[ From the employees who had retired before 01.09.2014 and exercised joint option under Para 11(3) of EPS Scheme prior to 01.09.2014 ]
To be exercised by eligible members of EPS-1995 on or before 03rd March 2023 with reference to Para 44(ix) read with Para 44(vi) of order dated 4.11.2022 of the Hon’ble Supreme Court in SLP No. 8658-8659 of 2019
DISCLAIMER I have gone through Supreme Court Judgement dated 04.11.2022 in SLP (c) No. 8658-8659 of 2019 and I am registering the application in terms of directions contained in the said judgement. I undertake that the pension will be calculated subject to formula determined under the Scheme.
Place : AMRAVATI
Date : 19/02/2023
Sl.No Details
1 PPO Number NGAKL00086190
2 PPO Date 28-APR-2015 SURESH G VIDHALE 3 Name of Member (as per PPO)
4 Gender MALE 5 UAN No. 100382862733
6 Date of Birth of Member 02-JUL-1956
GUNWANTRAO 7 Father’s / Spouse Name (as per PPO)
8 Office by which PPO was issued AKOLA
9 Service Details Date of joining Date of leaving Date of joining Date of leaving PF Account Number Establishment Name FPS FPS EPS EPS
MHBAN00012510000135 9.1 M.S.E.B. 29-APR-1981 15-NOV-1995 16-NOV-1995 02-JUL-2014 183 Date of Superannuation 10 02-JUL-2014 (applicable only if date of filing joint option is before 01-09-2014)
Date from which employer’s contribution was received on wages
exceeding statutory wage ceiling of Rs 5000 in EPF prior to 01.06.2001 from the day his salary exceeded Rs 5000? 11 16-NOV-1995 (applicable only if date of joining is prior to 01.06.2001)
Whether Employer’s contribution was received on wages
exceeding statutory wage ceiling of Rs 6500 in EPF prior to 01.09.2014 from the day his salary exceeded Rs 6500? 12 N.A. (applicable only if date of exit is on or after 01.06.2001)
Date of filing joint option under the proviso to Para 11(3) of
EPS Scheme? 13 Please attach the copy of joint option form. 15-NOV-1995
(applicable only if date of filing joint option is before 01-09-2014)
14 Date of rejection of joint option by EPFO. N.A.
Office by which rejected 15 N.A. Please attach the copy of the order of rejection.
16 Aadhaar No. of Member XXXX XXXX 6599
17 Aadhaar linked Mobile No. of member 9766305301 SURESHVIDHALE19@GMAIL.COM 18 Email ID of member
19 Aadhar linked Bank Account no. 30056133679
20 IFS Code SBIN0003327 Whether member wants to use accumulation available in 21 his / her PF account for payment of due contribution for this option? No
22 How much is the PF account balance on the date of filing option? N.A. Whether member is giving undertaking to deposit the contributions 23 along with interest due till date of payment through his last Yes employer [only when PF account has no / insufficient balance]?
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Declaration:
1. I hereby declare that I have read and understood the Supreme Court Judgement in SLP (c) no.8658- 8659 of 2019.of the Hon’ble Supreme Court and I am registering this application in terms of the directions contained in the said judgement.
2. I understand and agree that as a member of the Employees’ Pension Scheme, my rights to claim pension are limited to the scope of judgement and within the EPF & MP Act, 1952 and the Schemes framed thereunder.
3. I further understand that the central government is empowered to amend the scale of benefits, commensurate with the contributions made, either prospectively or retrospectively, on which the pension payable to me shall be computed.
4. I do hereby agree that the details of contribution and interest given by my employers are essential for the computation of dues payable for this application, and this is the full and final submission.
5. I hereby certify that the services details in the above form are correct and no material fact has been mis-represented or hidden by me.
6. I hereby agree to pay due contribution in a single tranche as specified by EPFO, along with interest at rates declared under Para 60 of EPF Scheme 1952 or at the rate declared by the concerned trust of such establishment, from time to time, whichever is higher,if any.
7. I hereby jointly apply along with my employer to pay full amount of contribution on salary exceeding wage ceiling under erstwhile para 11(3) (since deleted) of EPS 95 along with interest upto the last date of the month in which payment is made, in accordance with the judgement dated 04.11.2022 of the Hon’ble Supreme Court through my last employer within such period as directed by EPFO after validation of my application. If the full amount payable is not deposited by my last employer within such period as directed by EPFO after validation of my application, this application shall be treated as Null and Void.
8. I undertake that all the facts are true. If the details submitted by me or my employer are found to be incorrect at any point of time, this application shall be treated as Null and Void.
9. I am aware that in case of false declaration and willful mis-representation, appropriate penal action may be taken by EPFO against me.
