PF Ready Reckoner Written by M Ravi Shankar, [email protected] 2012 Employees’ Provident Fund and Misc. Provisions Act, 1952 Ready Reckoner
PF Ready Reckoner
Written by M Ravi Shankar, [email protected] Page 1
2012
Employees’ Provident Fund and Misc. Provisions Act, 1952 Ready Reckoner
PF Ready Reckoner
Written by M Ravi Shankar, [email protected] Page 2
Written by M Ravi Shankar
Dedicate to all the unknown gurus on Internet who helped me in learning various subjects.
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Index
1 Introduction
2 Enrollment
3 Compliances
4 EPF Calculations/benefits
5 EPS Calculation/benefits
6 Withdrawal/Advances
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The Employees' Provident Fund & MP Act,1952 is an important piece of Labour Welfare legislation enacted by the Parliament to provide social security benefits to the workers . At present , the Act and the Schemes framed there under provides for three types of benefits -Contributory Provident Fund , Pensionary benefits to the employees/ family members and the insurance cover to the members of the Provident Fund. The object of the Act in 1952 was to institute the compulsory contributory Provident Fund to the employees to which both the employee and the employer would contribute. The Employees' Provident Fund Scheme was accordingly framed under the Act and it came into effect from 1-11-1952. On a review of the working of the scheme over the years by EPFO, it was found that in the event of the premature death of the employees the accumulation in the Provident Fund were too meagre to the family of the deceased .Thus another social security benefit of providing Family Pension through the Employees' Family Pension Fund Scheme , 1971 was introduced by amending the Act . At this stage, the Act was renamed as "The Employees' Provident Fund & Family Pension Act, 1952" and the Employees' Family Pension Scheme came into force on 1-3-1971. The Act was further amended in the year 1976 to introduce another social security benefit to provide an insurance cover to the members of the Provident Fund in covered establishment. The Employees' Deposit Linked Insurance Scheme, 1976 came into force from 1-8-1976. The name of the Act was then changed to the present one i.e. 'The Employees' Provident Fund & MP Act, 1952‟. From 16-11-1995, the Employees' Pension Scheme has come into force which provides pension to retiring employees on reaching 50/58 years of age, widow pension, children pension and nominee pension on death of the member to his eligible family members. This replaces the Employees' Family Pension Scheme 1971. Employee Provident Fund Organization is the nodal agency for administration of the fund as well as statutory authority under the Act to ensure Compliances. EPFO had Launched online receipt of Electronic Challan cum Return (ECR) from the Month of April 2012 (March paid in April. Through, this portal registered employer can upload the Electronic Return and the uploaded return data will be displayed through a digitally signed copy in PDF format. The employer may choose to make the payment through internet banking of SBI or take a print out of the Challan and pay at any designated branch of State Bank of India (SBI).
The Benefits of this portal are as follows::
No paper returns to be prepared and submitted to EPFO.
No need to submit other returns viz Form 5/10/12A,3A and 6A
Employers will get the confirmation of payment through SMS instantly.
Introduction
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The contribution will be credited to the members' account on monthly basis.
Employers can view the annual accounts slip for accounting year 2011-12 online.
For earlier years employers can request for the annual slips through this portal.
Though the EPFO has provided many features in its portal, still the employers have to preserve Physical Copies of Forms Such as Form 2 (Nomination form) Form 5/10 (to be provided to members after joining/ leaving the service) and Form 3/3A (to be used for filling Form 10 C /D or Form 19 for withdrawal of Pension). Further, claiming benefits under EPF Act is not yet made online. Therefore, in the subsequent chapters of this book, procedures on how to fill the form, the relevant provisions pertaining to the form are explained. The First part of book deals with the compliances that are required to be made by the employer. The second part deals with benefits and withdrawals.
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The EPFO Act is applicable to a factory or establishments engaging more than 20 workmen. In order to obtain coverage under EPFO Act, the Contractor shall submit an application to PF office in the Form for Proforma of coverage (Template given in Next page): Attachments Required along with Proforma of Coverage: Procedure Point to be noted before submission of Form Illustrative Form
Proforma for Coverage
1. Memorandum & Articles of Association with Certificate of Incorporation/Partnership Deed as applicable.
2. Copy of Work Orders 3. Labor License 4. Copy of Company PAN 5. Bank a/c existing Certificate 6. Copy of VAT/ST Registration 7. Copy of Factory/Shop & Comm. Est Registration 8. DD/Cheque for One month advance contribution 9. Copy of Trade license 10. First Sales Invoice/ Commencement of Business Certificate issued by the
Registrar of Companies. As proof of date of commencement 11. Proof of Residence: rent agreement/Electricity Bill etc
1. The form to be submitted to PF office
2. The Concerned enforcement Officer will visit the establishment for verifying the
Original records
3. Thereafter EPF will assign the code.
4. Advance Contribution for two months is required to be paid for coverage.
1. If workmen are more than twenty, a separate sheet should be attached along with
the form.
2. Balance sheet is to be attached to determine actual date of coverage.
3. Date of Incorporation will be in Certificate of Incorporation
4.
Enrollment
The Illustrative sheet given in the Next page pertains to ABC Company with employee
strength of 20 workmen
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Performa for Coverage
( to be submitted by an employer along with one or more of the documents
mentioned
below for obtaining Code Number)
1. Name of the establishment/factory and address. ABC Company Limited
2. Details of Head Office and branches with address.
804, SAI KRUPA BUILDING, VASHINAKA, CHEMBUR, MUMBAI-400074
3. Details of Code No. if any allotted to the Head Office.
MH/19116
4. Date of Incorporation/Set up (Please furnish any one of the documents mentioned overleaf in support of the proof of date of set up of the est./factory)
05.06.2010
5. Employment Strength At present : (ii)Month wise employment strength from the date of set up may be furnished in separate statement :
20
6. Nature of business activity/ manufacturing activity :
Construction/Civil
7. Details of legal set up of the establishment (Please mention whether it is an incorporated Private or Public Limited Company, Society, Partnership or Proprietary concern) :
Private
8. Details of the employers/ownership particulars etc. (Names, Designation and Addresses of Managing Director, Directors, Partners, Secretary etc. to be furnished) :
P H Patil 804, SAI KRUPA BUILDING, VASHINAKA, CHEMBUR, MUMBAI-400074
9. Wages disbursed for the month July 2012
10. Details of Bankers: (Including Bank Branches & Account Number (s).)
SBI, MAHUL, CHEMBUR MUMABI
11. Income Tax Permanent A/c. No.
AABPS1205E.
This field need not be filled for first time registration of Company
The date of incorporation will be in the Certificate of Incorporation
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(In case you have more than 21 employees the above information in respect of
the other employees may be added in a separate sheet of paper in the same
format continuing the serial number. )
12. Details of bank draft amounting to the contribution. Name of the Bank Branch & And administrative charges paid in respect of the above employees. (Rate of Contribution at present is12% by employer and employees+ 0.5% towards E.D.L.I. contribution and 1.15% towards administrative charges
SBI, Mahul Chembur Branch DD No:33675 Amount:99840
VERIFICATION The details furnished above are correct to the best of our knowledge and belief. It is
clearly understood that we are liable for coverage from a date antecedent to the date
of set up furnished above in the event of furnishing of false information. (signature) Employer.
Sl.No.
Name of the employee Father‟s Name Date of Joining
Wages (basic +DA & Cash value of Food Concession)
1. Chhya R Dagde Eknath R Dagde 05/04/2010 6500
2. Eknath K Jore Nitin K Jore 05/04/2010 5500
3. Madhav Manikar Cheyya Manikar 05/04/2010 6500
4. Nenu N Bagv Madhav N Bagv 05/04/2010 4500
5. Nitin Suravanshi Nitin Suravanshi 05/04/2010 6500
6. Poonam Munde Ashok Munde 05/04/2010 6500
7. Rajkumar N Kagda Vijay N Kagda 05/04/2010 3500
8. Sanjay B ukande Sunil B ukande 05/04/2010 6500
9 Santosh J shirke Sanjay J shirke 05/04/2010 6500
10 Vijay D Wagmare Vilas D Wagmare 05/04/2010 6500
11 Vilas B sable vinod B sable 05/04/2010 8500
12 Yogesh S Salve Bhaskar S Salve 05/04/2010 6500
13 Prashant A Bhilarew Prateek t A Bhilarew 05/04/2010 6500
14 Anil Y Mihsra Ajay Y Mihsra 05/04/2010 9000
15 Basavaraj k himatre Dinesh k himatre 05/04/2010 6500
16 G Krishan Naidu G Appala Naidu 05/04/2010 6800
17 Vemal R Bhale rao Ajayl R Bhale rao 05/04/2010 6500
18 Chinta Appa Rao Chinta Sanjeev Rao 05/04/2010 6500
19 Dianmaran C Dinakaran C 05/04/2010 6500
20 Hanumanta Mudakappa Vinay Mudakappa 05/04/2010 6500
Sign of Employer
Required
Fill the detail of
Workmen engaged
by the company
Fill the details of
DD Number and
Amount
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Enrolment of Employees After registration under EPF Act, the employee should be enrolled under the EPF/EPS/EDLI scheme by submitting Form 2 i.e. Nomination Form under Para 33 & 61(1) of EPF Scheme 1952 and paragraph 18 of Employees‟ Pension Scheme, 1995.
Point to be noted before submission of Form
Illustrative Form
Nominees under Employees Provident Fund Scheme
Male Members : his wife, his children, his dependent parents and his deceased
son's widow and children
Female Members: her husband, her children, whether married or unmarried, her
dependent parents, her husband's, dependent parents, her
deceased son‟s widow and children;
Nominees under Employees’ Pension Scheme
Male Members : his wife, Sons & Daughters (includes legally adopted)
Female Members: her husband, Sons & Daughters (includes legally adopted)
** Dependent parents cannot be made as dependent in EPS scheme
1. A member can distribute the amount in his nomination form
2. If a member has a family at the time of making a nomination, the nomination shall be in favour of one or more persons belonging to his family. Any nomination made by such member in favour of a person not belonging to his family shall be invalid. Fill in the required details in the fileds from 1 to 7, except 6.
3. In total there are three tables/ schedules in each form: a. First table (Part A) should be filled with the details of either parents or Spouse.
(If married). b. Second table (Part B) should be filled only if employee is not married else
empty. - Table 2 c. Third table (Part B) should be filled only if employee is married else empty.. -
Table 3
The illustrative form given in the next page is of a married person wherein he has distributed EPF benefits among his dependent parents and EPS benefit to his wife.
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(For Unexempted /Exempted Establishments)
NOMINATION AND DECLARATION FORM
FORM 2
(Declaration and Nomination Form under the Employees‟ Provident Funds and Employees‟ Pension Scheme)
(Paragraphs 33 & 61 (1) of the Employees’ Provident Funds Scheme, 1952 and paragraph 18 of the Employees’ Pension Scheme, 1995)
1 Name (in Block Letters) : Eknath Ram Shelke 2 Father‟s/Husband‟s
Name : Laxman untru shelke
3 Date of birth : 15/4/1988 4 Sex : Male 5 Marital Status : Married 6 Account No. (PF/EPS
Number) : MH/19116/809
7 Address (Residential) : Permanent Block No- 04, Sadgur Apratment, Devalali, Thane
Temporary Sai Darpar Apartment, Vashinak Chembur
PART A (EPF) I hereby nominate the person(s)/cancel the nomination made by me previously and nominate, the person(s) mentioned below to receive the amount standing to my credit in the Employees‟ Provident Fund, in the event of my death: Name and Address of the nominee/ nominees
Address Nominee’s relationship with the member
Date of Birth
Total amount or share of accumulations in Provident Fund to be paid to each nominee (%)
If the nominee is a minor, name and relationship and address of the guardian who may receive the amount during the minority of nominee
(1) (2) (3) (4) (5)
Laxman Munda Shleke
Block No- 04, Sadgur Apratment, Devalali, Thane
Mother 01/05/1968
50% NA
100%
1 * Certified that I have no family as defined in para 2(g) of the Employees’ Provident Funds Scheme, 1952, and should I acquire a family hereafter, the above nomination should be deemed as cancelled.
2 * Certified that my father/mother is/are dependent upon me.
3. * Strike out whichever is not applicable.
Put Cross Mark at
point 1 if you have a
family and Point 2 if
your parents are
dependent
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Signature or thumb impression of the subscriber
Note: - A Fresh nomination shall be made by the member on his marriage and any
nomination made before such marriage shall be deemed to be invalid # If Married –> Spouse, Children (married or unmarried), his/her dependent parents, deceased son‟s widow and children. If unmarried then Parents, Brother, Sister or any other person(s).
Page No. – 1 Part B (EPS) (Para 18) $
I hereby furnish below particulars of the members of my family who would be eligible to receive widow/children pension in the event of my death.
Sl.No. Name and address of the family members Date of Birth Relationship with the member
(1) (2) (3) (4)
1 Sumanta Shelke 15/4/1989 Wife
** Certified that I have no family, as defined in para 2(vii) of Employees‟ Pension Scheme, 1995 and should I acquire a family hereafter I shall furnish particulars thereon in the above form.
I hereby nominate the following persons for receiving the monthly widow pension (admissible under para 16 2(a) (i) and (ii) of Employees‟ Pension Scheme, 1995 in the event of my death without leaving any eligible family member for receiving Pension.
Name and Address of the Nominee
Date of Birth
Relationship with the member
(1) (2) (3)
Sumanta Shelke 15/4/1989 Wife
Dated the :______________ Signature / thumb impression
of the subscriber **Strike out whichever is not applicable.
CERTIFICATE BY EMPLOYER Certified that the above declaration and nomination has been signed/thumb impressed before me by Shri/Smt./KumariEknath Ram Shelke_employed in my establishment after he/she has read the entries/the entries have been read over to him/her by me and got confirmed by him/her. Place: ___________________ Dated the __________________
…………………………………………………………. Signature of the Employer or other authorised
Officer of the establishment Designation……………………………………….
Name and address of the Factory/Establishment or rubber stamp thereof
Please fill details of parents
if not married.
Remember to take
sign of the
Subscriber
Remember to take
sign of the
Subscriber
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Form No.11: Declaration on EPF Subscription: Form 11 under EPF scheme pertains to information provided by an employee while joining a new employer, about his previous employments with name and address of employers along with duration of service. In this form a new joinee also declares that whether he was previously a member of EPF scheme or not. This form is to be kept by an employer and not to be deposited with Sub/Regional commissioner. EPF inspector while inspecting records of an establishment may ask for these forms to check the eligibility criteria. The Form 11 of EPF is a declaration by the employee for certifying that wherever has worked/or not worked, he never had a PF account number. The EPFO has introduced this form in order to stop the system of having multiple numbers of one employee. Duties of Employer As per Paragraph 34 of EPF Scheme, Employer shall take an undertaking from the member in Form 11 that employee was not enrolled earlier in the scheme. If the employee is previously enrolled, the employer should insist the member to submit the details of his previous account and fill the same in Form No 11. In case an employee is already member of phased out Family pension scheme 1971, the details of same are also required to be furnished Point to be noted before submission of Form
Illustrative form:
1. Points (a) to (d) in the form 11 are required to be filled in case the employee is earlier member of the scheme
2. Point (e) in the form 11 is required to be filed only in the case the member is not
enrolled earlier in the PF Scheme.
The form given in the next page is of a new entrant who wan not a member of PF Scheme earlier. Therefore all fields are kept blank except 1 (e) which is tick marked
34. Declaration by persons taking up employment after the Fund has been established
The employer in relation to a [factory or other establishment] shall, before taking any person into
employment, ask him to state in writing whether or not he is a member of the Fund and if he is, ask for the
Account Number and/or the name and particulars of the last employer. If he is unable to furnish the
Account Number, he shall, require such person to furnish and such person shall, on demand, furnish to
him for communication to the Commissioner, particulars regarding himself and his nominee required for
the Declaration Form. Such employer shall enter the particulars in the Declaration Form and obtain the
signature or thumb impression of the person concerned:
Provided that in the case of any such employee who has become a member of the Family Pension Fund
under the Employees’ Family Pension Scheme, 1971, the aforesaid Declaration Form shall also contain
such particulars as are necessary to comply with the requirements of that Scheme.
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FORM-11 (For unexempted Establishment only)
Paragraph 34 of the Employees‟ Provident Funds Scheme, 1952
Declaration by a person taking up employment in an establishment in which the Employees’ Provident
Fund and Family Pension Fund Scheme are in force :
I Vikas Praksh Ghodke (Name) ** son/wife/daughter of Prakash B Ghodke do hereby solemnly declare that – (a) I was last employed in________Company left service on 1/5/2010 (Prior to that I was employee of from to date (b) I was a member of Provident Fund and also/but not of the Family Pension Fund from to and my account number(s) was/were / / (c) I have /have not withdrawn the amount of any Provident fund/Family Pnsion Scheme. (d) I have/have not drawn any superannuation benefits in respect of my past service from any employer. (e) I have never been a member of any Provident Fund and/or Family Pension Scheme. Date Signature or **right/left hand thumb impression of the employee. (To be filled in by the employer only when the person employed had not already been a member of the Employees‟ Provident Fund) Shri Vikas Praksh Ghodke (name) is appointed as Rigger (Designation) in ABC Company(Name of the Factory/Establishment) with effect from 01.05.2010(Date of appointment)
From 01.05.2010 to 01.11.2010 No. of days worked
Date of completion of 120 actual working days in a period of 6 months or less or six months* continuous service or date of confirmation whichever is earliest. Date of admission as member of Employees‟ Provident Fund Account No.
Signature of the Employer or Manager or other Authorised Officer. Date ……………………………
** Strike out whichever is not applicable. N.B. – The principal employer should have filled it up also in respect of employees to be employed by or through a contractor.
(For Unexempted Establishment only) Contract Rest Total Total No. of Employees Total No. of Subscribers
Put a Tick Mark in
case employee is
not a member
earlier in this
scheme
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The Contribution payable by employer and employee is provided in Section 6, 6-A & 6-B of the EPFO Act. Relevant provision
Interpretation
Contributions
Section 6: Contributions and matters which may be provided for in Schemes. – The contribution which shall
be paid by the employer to the Fund shall be ten percent. Of the basic wages, dearness allowance and
retaining allowance, if any, for the time being payable to each of the employees whether employed by him
directly or by or through a contractor, and the employee’s contribution shall be equal to the contribution
payable by the employer in respect of him and may, if any employee so desires, be an amount exceeding ten
percent of his basic wages, dearness allowance and retaining allowance if any, subject to the condition that
the employer shall not be under an obligation to pay any contribution over and above his contribution
payable under this section:
Provided that in its application to any establishment or class of establishments which the Central
Government, after making such inquiry as it deems fit, may, by notification in the Official Gazette specify,
this section shall be subject to the modification that for the words ―ten percent‖, at both the places where
they occur, the words ―12 percent‖ shall be substituted:
Provided further that where the amount of any contribution payable under this Act involves a fraction of a
rupee, the Scheme may provide for rounding off of such fraction to the nearest rupee, half of a rupee, or
quarter of a rupee.
Explanation I – For the purposes of this section dearness allowance shall be deemed to include also the cash
value of any food concession allowed to the employee.
Explanation II. – For the purposes of this section, ―retaining allowance‖ means allowance payable for the
time being to an employee of any factory or other establishment during any period in which the
establishment is not working, for retaining his services.
The PF Contributions payable shall be paid by the employer to the fund shall be ten/twelve percent of basic wages, dearness allowance including cash value of food concession, retaining allowance and the employee contribution shall be equal to employer‟s contribution.
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The Amount of Contribution is divided in to three schemes as follows:
Calculation of Contribution
Let us calculate the contribution of an workman who is getting a minimum wage of Rs 236.30 per day. The wages payable for a month will be Rs 6149 (236.30 X 26 days)
In case, the salary of employee is more than Rs 6500 then the PF Contribution payable by employer is only limited to Rs 6500/- only as per Para 2 6 A (2) of PF Scheme, Para #(2) of EPS Scheme and Para 7 of EDLI Scheme. In such a scenario the following method may be adopted to pay their contributions.
Consider an employee getting a basic salary of 7500/-
Contribution Towards Calculation Amount
EPF Employees share 7500 x 12% 900
EPS Employer share 6500 x 8.33% 541
EPF employer share 6500 x 3.67% 239
EDLI charges 6500 x 0.5% 33
EPF Admin charges 6500 x 1.1% 72
EDLI Admin charges 6500 x 0.01% 0.65 ( Round up to Rs 1/-)
Scheme Name Employee contribution Employer contribution
Employee provident fund 12% 3.67%
Employees‟ Pension scheme 0 8.33%
Employees Deposit linked insurance
0 0.5%
EPF Administrative charges 0 1.1%
EDLIS Administrative charges 0 0.01%
Total 12% 13.61%
Contribution Towards Calculation Amount
EPF Employees share 6149 x 12% 738
EPS Employer share 6149 x 8.33% 512
EPF employer share 6149 x 3.67% 226
EDLI charges payable by employer
6149 x 0.5% 31
EPF Admin charges payable by employer
6149 x 1.1% 68
EDLI Admin charges payable by employer
6149 x 0.01% .61
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Points to be noted:
The employee has option to join or not to join PF Scheme in case his salary is more than Rs 6500
The minimum wages and special allowances notified by appropriate government can
not be further bifurcated for payment of PF Contributions . Mode of Payment An Electronic Challan Cum Return should be generated in the esewa portal of EPFO for payment of Contribution Amount. The Contributions of employee as well as employer shall be remitted in State Bank of India thru cheque or DD drawn in favor of EPFO along with Electronic Chalaln Cum. The ECR consists of the following fields: :
Contribution Towards Details of Account Calculation
Establishment Code Code/Number allotted by PF department to your Company
Account Group
A/c 1 Payment towards Provident fund Contributions
Employer 3.67% and Employee 12%
A/c 10 Payment towards Pension Employer *8.33%
A/c 2 Admin charger for PF and And Pension for all employees
Total employer contribution* 1.10%
A/c 21 Payment towards EDLI Employer contribution @ 0.5% (Basic +Da)
A/c22 Admin charges for EDLi A/c21 *0.5%
The remittance shall be made within 15 days of close of every month i.e. by 15 th of the following month of payment of salary
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Interpretation: By 15th of every Month Form 5 along with form 2 shall be submitted. Such Form 5 shall consist information of the new employees who have joined the scheme. Vide Notification date 4th May 2012, Form 5 shall be submitted electronically (ie in ECR text file Form 5 is getting submitted). However, a physical copy should be provided to the employee.
Form 5: Para 36 (2) (a) of EPF Scheme:
(2) Every employer shall send to the Commissioner within fifteen days of the close of each
month a return-
(a) in Form 5, of the employees qualifying to become members of the Fund for the first
time during the preceding month together with the declarations in Form 2 furnished by
such qualifying employees, and
(c) provided further that a copy of the forms mentioned in clause (a) and (b) above shall
be provided by the employer to concerned employees immediately after joining of the
service or at the time of leaving of the service as the case may be
(7)Every employer shall send to the Commissioner such returns in electronic format also, in
such manner and form as may be specified by the commissioner
Compliance
Employees Provident Fund Scheme
Form 5 [Paragraph 36(2)(a) of the Employees‟ Provident Funds Scheme, 1952 and
Para 20(4) of the Employees‟ Pension Scheme, 1995]
Return of Employees qualifying for membership of the Employees‟ Provident Fund, Employees Pension Fund & Employees‟ Deposit Linked Insurance Fund for the first time
during the month of July 2012 (To be sent to the Commissioner with Form 2 (EPF & EPS)
Name and Address of the Factory/Establishment: ABC COMPANY LIMITED, 804, SAI KRUPA
BUILDING, VASHINAKA, CHEMBUR
Code No. of Factory/Establishment: MH/19116
SL No
Account No
Name of Employees in Block Letters
Father‟s name (or Husband‟s name in case of married woman)
Date of birth
Sex Date of Joining of the fund
Total period of previous service as on the date of joining the Fund (Enclose Scheme certificate if applicable
Remarks
MH/19116/23 POONAM MUNDE
GUDDI MUNDE
12.4.81 M 10.4.2010
Signature of the Employer or other authorized officer of the Factory/Establishment
Date …………….. Stamp of the Factory/Establishment
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Compliance-II :Form-10
Interpretation: By 15th of every Month Form 10 shall be submitted. Such Form 10 shall consist information of the employees who have left the scheme. Vide Notification date 4th May 2012, Form 5 shall be submitted electronically (i.e., in ECR text file form 10 is getting submitted). However, a physical copy should be provided to the employee.
Para 36 of EPF Scheme:
(2)Every employer shall send to the Commissioner within fifteen days of the close of each
month a return-:
(b) [in such form as the Commissioner may specify], of the employees leaving service of the
employer during the preceding month:
Provided that if there is no employee qualifying to become a member of the Fund for the first
time or there is no employee leaving service of the employer during the preceding month, the
employer shall send a ‘NIL’ return.
( c) provided further that a copy of the forms mentioned in clause (a) and (b) above shall be
provided by the employer to concerned employees immediately after joining of the service or at
the time of leaving of the service as the case may be
(7)Every employer shall send to the Commissioner such returns in electronic format also, in
such manner and form as may be specified by the commissioner
Employees Provident Fund Scheme
Form 10
Paragraph 36(2)(a) & (b) of the Employees‟ Provident Funds Scheme, 1952
Return of Members leaving service during the month of
Name and address of the Factory/Estt. Code No
SL
No
Account
No.
Name of
member (in
block letters)
Father’s Name (or
husband’s name in
case of married
woman)
Date of
leaving
service
*Reasons
for leaving
service
Remarks
1 2 3 4 5 6 7
1 MH/19116/
12 Nitin S Vanshi Mahesh Suray Vanshi 10/4/2010
Attained age
of 58 yrs
2 MH/19116/
14
Vijay K
Gaikwad Prakash K Gaikwad 15/4/2010 Dismissed
3 MH/19116/
20 Ravindran K Padmanabhan K 18/4/10 Resigned
Signature of the employer or other authorised officer
Date : …………………….. Stamp of the Factory/Estt.
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Compliance-III :Form-3A & 6A
Relevant Provisions
40. Contributions to be entered in the contribution card
The amount recovered every month from the wages of an employee as well as the contribution made
by the employer in respect of each such employee shall be entered by the employer every month
in the contribution card opened in the name of each member under this Scheme.
Interpretation:
The Contribution card will be FORM 3/3-A. The amounts recovered shall be entered in Form 3/3-A
41. Currency of Contribution Cards The contribution cards issued under this Scheme shall be current for one year:
Provided that the said period of one year may commence and terminate at such different times, in different
[factories and other establishments] as may be decided by the Commissioner from time to time:
Provided further that the cards issued—
a. in respect of the first contribution period,
or
b. in respect of the contribution period immediately preceding the date from which the establishment
is notified as an annually posted establishment, may be for a period which may be less or more than
a year.
*Please state whether the member is (a) retiring according to Para 69 (1)(A) OR (B) of the scheme, (b) leaving India for permanent settlement abroad, (c) retrenchment, (cc) part of a total disablement due to employment injury, (d) ordinarily dismissed for serious and wilful misconduct, (e) discharged, (f) resigning from or leaving service, (g) taking up employment elsewhere. (The name and address of the Employers should be stated) (h) Death, (I) attained the age of 58 years.
A request for deduction from the account of a member dismissed for serious and willful misconduct should be reported by the following “Certified that the member mentioned at Sr. No.2 Shri Vijay K Gaikwad was dismissed from the service for willful misconduct. I recommend that the employer's contribution for Rs 5326 should be forfeited from his account in the fund. A copy of order of dismissal is enclosed (2) In case of discharge from service, the following certificate should be filled. Certified that the member mentioned in Sr. No. Shri was paid/ unpaid retrenchment compensation of Rs under the Industrial Disputes Act, 1947
Signature of the Employer
PF Ready Reckoner
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Interpretation: Form 3/3-A shall be maintained generally for accounting year i.e starting from April to March. If any person joins in between the year his card can be maintained from such month till end of March
42. Renewal of contribution cards An employer shall, on or before the expiration of the period of currency of the contribution card, prepare in
respect of each member employed by him a card [in Form 3] [or Form 3A] as may be appropriate, for the next
period of currency:
Provided that in the case of any such employee who has become a member of the Family Pension Fund
under the Employees’ Family Pension Scheme, 1971, the aforesaid Form shall also contain such
particulars as are necessary to comply with the requirements of that Scheme.
Interpretation: Fresh Form3/3-A shall be prepared after expiration of each year for every member. In other words Form3/3A is valid for one year only.
43. Submission of contribution cards to the Commissioner Every employer shall within one month from the date of expiration of the period of currency of the
contribution cards in respect of members employed by him, send the contribution cards to the
Commissioner together with a statement in Form 6:
Provided that where a member leaves service, the employer shall send the contribution card in respect of such
members before the twentieth day of the month following that in which the members left the service:
Provided further that in the case of any such employee who has become a member of the Family Pension
Fund under the Employees’ Family Pension Scheme, 1971, the aforesaid Form shall also contain such
particulars as are necessary to comply with the requirements of the Scheme.
Interpretation: Form 3/3A shall be submitted to RPFC within one month of expiration of currency period i.e. April 30th is the last date for submission of Form3/3A along with Form 6/6A to RPFC. If an employee leaves in between the year, then Form 3/3A shall be submitted within 20 of the following month of leaving. However, after launch of e-sewa portal Form 3/3A is not required to be submitted in commissioner’s office
44. Custody of contribution cards The employer shall retain in his custody the contribution cards in respect of each member employed by him
and shall take every precaution against loss or damage of the contribution cards
Interpretation: The employer shall keep the FORM 3/3A in his safe custody.
PF Ready Reckoner
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Para 38 (3) of EPF Scheme:
The employer shall send to the Commissioner within one month of the close of the period of currency, a
consolidated annual Contribution Statement in Form 6-A, showing the total amount of recoveries made
during the period of currency from the wages of each member and the total amount contributed by
the employer in respect of each such member for the said period. The employer shall maintain on
his record duplicate copies of the aforesaid monthly abstract and consolidated annual contribution
statement for production at the time of inspection by the Inspector.
Interpretation: Form 6A shall be submitted before 30th April of every year. Now Form 3/3A/6/6A will be generated electronically. There is no requirement of Physical submission of the Annual Returns
PF Ready Reckoner
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Interest: Relevant Provision
Meaning
Claiming of Provident Fund
60. Interest (1) The Commissioner shall credit to the account of each member interest at such rate as may be determined by
the Central Government in consultation with the Central Board.
The interest will be decided by Central Board of trustees the Apex Body of EPFO currently chaired by Labor and Employment Minister Mallikarjun Kharge. The interest rate for the year 2011-12 is 8.25% p.a. .
72. Payment of Provident Fund
(1) When the amount standing to the credit of a member, becomes payable, it shall be the duty of the Commissioner
to make prompt payment as provided in this scheme
(5)(a) Every employer shall, at the time when a member of the Fund leaves the service, be required to get the claim
application, for payment of provident fund in cases specified in clauses (a) to (dd) of sub-paragraph (1), of
paragraph 69, duly filled in and attested, and to forward the said application [within five days of its receipt] to the
Commissioner or any other officer authorised by him in this behalf.
(b) Every employer shall, at the time when a member of the Fund leaves the service, be required to get the claim
application, for payment of provident fund in cases specified in clause (e) of sub-paragraph (1), and in sub-
paragraph (2) of paragraph 69, duly filled in and attested, and to give the said application to the member, for
submission, on completion of the period specified in sub-paragraph (2) of paragraph 69, [provided the member
continues to remain unemployed in a factory or other establishment to which the Act applies] either through post or
in person with proper identification, to the Commissioner or any other officer authorised by him in this behalf.
(c) Every employer shall, on the death of the member and on receipt of an application for receiving the amount
standing to the credit of such member, forward forthwith [but not later than five days of its receipt] the said
application to the Commissioner or any other officer authorised by him in this behalf.
(d) If the applicant is unable to send the claim application through the employer or duly attested by him, for any
reason whatsoever, he may forward it to the Commissioner or any other officer authorised by him in this behalf,
and wherever necessary, the Commissioner or any other officer authorised by him in this behalf may forward such
application to the employer and the employer shall be required, to return it within five days of its receipt.
(7) The claims, complete in all respects submitted along with the requisite documents shall be settled and benefit
amount paid to the beneficiaries within 30 days from the date of its receipt by the Commissioner. If there is any
deficiency in the claim, the same shall be recorded in writing and communicated to the applicant within 30 days
from the date of receipt of such application. In case the Commissioner fails without sufficient cause to settle a claim
complete in all respects within 30 days, the Commissioner shall be liable for the delay beyond the said period and
penal interest at the rate of 12% per annum may be charged on the benefit amount and the same may be deducted
from the salary of the Commissioner.
Withdrawals & Benefits
PF Ready Reckoner
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Interpretation
Instructions: Form 19 should be filled for withdrawal of provident fund except for death. In case of Death Form 20 should be filled. The fields of both the forms are almost similar except in form 20 the details of claimant and his bank account details needs to be filled and signed by claimant. The example given below is of a resigned employee in Form 19.
Sl.
Particulars Instructions for furnishing the particulars in form 19
1
Reason for Leaving Service
From the following please Indicate the reason applicable to you: 1. Retired from Service after attaining 55 years 2. Retired on Disability to the work 3. Under Voluntary Retirement Scheme 4. Migration to abroad on Permanent settlement 5. Retrenched from Service 6. Resigned / Left Service *
* For cases of Resignation / Left Service, the claim should be submitted by the member only after two months from the Date of Leaving Service
2 Mode of Remittance
It is safer to have the payment through cheque. Account Payee cheque will be sent directly to the Scheduled bank / Coop Bank / Post Office in which Savings bank Account of the member is maintained. So, furnish correct SB account number with full address of the Branch of the Bank. wherever applicable furnish the MICR Number also. Please furnish the Xerox copy of the First page of Saving Bank account pass book or monthly statement/Cancelled Cheque wherein the account number and address of the Bank is clearly visible.
3 Contribution for the current financial year
In the table provided in Page 3, contribution for the current financial year with wages should be furnished or Form 3/3A for the current financial year with attestation of the employer should be furnished.
4
Attestation by the Employer
The authorized official of the establishment should attest the claim under the seal of his designation. It should be ensured, the specimen signature of the attesting official should have been already furnished to the EPFO.
5 Advance Stamped Receipt
Wherever payment is sought through account payee cheque, the advance stamped receipt should be signed by the member duly affixing One Rupee Revenue Stamp. The amount need not be filled in, which shall be filled in by the RPFC / OIC of the EPFO Office.
1. Employer shall send duly filled in withdrawal form to the PF Commissioner while a member leaves service
2. Employer shall send duly filled in withdrawal form to the PF Commissioner within 5 days of receipt in case of death
3. It is the duty of the commissioner to ensure that claim gets settled within 30 days from date of receipt
PF Ready Reckoner
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Employees Provident Fund Scheme
Form 19
Paragraph 72(5) of Employees‟ Provident Funds Scheme, 1952 Form to be used by a Major Member of Employees’ Provident Funds Scheme, 1952 for
Claiming the Employees’ Provident Fund Dues :
(Refer to Instructions) 1. Name of the member (in Block Letters) : Vikas Praksh Ghodke 2. Father‟s Name (or husband‟s name in the case of married woman) Prakash Bandhu
Ghodke ………………………………………………………………………………………….
3. Name and address of the Factory/Establishment in which the member was last employed …… ABC Company Limited, 804, SAI KRUPA BUILDING, VASHINAKA,
CHEMBUR, MUMBAI-400074 4. Account No. MH/19916/38 5. Date of leaving service: 31/06/2010 6. Reason for leaving service Resigned 7. Full Postal Address (in Block Letters)
Shri/Smt/Kumar. : Vikas Praksh Ghodke S/o. W/o: Prakash Bandhu Ghodke, No: 501, BLG:7/A, Vishwa Shanti Bldg, Vashinaka, Chembur, Mumbai, Pin: 400074
Put a „tick‟ in the box against the one opted () ( ) to the address given against item No. 7 ( ) S.B. A/c No. in figure: 129000100241065 Name of the Bank: State Bank of India Branch: Chembur (Mumbai) Full Address: Nr Post Office, Ashish Theatre, Chembur, Mumbai
8. Mode of Remittance ………………………………………………………………… (a) by postal money order at my cost (b) by account payee cheque sent direct to credit to my S.B./A/c (Scheduled
Bank/P.O.) under intimation to me. (Tick here)
(Advance Stamped Receipt furnished below)
Certified that the particulars are true to the best of my knowledge.
Date of Joining the Establishment : 5/12/2000 Date of Leaving Service:31/6/2010
Contribution for the current financial year
PF Ready Reckoner
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Month
Employees’ Share Employers’ Share
Remarks Amount of
Wages E.P.F
EPF Cont.(-)
Pension
Fund Cont.
Pension Fund Refund of
Adv. Period of Break
March paid in
April 6200 744 228 516
May 6200 744 228 516
June 6200 744 228 516
July 6200 744 228 516
August 6200 744 228 516
September 6200 744 228 516
October 6200 744 228 516
November 6200 744 228 516
December 6200 744 228 516
January 6200 744 228 516
February 6200 744 228 516
Feb. paid in
March 6200 744 228 516
Suppl.( if any)
Total 74400 8928 2736 6192
(Information tobe furnished by the employer if the claim form attested by the employer) Certified that the above contributions have been included in the regular monthly remittance. The applicant has signed/thumb impressed before me. ……………………………………………… …………………………… Signature of the employer or authorised Official Signature of left/right
Thumb impression of the member Advance Stamped Receipt ( Received a sum of Rs* ………………………. (Rupees*…………………………) From Regional Provident Fund Commissioner/Officer-in-Charge of Sub-Regional Office…………………………… deposit in my Savings Bank Account towards the settlement of Provident Fund Accout. * The space should be left blank which shall be filled in by Regional Provident fund Commissioner/Officer-in-charge of S.R.O.
Affix 1 ruppes Revenue Stamps
Signature of left/right hand thumb impression
of the member
(For the use of Commissioner‟s Office)
Remember to take
Sign of Member
Remember to take
Sign of Member
PF Ready Reckoner
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A/c. settled in part/Full Entered in F-21-A/224/29 Withdrawal Register. Clerk Head Clerk
(P.I. No.) ……………………………… (M.O./Cheque)……………………………….. Account No. ………………… (Section)………………………. Under Rs…………… Passed for Payment of Rs. …………………… in words) M.O. Commission If any) Accounts Officer Net Amount to be paid by M.O. Date ………………………….. Paid by inclusion in Cheque No. …………………………. dt………………………... Vide Cash Book (Bank) Account No. 10 Debit Item No. ……………………………. H.C. AC/RC
Remarks
Acknowledgment Card Account No. EPFO Office of the RPFC/Officer-in
Charge of Sub-Regional Office Acknowledgement Received the following claims. Registration No. ………………………. EPF Date Office Seal……………………….. FPF …………………………………………… IF …………………………………………… In case, no intimation is received within a Month, you may write to the complaints Postcard Postage Officer, Employees‟ Provident fund duly Prepaid quoting the Registration Number and your Provident Fund Account Number ……………………………………. ……………………………………. PIN……………………………… Employees‟ Provident fund Organisation Office of the Regional Provident Fund Commissioner/ S.R.O. …………………..
PF Ready Reckoner
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Funding of the Pension Scheme An amount equal to 8.33% of Wages is paid into the EPS from the Employer's contribution. i.e., if a PF member gets Rs. 1000/- as monthly wages and he and his employer contributes 12% each, Rs. 83 goes to Pension Fund. Government also contributes to this Welfare Scheme at the rate of 1.16% of wages. Calculation of pension (A) Those who joined service before 15.11.1995:
The formula for calculation of pension for employees who joined service before 15.11.1995 is Past Service Benefit + Pensionable service benefit - Proportionate reduction The employee who joined service before 15.11.1995 are divide in to three groups. The three groups are divide basis their as on 16.11.1995.
X : those who have not attained 48 years as on 16.11.1995 Y : those who have attained 48 years but less that 53 years as on 16.11.1995 Z : those who have attained 53 years or more as on 16.11.1995
The minimum pension specified for each group i.e. X - Rs.800, Y - Rs.600, Z - Rs.500. The pension payable is calculated as follows: Past Service Benefit: Past Service benefit depends upon the wage as on 15.11.1995 and the service rendered. upto 15.11.1995 as shown below: TABLE – A
Past Service before 15.11.1995 Benefit in Rs. Benefit in Rs.
Wages as on 15.11.1995 is upto Rs.2500/
Wages as on 15.11.1995 is more than Rs.2500/-
Upto 11 years 80 85
More than 11 years but upto 15 years 95 105
More than 15 years but less than 20 years
120 135
Beyond 20 years 150 170
The above amount is the benefit payable on completion of 58 years of age as on 16.11.1995.
Pension Benefit
PF Ready Reckoner
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For the calculation of pension benefits before 58 years (if a member do not complete 58 years of age on 15.11.1995, his past service benefit will be increased by the below factor - Early pension cases ) the above benefit is multiplied by the TABLE - B factor to arrive at the past service benefit. Table B
If Years to 58 of age from
15.11.1995 is: then factor is:
If Years to 58 of age from
15.11.1995 is:
then factor is:
less than 1 year 1.049 less than 13 years 3.29
less than 2 years 1.154 less than 14 years 3.621
less than 3 years 1.269 less than 15 years 3.983
less than 4 years 1.396 less than 16 years 4.381
less than 5 years 1.536 less than 17 years 4.819
less than 6 years 1.689 less than 18 years 5.301
less than 7 years 1.858 less than 19 years 5.810
less than 8 years 2.044 less than 20 years 6.414
less than 9 years 2.248 less than 21 years 7.056
less than 10 years 2.473 less than 22 years 7.761
less than 11 years 2.720 less than 23 years 8.537
less than 12 years 2.992 less than 24 years 9.390
2. Pensionable Service benefit= Pensionable salary X Pensionable Service --------------------------------------- 70 The pensionable salary will be the last drawn salary (Basic+DA which is less than Rs 6500) and Pensionable is the total service. The pension payable is Subject to minimum pension assured by EPF. 3. Proportionate reduction: arises if the past service is less than 24 years and aggregate pension calculated is less that Rs.500/-
(B) Pension Calculation for Employees who Joined Service after 15.11.1995: Pension benefit= Pensionable salary X Pensionable Service
--------------------------------------- 70
The pensionable salary will be the last drawn salary and Pensionable is the total service. The pension payable is subject to minimum pension assured by EPF Suppose a workmen has service of 20years and his last drawn pensionable salary is 5000 (Basic+DA which is less than Rs 6500) then the pension benefit is as follows:
Pension benefit = 5000 x 20 = 1428 p.m 70
PF Ready Reckoner
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Types of Pension:
Type of Pension
Description Calculation Formula
Superannuation If age is 58 years or more 20 years or more service
As provided in the Formula above
Retirement If age is between 50 and 58 years 20 years or more service
As provided in the Formula above
Short Service (Cessation)
If service is more than 10 years As provided in the Formula above
Return of Contribution on exit from employment
If Service is less than 10 years
Return of contribution will be provided as per service i.e Yrs of service
Return of Contribution
Yrs of service
Return of Contribution
1 1.02 6 6.4
2 2.05 7 7.54
3 3.1 8 8.7
4 4.18 9 9.88
5 5.28
Suppose last drawn salary is Rs 5000/-
Widow/Child Pension
Provided to widow and child Widow pension would be same as he would have received on members date of retirement. In addition to this child would receive 25% of widow pension as child pension.
Disability Pension
Certificate to the effect of permanent and 100% disability should be produced Commutation not applicable
Would be same as he would have received on members date of retirement
For withdrawal of pension for service less than 10years Form 10-C is required to be used where as for claim of monthly pension on superannuation/retirement/short service pension/disabled pension/widowed pension/children person/ orphan pension form 10 d should be used. The below given form is an example of Form 10-d of a widower subsequent to her death orphan pension is being given to her children.
PF Ready Reckoner
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Form 10-D
The information you should know before you fill claim form seeking settlement under Employees Pension Scheme 1995. If you are a member of pension scheme and If you have less than 10 years contributing
service and seek settlement of withdrawal
benefit
Submit claim in Form 10-C
If you are applying for Superannuation pension / Reduced pension / Widow pension
/ Children / Orphan Pension / Permanent
Disability pension
Submit claim in Form 10-D
If the claimant is minor
The claim should be submitted by the Natural guardian / Guardian
appointed by the Competent court
How to fill Form 10-D claim application
Sl.
Instructions for furnishing the particulars
1
Please fill the claimant‟s name. If the member is claiming for Retirement /
Reduced / Disablement pension, he should fill in his name.
2
The type of pension claimed is to be furnished For Example - Retirement pension or Reduced pension or Widow pension or
Children / Orphan pension / Disability pension
3 (d)
While furnishing Date of birth, it should tally with Date of birth furnished in
Form 9 and other office records. If you want to correct the Date of birth now, documentary evidence such as Birth Certificate / School Certificate / Service
records of the establishment duly attested by the employer should be
furnished.
6(a)
Date of joining in the Pension Scheme either old pension scheme or
new pension scheme should be furnished
6(b)
Date of leaving service be furnished. If the member had attained age of 58 years and still continuing in service, Date of attaining 58 years of age
be furnished.
6 ( c )
Member should mention the Date from which he opts to receive pension in
case of reduced pension
7 Reason for leaving service be furnished correctly as (1) Retirement or Superannuation or (3) Resigned / Retrenched or (4) Disablement or (5) Attained 58 years and continuing service (2)
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9
Facility of Commutation of pension and benefit of Return of Capital are withdrawn. Keep Nil in case of no option
12
Particulars of family of the member be furnished. As per the pension
scheme, the spouse and children only are family members. Birth
certificates of the children be furnished, if children pension is claimed. If
the member is un- married, parents name can be furnished. If the child
is disabled, birth certificate and disability certificate from the competent
medical officer should be furnished.
13
If the member is deceased, furnish the Date of Death as per the
Death certificate. Furnish Death Certificate in original.
14
Details of Savings Bank account with branch address is furnished. If the children pension claimed, separate SB account number for each of the child, who is a minor maintained in the same bank branch of the widow /
widower be furnished. Please furnish the Photostat copy of the first page of
pass book.
15
If the applicant / claimant is in possession of Scheme Certificate, the original Scheme Certificate should b e s u b m i t t e d r e t a i n i n g a P h o t o s t a t
copy, i f necessary. Furnish the control number of the Scheme Certificate.
16
If the claimant is drawing pension under this Scheme, pension payment order number and name of the office which issued the PPO be furnished.
17
The documents enclosed with the claim form should be invariably mentioned
individually. The enclosures should be attested by the employer / authorized official of the establishment
18
Wages / Contribution be furnished for a period of 12 months preceding the Date of Leaving / Death. Break-in-Service details for entire period of service
be furnished along with the claim application.
19
Descriptive role of the pensioner / claimant be filled correctly and attested by
the employer
20 If the establishment is closed, the claim may be attested by any one of the authorized official.
PF Ready Reckoner
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Major Orphan Orphan Pension
PH/18116/3103
----- ------ -----
for Office Use Only
Inward No.
APPLICATION FOR MONTHLY
PENSION FORM 10-D(EPS) EMPLOYEE’S PENSION SCHEME,
1995
(Read INSTRUCTIONS before filling in this Form)
1. By whom the pension is claimed? 2. Type of Pension Claimed.
3.
(a) Member‟ Name : (In Block Letters)
DWARAK JADHAV
FEMALE
WIDOW
42
RAMESH
(b) Sex : (c) Marital Status : (d) Date of Birth/Age : (e) Parent/Spouse Name :
4.
E.P.F. Account Number :
RO
SRO Establishment Code No.
Members‟s Accounts No:
5. Name & Address of the establishment :
in which the member was last employed 6. Date of Leaving Service : Not Applicable
7. Reason for leaving Service : Not Applicable
8. Address for communication : Om ganesh Nagar Sainath seva Mandal Vaisnaka, R C Marg Chmebur, Mumbai
PIN: 400074
9. Option for commutation of 1/3 of Quantum: Yes No Amount
Pension (If option is for lesser) commutation indicate the quantum
Abc Company Limited, 804, Sai Krupa Building, Vashinaka,
Chembur, Mumbai-400074
Tick No as scheme is
phased out
PF Ready Reckoner
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10. Option of Return of Capital (Please refer Serial Number 10
Yes No
of INSTRUCTIONS) [Put a Tick ( )]
If Yes, indicate your choice of alternative
11. Mention your Nominee for Return :
of Capital
Name :
Relationship :
Date of Birth :
Address :
12. Particulars of Family :
1 2 3
SI. No. Name Date of
Birth/Age Relationship with Member
Indicate against Minor
Guardian Relationship with Member
(1) (2) (3) (4) (5) (6)
SANAY R JADHAV 22/11/1984 SON NA NA
VIKRANT R JADHAV 20/11/1988 SON NA NA
Note : If any child is physically handicapped, please indicate “DISABLED” below the name.
13. Date of death of Member 17/11/2008
(if applicable)
14. Details of Saving Bank
Account Opened
Name of the Bank 31140646055
Name of the Branch STATE BANK OF INDIA
Full Post all Address MAHUL ROAD, CHEMBUR, MUMBAI
Not Applicable
Tick No as scheme is
phased out
PF Ready Reckoner
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NA
NA
NA
SI.No Name of the Claimants(S) Saving Bank Accounts No.
1 SANAY R JADHAV 31140646055
2 VIKRANT R JADHAV 31140646054
14(A) If the claim is preferred by nominee, indicate his/her
(1) Name : (2) Relationship :
with the deceased Member
15. Details of Scheme Certificate Scheme Certificate
received & enclosed
Already in possession of the Not Received
Member, if any Not Applicable
If received, indicate:
SI. No
Scheme Certificate Control No. Authority who issued the Scheme certificate
NA
NA
Not Applicable
PF Ready Reckoner
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RO SRO
16. If Pension is being drawn PPO No.
Under E.P.S., 1995 issued by
17. Documents enclosed (Indicate as per the Instructions)
1.death certificate
2.pass book
3.canclled cheque
4.
5.
6.
7.
8.
9.
10.
PF Ready Reckoner
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TO BE SUBMITTED IN DUPLICATE IN RESPECT OF EACH PERSON ELIGIBLE FOR PENSION
Descriptive of Pensioner and
his/her Specimen Signature/Thumb impression
1. Name of the Member : DWARAK R JADHAV
2. E.P.F. Account Number : MH/18116/3103
3. Name of the Pensioner : SANJAY
4. Father/Husband name : RAMESH
5. Sex : MALE
6. Nationality : INDIAN
7. Religion : BUDDHA
5 Height : 5
9. Personal Marks of :
Identification
1. Black mark on head
2…………………………………………….
10.
Specimen signature of Pensioner :
1……………………………………………
2……………………………………………
3……………………………………………
10. (Only in the case of illiterate Claimant (Pensioner)
Left Hand Finger Impression);
THUMB INDEX MIDDLE RING SMALL
Signature
Place : Date :
Certified that:
Name of attesting
Authority Official Seal:
(i) I am not drawing Pension under Employees Pension Scheme, 1995:
(ii) The particulars given in this application are true and correct.
Signature of the applicant /
Left hand Thumb Impression
Remember to
take 3
specimen
signatures
Remember to
take 3
specimen
signatures
PF Ready Reckoner
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(TO BE FILLED IN BY THE EMPLOYER / AUTHORISED OFFICER OF THE ESTABLISHMENT)
Certified that:
(i) the particulars of the member are correct;
(ii) the particulars of Wages and Pension Contribution for the period of 12 months
preceeding the date of leaving service are as under :-
(In case, the wages is not earned for all 12 months, the block of 12 months will commence backwards from the last drawn)
Year Month Wages Pension Details of period of non- contributory service. If there is no such period, indicate „Nil‟
No of
Days Amount Year No.of days for which no
wages were earned
(1) (2) (3) (4) (5) (6) (7)
2007 Jan 19 2682 223
Feb 22 3182 265
Mar 15 2097 154
April
May 08 1157 139
June 09 1302 108
July 19 2748
August 18 2598 216
September 14 2021 168 ------23 days--------
Ocober 16 2310 192 -----131 days--------
November 03 433 36
Encls: 1. Documents as given in the Instructions.
2. Form of descriptive roll and specimen signature.
Signature of Employer/ Authorised Official of The Establishment with
Seal & Date
Fill the details
as mentioned
in Form 3/3A
H i n d u s t a n P e t r o l e u m C o r p o r a t i o n L i m i t e d
Page 38
(FOR OFFICE USE ONLY) (PENSION SECTION / ACCOUNTS SECTION)
Certified that the particulars in the application have been verified with the relevant concerned documents. The claimant is eligible for Pension. The Input Data Sheet is placed below for approval.
Entered in Form 9/Form 3(PS), Master Ledger Card/Claim Inward Register
Form 2(R) enclosed along with the documents furnished by the claimant.
CLERK S.S A.A.O A.P.F.C date date Date date
FOR USE IN PENSION PRE-AUDIT CELL
The Input data sheet verified with reference to the application and the documents enclosed and found correct. P.P.O. may be generated through Computer.
CLERK S.S A.A.O A.P.F.C(Pension)
date Date Date date
FOR USE IN PENSION DISBURSEMENT SECTION
P.P.O. No
Date of issue to the Bank
Intimation sent to the Claimant and also to Accounts Branch on
CLERK S.S A.A.O A.P.F.C date date Date date
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Withdrawals:
Types of Benefit Eligibility Eligible Amount Form Documentary Support
The purchase of site for construction of house
5 Years of membership of the Fund (Minimum balance in member‟s a/c should be Rs. 1000/-) * The purchase should be in favour of member or member & spouse.
24 months wages (Basic & DA) OR Member‟s own share of contribution + Company‟s share of Contribution with interest thereon
No.31
A declaration from the member that, dwelling site or dwelling house/flat or the house under construction is free from encumberances and the same is under the title of the member or the spouse (notification dated 25.2.2000)
The Construction of House
5 Years of membership of the Fund (Minimum balance in member‟s a/c should be Rs. 1000/-) * The purchase should be in favour of member or member & spouse.
36 months wages (Basic+DA) OR Members own share of contribution + Company‟s share of contribution with interest thereon
No.31
A declaration from the member that, dwelling site or dwelling house/flat or the house under construction is free from encumberances and the same is under the title of the member or the spouse (notification dated 25.2.2000)
The purchase of dwelling flat
5 Year of membership of the Fund (Minimum balance in member‟s a/c should be Rs. 1000/-) * The purchase should be in favour of member or member & spouse.
36 months wages (Basic+DA) OR Members own share of contribution + Company‟s share of contribution with interest thereon
No.31
A declaration from the member that, dwelling site or dwelling house/flat or the house under construction is free from encumberances and the same is under the title of the member or the spouse (notification dated 25.2.2000)
Withdrawal/Advances
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Additions, Alterations or improvements to the dwelling house
5 years from the date of completion of dwelling house
12 months basic or members own share of contribution with thereon.
No.31
Advance:
68 BB : REPAYMENT OF LOAN
Types of Benefit
Eligibility Eligible Amount Form Documentary Support
Advance from the fund for repayment of loan
10 years membership of the fund & member should have taken loan from Govt. Body
36 month wages (Basic + DA) OR Members own share of Contribution + Company‟s share of Contribution with interest thereon.
No.31
A certificate from the lending authority furnishing the details of loan and outstanding amount.
68 J : ADVANCE FROM FUND FOR ILLNESS
Types of Benefit Eligibility Eligible Amount
Form Documentary Support
Advance from the fund for illness viz. hospitalisation for more than a month, major surgical operation or suffering from TB, Leprosy, Paralysis, Cancer, Heart ailment etc.
Stay in Hospital at least for a month
6 moths wages (Basic + DA)
No.31 A certificate from the Medical Practitioner for hospitalisation or operation.
68 K : ADVANCE FROM THE FUND FOR MARRIAGE
Types of Benefit Eligibility Eligible Amount Form Documentary
Support
Advance from the fund for Marriage of self/son/daughter/ sister/brother etc.
Advance from the fund for education of Son/Daughter
7 years membership of the fund & minimum balance in member‟s account should be Rs. 1000/-
50% of member‟s own share of contribution
No.31 Declaration by the member which is attested by the employer.
68L : ADVANCE IN ABNORMAL CONDITIONS
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Types of Benefit Eligibility Eligible Amount Form Documentary
Support
Grant of advance in abnormal conditions, Natural calamities etc.
Certificate of damage from appropriate authority.
Rs. 5000/- or 50% of member‟s own share of contribution (To apply within 4 months)
No.31 l Certificate from the Appropriate Authority.
68 M : ADVANCE TO MEMBER AFFECTED BY CUT IN THE SUPPLY OF ELECTRICITY
Types of Benefit Eligibility Eligible Amount
Form Documentary
Support
Grant of advance to members affected by cut in the supply of electricity
The advance may be granted only to a member whose total wages for any one month commencing from the month of January 1973 were 3/4th or less than 3/4th of wages for a month
Wages for a month OR Rs.300/-
No.31 Certificate from State Govt. regarding cut in the supply of electricity.
68 N : GRANT OF ADVANCE TO MEMBERS WHO ARE PHYSICALLY HANDICAPPED
Types of Benefit Eligibility Eligible Amount Form Documentary
Support
To Physically Handicapped member for purchase of an equipment required to minimize the hardship on account of handicap.
Production of medical certificate from a competent medical practitioner to the effect that he is physically handicapped
Basic wages+ DA for six months or own share of contribution with interest or cost of equipment which ever is least.
No.31 Certificate from the Medical practitioner to the effect that the member is physically handicapped..
Form No 31 shall be filled for withdrawal or taking advance from EPFO for any of the above reasons. An illustrative form 31 is provided below.
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EMPLOYEES’ PROVIDENT FUNDS SCHEME,1952
FORM NO 31 APPLICATION FOR ADVANCE FROM THE FUND
Purpose for which advance is Required: Marriage of Daughter
: Amount of advance required Rs 50,000/-In Words fifty
thousand only
1. Name in full ( in block letters) : Raman Shelke
2. Father’s/Husband’s Name : Laxman Shelke
3. Name of the factory/establishment in
which employed and address
: ABC Company, Om ganesh Nagar, Sainath seva Mandal
Vaisnaka, R C Marg, Chmebur, Mumbai
4. Provident Fund Account No. : PH/18116/05
5. Monthly basic wages and DA : BASIC D.A. TOTAL
6. Full postal address of the member to
which payment/intimation to be sent
8/604, PC Lane, Indira Nagar, Govandi
PIN:400074
7. MODE OF REMITTANCE :
(a) In case of advance for purchase of site/house/flat or construction through an ‘agency’-or repayment of
housing loan, indicate
(i) in whose favour the cheque is to be drawn
( ii ) Full address :-
In other cases, put a tick ( ) against any one of the following :
(b) By account payee cheque through the employer (to the address given against Sl. No.3.
(c) By deposit in bank account no.31000059765(Name of the Bank) State Bank India located Govandi
(Full postal address) opp Nr. Post Office, Mahul, Chembur, Mumbai
(d) By money order at my cost to the address given against SL. No. 6.
*I declare that the advance is required to meet the expenses in connection with my marriage / marriage of
my son/daughter/brother/sister. Shri/Kumari Ms Lakshmi (Name) 21 (aged) to be celebrated on 10
Aug 2012 (date) at address 8/604, PC Lane, Indira Nagar, Govandi.
I declare that the above particulars are true to the best of my knowledge and I will abide
by the conditions governing the grant of advance under the Scheme.
Certificates/documents in support of my application is/are furnished/enclosed.
Date :
Station : Signature/left /Right/hand thumb impression of
the member
* Delete if the advance applied for is not for marriage
6500 1000 7500
Remember to take
signature of
employee
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ADVANCE STAMPED RECEIPT
[ To be furnished with reference to 7(a) or (b) or (c) above only] Received a sum of Rs. Fifty thousand (Only) from the Regional Provident Fund Commissioner/Officer in
–charge of Sub-Regional Office/Sub-Accounts Office, Employees‟ ProvidentFund towards the grant of advance from my Employees‟ Provident Fund Account maintained by him. * (To be filled in by the EPF Office)
[ TO BE FURNISHED BY THE EMPLOYER]
During closure/lock out of the factory/establishment by any Gazetted Officer or the Chief Executive/ Head of a local authority or M.P. or M.L.A. or member CBT/ Regional Committee, EPF. Certified that the application has been signed by the member in my presence after he/she had read the contents/ the contents have been explained to him/her by me and that the information given in the application is correct. Required certificate(s) is/are enclosed. Date_______________ Designation of the signing official with Signature of the employer or an authorised Stamp of the Factory/establishment official of the factory/establishment
Encls.:________________________
FOR USE IN PROVIDENT FUND COMMISSIONER’S OFFICE
Section _____________________________________ Account No.____________________
( AUTHORITY FOR PAYMENT OF ADVANCE UNDER PARA 68 ) Passed for payment of Rs.______________ Rupees ________________________________________only Mode of remittance ( Refer S.No. 7 ) M.O. Commission, if any Net amount to be paid by money order P.l. No. Clerk : Section Supervisor A.A.O./A.P.F.C. Vide payment scroll P.C. to A.A.O./A.P.F.C.
FOR USE IN CASH SECTION
Paid by inclusion in Cheque No._________________________________dated the ______________vide Cash Book Account No. 1 debit item No.____________________________________________________ Clerk Section Supervisor Assistant Commissioner
REMARKS
Affix Re. 1/- Revenue
Stamp
Signature of the member
sign of
employer
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INSTRUCTIONS
A MEMBER OF THE FUND MAY AVAIL THE FOLLOWING WITHDRAWALS/ADVANCE
1. PURCHASE OF A DWELLING SITE :
( From an “Agency” Original allotment order) From an individual : Original Title deed, non -encumbrance certificate ( for verification and return ) agreement with the seller.
2. PURCHASE OF DWELLING HOUSE/FLAT : ( From An “Agency”Original Allotment Order ) From an individual : Original title deed for (verification and return), agreement with the seller, non-encumbrance certificate.
3. CONSTRUCTION OF A HOUSE : Original Title Deed (for Verification and Return ),non-encumbrance certificate ,estimated cost of
construction,Approved Plan.
Note :- While claiming the second and subsequent installments, the declaration/certificate as required by the Commissioner in his letter sanctioning the advance should be submitted along with the application. “ Agency” referred to in 1 to 3 would above mean, Central/ State Government, a Co-operative Society, an Institution, a Trust, a local body or a Housing Finance Corporation. In case of Transactions through an agency the payment will be made only by Account payee cheque, direct to the “ Agency” concerned.
4. ADDITIONS, ALTERATIONS OR IMPROVEMENT TO THE HOUSE OWNED BY MEMBER OR BY SPOUSE OR JOINTLY MEMBER AND SPOUSE: (Approval of the appropriate authority, estimate of the work, original title deed of the house ( for verification ), non-encumbrance certificate , a certificate from the appropriate authority specifying the date of completion of the house).
5. REPAYMENT OF HOUSING TO LOAN TO STATE GOVT. HOUSING BOARD, MUNICIPAL
CORPORATION OR A BODY SIMILAR TO DELHI DEVELOPMENT AUTHORITY.: ( A certificate from the lending authority furnishing the details of loan and outstanding amount).
ON ATTAINMENT OF AGE OF 54 YEARS OR WITHIN ONE YEAR BEFORE RETIREMENT : (Date of birth/age of the member and due date of retirement should be furnished by the employer)
CLOSURE /LOCKOUT OF THE FACTORY/ ESTABLISHMENT, FOR THE REASONS OTHER THAN STRIKE :
( Furnish the Certificate “A” given overleaf )
NON RECEIPTS ON WAGES FOR 2 MONTHS FOR REASON OTHER THAN STRIKE:
(Furnish Certificate “B” given overleaf.)
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DISCHARGE OR DIMISSAL OR RETRENCHMENT ARE CHALLENGED BY THE MEMBER-THE
CASE IS PENDING IN THE COURT OF LAW ( A copy of the petition filed by the member in the court of law and certificate from the advocate that the case is pending in the Court of Law, should be furnished.)
ILLNESS OF MEMBER/FAMILY MEMBER : (Furnish Certificate “C” given overleaf.)
MARRIAGE OF SELF/SON/DAUGHTER/SISTER BROTHER : ( Furnish a declaration in Form 31 )
POST MATRICULATION EDUCATION OF SON/DAUGHTER :
( Certificate from the institution regarding the course of study and anticipated expenditure )
DAMAGE TO THE PROPERTY DUE TO NATURAL CALAMITY(FLOOD/RIOT/EARTH QUAKE) :
(Furnish the Certificate “D” given overleaf.
AFFECTED BY CUT IN ELECTRICITY : ( Furnish the Certicate “E” given overleaf )
PURCHASE OF EQUIPMENT FOR PHYSICALLY HANDICAPPED MEMBERS : Furnish the
Certificate “F” given overleaf
NOTE :-
1. Such other documents, Certificate etc. as may be required by the sanctioning authority are also required to be furnished.
2. In case no intimation received within a month, please write to R.P.F.C./officer in charge of Sub-Regional office. through the establishment.
3. “In case the advance granted for the purpose at SL. NO. 1 to 3 above is misused the amount of the advance granted will be recovered with penal interest and no further advance under the paragraph shall be granted for a period of three years from the date of grant of said advance.
4. In case of misuse of the advance granted for marriage the amount of advance will be recovered with penal interest.
CERTIFICATE – A
CLOSURE /LOCKOUT OF THE FACTORY/ ESTABLISHMENT FOR THE REASONS OTHER THAN STRIKE
Certified that the establishment has been closed down/locked up for reasons other than strike. Certified that no compensation was not paid to the member Sh/. Smt.______________________________________________________for the period of Lock Out/Closure.
Signature of the Employer /Authorised Official With date & seal
CERTIFICATE – B
NON RECEIPTS ON WAGES FOR 2 MONTHS FOR REASON OTHER THAN STRIKE
Certified that the member Sh./Smt.______________________________________has not received his wages for a continuous period 2 months or more i.e. from _____________to_____________________for reasons other than strike.
Signature of the Employer /Authorised Official With date & seal
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CERTIFICATE – C ILLNESS OF MEMBER/FAMILY MEMBER
I. Certified ( i ) The member Sh./ Smt. ___________________________ has/ had been granted leave for a period
of_______________________ from _____________to _________________
II. The E.S.I. facilities/Cash benefits are not actually available to the member/ the member has ceased to be eligible for cash benefits under E.S.I. (Certificate from E.S.I. enclosed )
Signature of the Employer/ Authorised Official With date & seal
MEDICAL CERTIFICATE TO BE ISSUED :- 1. In case of major surgical operation or where the Hospitalisation for one month or more had or has become necessary the
Doctor of the Govt. E.S.I./ Private Hospital . 2. In case of Treatment of T.B/ Leprosy/ Paralysis or cancer By a Doctor of Govt./Private Hospital E.S.I./or by a Regd. Medical
Practitioner. 3. In case of Treatment of heart ailment or mental derangement: By a specialist Doctor. Certified that Shri/Smt./Kumari______________________S/o.W/o.D/o____________________________ I. is suffering from T.B./Leprosy/Paralysis/Cancer/Mental Derangement/Heart ailment. II. is suffering from ____________________________________( disease)for which a major surgical operation /and
hospitalisation for a period of ____________________day from ___________to___________________________has or had become necessary.
III. is suffering from _____________________________and hospitalisation for a period of ________days from ________________________ to _____________________had or has become necessary. *Delete if not applicable Signature of Doctor with dated Seal
CERTIFICATE - D
DAMAGE TO THE PROPERTY DUE TO NATURAL CALAMITY(FLOOD/RIOT/EARTH QUAKE)
Certified that the movable/immovable property of Sh._____________________________ situated at_______________________has been damaged due to ____________________________on date_______________________. The estimated loss of property due to calamity is valued at Rs.______________________The State Govt. has declared that calamity has effected the general public in the area in which the property of the member is/was located vide Notification/press release no. and date _________________
Signature of Employer/Revenue official/Gazetted Officer/ M.L.A./M.P./Member of C.B.T. /Regional Committee with
seal and date
CERTIFICATE - E
CUT IN ELECTRICITY
Certified that the fall in wages amounting to 25% more than 25% of wages in respect of Sh./Smt ./Kumari______________________is due to power cut
Signature of Employer/authorised official
with dated seal
CERTIFICATE – F
PURCHASE OF EQUIPMENT FOR PHYSICALLY HANDICAPPED MEMBERS
Medical Certificate from a competent Medical practitioner: Certified that Sh./Smt./Kumari__________________________________S/o/W/o/D/o____________________________is physically handicapped viz_____________________and requires the equipment viz. ( nature of handicap)_________________________ costing about Rs._______________to minimise the hardship on account of handicap.
Signature of the Doctor with Date and Seal
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