Sumit

Download as pdf or txt
Download as pdf or txt
You are on page 1of 2

Submitted online at UAN e-seva portal on 2022-02-22 19:51:41 (IP www.epfindia.gov.

in
Address:223.229.212.136)

deZpkjh Hkfo"; fuf/k ;kstuk] 1952


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
(mu ekeyksa esa ykxw tgka QkeZ 11(u;k)esa deZpkjh dk iwjk fooj.k] vk/kkj la[;k vkSj cSad [kkrk la[;k ;w-,-,u- iksVZy vkSj ij
miyC/k gS rFkk ;w-,-,u- esa lfØ; gSA)
(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 / eksckby uacj - 9920546369
1. I want to apply for PF Advance
2. Universal Account Number(UAN) / ;wfuolZy [kkrk la[;k 100587799903
3. Name of the member VINAYAK UPENDRA SINGH

4. Date of Joining 13-Aug-2018


5. Permanent Account number / LFkk;h [kkrk la[;k FGXPS6732M

6.a Purpose of Advance OUTBREAK OF PANDEMIC (COVID-19)

6.b Amount of Advance (In Rs) 23000


7 In case of Advance for purpose of Site/House/Flat Not Applicable

8 Bankers details for Electronic Payment (Only for the Advance if payable to Not Applicable
third party)

9. Payee Address room no 19 babaji patil wadi old mumbai


pune road ,mumbra
,THANE,MAHARASHTRA-400612

* eSa çekf.kr djrk gw¡ fd eSaus ;w , ,u iksVZy ij lhM MkVk dks Hkyh Hkk¡fr ns[k fy;k gS rFkk QkeZ u- 11( u;k ) cSad [kkrk fooj.k vkSj vk/kkj
la[;k lfgr lHkh MkVk lgh ik;k x;k gSA
* 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: UPENDRA SINGH Date Of Birth: 16-Jun-1995
Bank Account Number 50100246239622 Bank IFSC Code HDFC0000835
Bank Details HDFC BANK,BANDRA EAST - KALANAGAR
Aadhaar 79XXXXXXXX10
Member ID KDMAL14655480000032890
* —i;k ;w-,-,u-iksVZy ij n'kkZ, x, cSad [kkrs esa Hkqxrku djsaA
* Please make payment in the bank account mentioned in the UAN portal .
UAN - 100587799903 Tracking ID - 10058779990306004

You might also like