full amount standing in the applicant's credit after applicable deductions. It collects information such as the applicant's name, employee number, account number, current and previous employment details, and reason for withdrawal. Supporting documents may be required depending on the reason for withdrawal, such as a medical certificate for permanent disability or passport details for emigrating abroad. The form must be signed by the applicant and authorized witness such as a gazetted officer or local official to certify the applicant is not currently employed under another provident fund.

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    © All Rights Reserved
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    din 2

    (Form 19)

    (Please print all pages)

    APPLICATION FORM FOR WITHDRAWAL OF


    ACCUMULATION FROM PROVIDENT FUND
    The Chairman
    Board of Trustees
    WIPRO SYSTEMS PROVIDENT FUND TRUST
    D Block, Sarjapur Road, Dodda Kannelli
    Bangalore 560 035, Karnataka
    Sir,
    I hereby request you to pay the full amount standing to my credit in the Fund after making such
    deducion as may be authorised under your Provident Fund Rule Nos.22 and 23
    1.

    Name (in block letters): Sri / Smt

    2.

    Employee Number

    3.

    Account Number

    : KN/11394/

    4.

    Permanent Address
    (where you want the
    cheque to be sent)

    5.

    Name & address of the present employer

    6.

    If there is any Provident Fund Scheme under present employment

    7.

    Ground on which the request for withdrawal is made


    (please proved documentary proof)

    8.

    Date of leaving India in case of migrating abroad

    9.

    The payment may be made by M.O. at my cost / cheque / cash :

    10.

    Particulars of last subscription i.e. month and amount

    Locn :

    Divn :

    YES/NO

    I certify that the particulars given above are true to the best of my knowledge, I hereby pledge to
    indemnify you against any claim for Income Tax that may arise in future in this connection.

    Date

    Signature of the member:

    The member should state whether he :


    a.
    is retiring from service in the industry attaining the age of superannuation
    b.
    is retiring on account of permanent and total incapability for work in any industry due to bodily
    or mental infirmity
    c.
    is migrating from India on permanent settlement abroad
    d.
    has not been employed in an establishment to which the scheme applies for a continuous
    period of not less than sixty days immediately preceding the date of application
    2/-

    Wipro Technologies, HRD


    Ver HR 1.0 Jan 2000

    Company Confidential

    Page 1

    If the claim for withdrawal is made on grounds mention in footnote (b) above, the certificate by a
    registered medical practitioner or the medical officer of the establishment should be enclosed. If the
    claim for withdrawal is made on grounds mentioned in (d) above, a certificate from such authority as
    may be specified, of non-employment for a period of sixty days in any establishment to which the
    scheme applies, should be encloses. If the claim for withdrawal is made on grounds mentioned in
    (c), the member should produce copies of passport, visa and flight details.
    CERTIFICATE
    This is to certify that Sri / Smt _________________________________________________________
    has signed before me the application for withdrawal of Provident Fund money.
    He / she is not
    employed in any establishment where there is provision for Provident Fund under Employees
    Provident Fund Act, 1952.

    Date

    Name :

    Authorised Signatory

    Address:

    Designation & Seal


    Persons authorised to attest the application :
    1.
    2.
    3.
    4.
    5.
    6.
    7.
    8.

    Gazetted Officer
    Post Master or Sub Post Master
    President of the Village Union
    President of the Village Panchayat
    Chairman / Secretary of the Municipal / District Local Board
    Village Munsiff
    MLA
    Member of Municipalities and Municipal Corporation

    Wipro Technologies, HRD


    Ver HR 1.0 Jan 2000

    Company Confidential

    Page 2

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