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The document is an online application for PF Final Settlement submitted through the UAN e-seva portal. It includes details such as the applicant's UAN, name, dates of joining and leaving service, and bank account information. The application confirms that all data on the UAN portal is correct and requests payment to the specified bank account.

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10 views2 pages

PDF Download

The document is an online application for PF Final Settlement submitted through the UAN e-seva portal. It includes details such as the applicant's UAN, name, dates of joining and leaving service, and bank account information. The application confirms that all data on the UAN portal is correct and requests payment to the specified bank account.

Uploaded by

lokhandeajay8329
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 2024-12-13 21:56:32 www.epfindia.gov.

in

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

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 - 6303690640

1. I want to apply for PF Final Settlement


2. Universal Account Number(UAN) / 101319747123

3. Name of the member KAMBLE KAILAS RAMDAS


4. Date of Joining 14-May-2024
5. Date of Leaving Service/ 11-Jun-2024

6. Reason of Leaving Service/ CESSATION (SHORT SERVICE) -


Any other reason
PAN NOT AVAILABLE ( Member
7. Permanent Account number opted to submit the online claim
without seeding PAN.)
8. Payee Address COLLEGE,Vishnupuri,Mahars,591,17-
431601

* 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: KAMBLE RAMDAS Date of Birth 05-Jun-1999


Bank Account Number 3684260572 Bank IFSC Code CBIN0284821
Bank Details CENTRAL BANK OF
INDIA,VISHNUPURI
Aadhaar 33XXXXXXXX85
Member ID BGBNG19877530000075889

* Please make payment in the bank account mentioned in the UAN portal.

EPFO UMANG
EPFO UMANG

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