You are on page 1of 2

FORM 13 (Revised)

THE EMPLOYEES' PROVIDENT FUNDS SCHEME, 1952


(Para-57)

FOR OFFICE USE ONLY Date Seal/Reg. No. .

Application For Transfer of EPF Account


NOTE : (i)
ii iii (ii) To be submitted by the member of the present employer for onward transmission to the Commissioner ,EPF by whom the transfer is to be effected.
In case the P.F. transfer is due from the P.F. Trust of an exempted establishment, the application should be sent direct by the employer to the P.F. Trust of the exempted establishment, with a copy to the RPFC concerned for details of the Pension membership.

To The Commissioner, Employees' Provident Fund, ------------------------------------------------------------------------------------------------------------------------------------------

To M/s ..
(To be filled in, If Note (ii) above is applicable)

Sir, I request that my Provident Fund balance alongwith the membership details in Pension Funds may please be transferred to my present account under intimation to me. Necessary particulars are furnished below : 1. 2. 3. 4. 5. Name : Father's/Husband's name in case of married Woman : Name & Address of Previous employer : EPF account Number with the previous employer By whom the PF account of the previous Estt. is kept Pension Fund Account Number with the previous employer (if allotted a separate one) Date of leaving service with previous employer : Date of joining the present employer : Signature/Left Hand Thumb Impression of the Member Regional PF Commissioner at Name of the PF Trust

6. 7. 8.

Date.

TO BE FILLED IN BY THE PRESENT EMPLOYER


9.
Name & Address of the establishment: Kodiak Networks India Pvt. Ltd. #401, 4th Floor, Prestige Sigma, No.3, Vittal Mallya Road, Bangalore 560 001. KN/BN/25943/ -

10. EPF Code & Account No. allotted to the member 11. Pension Fund Account No. allotted to the member
separately, if any:

P.T.O

12. By whom the EPF account of the member in the present establishment is kept : a) Being an unexempted establishment (i) By Regional office at station: Bangalore (ii) Sub-Regional office at b) Being an exempted establishment (i) By exempted PF Trust, VIZ. (ii) By private PF-Not covered under the Act viz.

13. By whom the Pension Fund Account


14. of the member in the present establishment is kept.

(I) By Regional Office at: Bangalore

(ii) Sub-Regional office at Bangalore

15. In whose favour cheque has to be drawn?


Payees details

RPFC A/c KN/BN/25943/

Date..

Signature of Employer/Authorised Official with Office Seal

(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 Cheque to the Regional PF Commissioner/Officer in charge of Sub-Regional Office By Cheque to the PF Trust of the establishment with reference to details in Serial no 14 above Membership details under Pension Fund forwarded to PF Regional Office/ Sub-Regional Office at______________________________________. By transfer through Annexure K ( Revised) sent through EDP for intra office transfer. Transfer intimation copy of Annexure-K ( Revised) to the member placed below.

P.I. No. Scroll NO.

CLERK

S.S.

A.A.O./APFC

Paid by Cheque No.______________________dated:

Cashier/Clerk

Section Supervisor

A.P.F.C.

You might also like