(FORM-13 REVISED)

THE EMPLOYEE’S PROVIDENT FUNDS SCHEME, 1952

(Para 57)
APPLICATION FOR TRANSFER OF EPF ACCOUNT

To,
The Commissioner
Employee’s Provident Fund,
SAO Thane

Sir,

I request that my Provident Fund balance alongwith the membership detail in family Pension fund
may please be transfer to my present account under intimation to me. Necessary particulars are
furnish below:-

1) Name:- _______________________________________________

2) Father’s Name (Husband’s name in case of married woman):- __________________________

3) Name and address

of previous employer

4) EPF account Number with the Previous Employer: _______________________________

5) By whom the PF account of the Regional PF Name of the P. F. Trust

previous estt. Is kept Commissioner at

6) FRF/EPS Account Number with the Previous Employer (if allotted a separate one) :-

7) Date of Leaving service with Previous Employer:- _________________

8) Date of Joining the Present Employer:- __________________

Date Signature/L. M. T. I. of the Member

To be filled in by the Present Employer

9) Name and Address Global InnovSource Solutions Pvt. Ltd.

of the Establishment:- A-203, Kailas Complex, Off. Hiranandani Powai,
Parksite, Vikhroli (West), Mumbai-400 079

10) EPF Code & Account No. allotted to the member: ___________________________________

11) EPF/EPS Account No. allotted to the member separately, if any:- ______________________
12) By whom the EPF account of the member in the present Sub Accounts Office, Thane
establishment is kept

Being an unexempted establishment 1. By Regional Office at (Station) _____

Being an unexempted establishment
Group No. :- Thane – 9
2. Sub-Regional Office at _______GR. No.:____
3. By exempted PF Trust, viz________________
4. By Private PF-Not covered under the
Act-viz_______________________________

13) By whom the FPF/EPS Account of the member 1) PF Regional Office at (station)___________
in present establishment is kept
2) PF Sub-Regional Office at______________

14) In whose favour transfer is to be effected, _____________________________________

i.e. payee’s details _____________________________________
_____________________________________

____________________________
Signature of Employer / Authorised
Official with Office Seal
Date __________________________
_______________________________________________________________________________

(FOR THE USE OF P.F.OFFICE ONLY)

A sum of Rs._________________ (Rupees ____________________________ is authorised for

transfer, vide Annexure ‘K’ (Revised). Transfer proceeds to be sent alongwith Annexure ‘K’
(Revised)

By D.D. to the Regional PF Commissioner Officer-in-charge of Sub-Regional office ____________

By D.D. to the P.F. Trust of the establishment with reference to details in Serial No. 14 above.

Membership details Family Pension Fund Forwarded to P.F. Regional Office/Sub-Regional Office
at ___________________________________________________________________________

By transfer entries to the Memer’s Ledger Card bearing Number _________________ in the
present establishment from the Ledger Card bearing Number _______________ of the previous
establishment.

Transfer Intimation/copy of Annexure-K (Revised) to the member placed below:

Serial No. CLERK H.C. A.A.O. A.O./A.P.F.C.

P.I.No.

Paid by cheque No. _____________________ dated __________________

Cashier/Clerk Head Clerk A.P.F.C.