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‘Submitted ontine t UAN e-eva portal on 2073-04-06 072546(1 _ww.epfindia.gov.in
‘Addrese4995.242.131)
‘it aor AE a, case
EMPLOYEES’ PROVIDENT FUND SCHEME, 1952,
LUAN Based Combined Claim Form 19/10¢ W/31 for Advances/PF Final Setlement/Pension Fund Withdrawal
(or saat 8 ory oat an irae weed ay A Reem, oe sto ote es TT or ET, ea te
‘oreet & ae RTT, # aT tH)
{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 {arse ace - 8393981207
1. _|Iwanto-apaly for inal Setlement
2 Universal Account Nurber(UAN) / oats ere wa so1se44228se
3. Name of the member ‘EET SINGH
4. Date of ining 126-000-2039
5. Date of Leaving Service/ SA wr oie 31-Mar-2020
6. Reason of Leaving Service/ im A eT CESSATION (SHORT SERVICE) Any other
7. Permanent Account number / x) ay a MURPS#367«
8. Payee Address Vill post Kher satt teh Khe dist iar
201 eral ALIGARH UTTAR PRADESH
202138
2 st en & PA EL
ia abe GH wee TT TAY
* | certify that | have gone through the data seeded in UAN Portal and found all data including Form No.1
(New) , bank account details and Aadhar Number to be correct
ete ee re AN eh A Bee eT en me 4s) es ee Ree ae TE
Father/Husband/Spouse Name: MAN SINGH Date Of Birth: 18-Ju/-1995
Bank Account Number 4702108000312 Bank IFSC Code ‘cwre0004702
Bank Details _ CANARA BANK,KHAIR
‘wedhaar SOXXIOKXKGS
MemberID GNGGN00266520000019647
Fon ququtés w ety ry fe ert f grat we
* Please make payment in the bank account mentioned in the UAN portalUAN- 101544422858 ‘Tracking ID-__10154442285801001,