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Instructions for a member while sending application to
Employees' Provident Fund Organization:
General:
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Use the appropriate form for claiming Provident Fund
Pension, withdrawal benefit/scheme certificate, Employees' Deposit Linked
Insurance benefit, etc. as given below :-
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Form-19 : To claim final settlement of Provident Fund
by a member.
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Form-20 : To claim Provident Fund by nominee/legal
heir on death of the member.
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Form-10-D : To claim pension. (In duplicate : If
within state, In triplicate : If outside state.)
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Form-10-C : To claim withdrawal benefit/scheme
certificate under Employees' Pension Scheme '95.
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Form-5IF : To claim assurance benefit under
Employees' Deposit Linked Insurance '76 by nominee/legal heir of a member.
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Form-31 : To claim temporary withdrawal/advance under
Employees' Provident Fund scheme
'52.
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Form-13 : To effect transfer of Provident
Fund/Pension from one A/C to another.
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Ensure that all columns of the application are filled
completely.
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Information in the application form relating to name, a/c
no. should agree with the details
available with Employees' Provident Fund Organization; which were furnished
by the employer at the time of enrolling to Provident Fund.
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Application should be signed by the member/claimant.
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It should be attested by the former employer. In case
attestation by the former employer is not possible, it should be got
attested by any other authorized official specified with application form.
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Application for final settlement can be sent by a member on
completion of 2 months from the date of leaving service, if the reason for
leaving service is other than superannuation, medical ground, retrenchment
and V.R.S./ Female members getting married etc.
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Desired mode of payment can be given legibly, if the amount
involved is more than Rs. 2000/-. The amount will sent by deposit in payees'
bank a/c. To facilitate this, Bank a/c no., name and address of the bank
should be furnished. An advance stamped receipt should also accompany this
application.
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Application may be supported by the return Form-10, showing
the details of leaving service and details of contribution for the year in
Form-3A, if not sent earlier by the employer.
Specific additional requirements:
A) Death cases:
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Nominee/legal heir should apply in Form-20 /Form-10-D /Form-5IF.
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If the
member has not executed any nomination, application should be supported
by certificate of family members issued by employer/revenue
official/sworn in an affidavit by the family/ member/legal certificate
from a court of law.
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Death
certificate of the member.
Certificate of the employer stating whether the death was
while in service of the member or not.
B) Pension cases:
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Joint photograph of
member/spouse or the claimant should accompany the application.
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Option for return of
capital/commutation should be specified clearly.
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Details of non-contributory
period during the service, wages/salary for last 12 months should also
accompany, if not already sent.
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Details of the branch of the
specified bank may be given legibly.
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Date of birth certificates of
children
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In case of death away from
service, an undertaking by the claimant to the effect that the member
was not working / had not worked in any other covered establishment
after exit from the establishment on the basis of which pension is being
claimed.
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