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Form 10c Epfo PF Withdrawal

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Sai Kiran Yamsani
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139 views2 pages

Form 10c Epfo PF Withdrawal

Uploaded by

Sai Kiran Yamsani
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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Submitted online at UAN e-seva portal on 2020-02-15 09:10:05 www.epfindia.gov.

in

deZpkjh Hkfo"; fuf/k ;kstuk] 1952


EMPLOYEES' PROVIDENT FUND SCHEME,1952
EMPLOYEES' Pension Scheme,1995
UAN Based Combined Claim Form 19/10C WB/31 for Advances/PF Final Settlement/Pension Fund Withdrawal
(mu ekeyksa esa ykxw tgka QkeZ 11(u;k)esa deZpkjh dk iwjk fooj.k] vk/kkj la[;k vkSj cSad [kkrk la[;k ;w-,-,u- iksVZy vkSj ij
miyC/k gS rFkk ;w-,-,u- esa lfØ; gSA)
(Applicable in cases where employee's complete details in Form 11(New),Aadhaar Number and Bank
Accounts details are available on UAN Portal and UAN has been activated.)
Mobile Number / eksckby uacj - 9901902900
1. I want to apply for Pension Fund Withdrawal
2. Universal Account Number(UAN) / ;wfuolZy [kkrk la[;k 101139360506
3. Name of the member SAI KIRAN YAMSANI
4. Date of Joining 27-Jun-2017
5. Date of Leaving Service/ NksM+us dk fnukad 02-Dec-2019
6. Reason of Leaving Service/ lsok NksM+us dk dkj.k CESSATION (SHORT SERVICE)
7. Permanent Account number / LFkk;h [kkrk la[;k AGJPY2995F

8. Payee Address Flat 105 , Shanta sriram supreme residency


, Road no 8 jubilee enclave,
Kondapur,Hyderabad

* eSa çekf.kr djrk gw¡ fd eSaus ;w , ,u iksVZy ij lhM MkVk dks Hkyh Hkk¡fr ns[k fy;k gS rFkk QkeZ u- 11( u;k ) cSad [kkrk fooj.k vkSj vk/kkj
la[;k lfgr lHkh MkVk lgh ik;k x;k gSA
* I certify that I have gone through the data seeded in UAN Portal and found all data including Form No.11
(New) , bank account details and Aadhar Number to be correct
Father/Husband/Spouse Name: SRINIVAS YAMSANI Date Of Birth: 12-Jun-1996
Bank Account Number 5660912552 Bank IFSC Code CITI0000006
Bank Details CITI BANK,HYDERABAD
Aadhaar 97XXXXXXXX57
Member ID APHYD00478010000019329
* —i;k ;w-,-,u-iksVZy ij n'kkZ, x, cSad [kkrs esa Hkqxrku djsaA
* Please make payment in the bank account mentioned in the UAN portal .
UAN - 101139360506 Tracking ID - 10113936050604001

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