PF form v.xls

8/10/2019 PF form v.xls

1/60

Sl.

No. Basic @ 12% 3.67% 8.33% TOTAL

1 2 3 4 5 6

1 60 SATENDRA KUMAR 3795 455 139 316 911 KHURJA

2 62 BHARAT LAL BARTHWAL 4618 554 169 385 1108 KHURJA

3 63 MUKESH KUMAR 3661 439 134 305 879 KHURJA

4 64 SHASHI KANT MISHRA 4803 576 176 400 1153 KHURJA

5 65 AMIT KUMAR SHARMA 4161 499 153 347 999 KHURJA

6 68 CHANDAN KUAMAR PANDEY 2163 260 79 180 519 KHURJA

7 69 SURESH KUMAR GAUTAM 4327 519 159 360 1038 KHURJA

8 70 ARUN TIWARI 185 22 7 15 44 KHURJA

9 72 BIPLAB MISHRA 3994 479 147 333 959 KHURJA

10 73 MD. MUSTAFA ANSARI 4803 576 176 400 1153 KHURJA

11 77 RAMCHANDER YADAV 3325 399 122 277 798 KHURJA

12 78 AJIJ KHAN 2771 333 102 231 665 KHURJA

13 79 RAJU CHAUHAN 4803 576 176 400 1153 KHURJA

14 80 RAHUL KUMAR RAI 4161 499 153 347 999 KHURJA

15 81 GAUTAM KARMAKAR 2627 315 96 219 630 KHURJA

16 174 RAJU SINGH 2496 300 92 208 599 KHURJA

17 177 KISAN SWROOP SHARMA 1478 177 54 123 355 KHURJA

18 180 SHIV CHAN SAHU 4434 532 163 369 1064 KHURJA

19 181 MD.RIZWAN ANSARI 0 0 0 0 0 KHURJA

20 182 RAJESH KUMAR RAI 4161 499 153 347 999 KHURJA

21 183 RAMBABU SHARMA 3994 479 147 333 959 KHURJA

22 184 VED PAL 4249 510 156 354 1020 KHURJA

23 185 AKASH 3795 455 139 316 911 KHURJA

24 186 GORAKH SAH 2481 298 91 207 595 KHURJA

25 187 VIRENDRA KUMAR 4434 532 163 369 1064 KHURJA

26 188 ANISH 3795 455 139 316 911 KHURJA

27 189 GOPAL SINGH 369 44 14 31 89 KHURJA

28 190 RAMBABU PANDIT 4803 576 176 400 1153 KHURJA

29 191 SANJIV SAHA 3994 479 147 333 959 KHURJA

30 193 RAMESH CHAND GAUTAM 4803 576 176 400 1153 KHURJA

31 194 SHASHI KANT SINGH 2829 339 104 236 679 KHURJA

32 195 SHASHI KUMAR 3879 465 142 323 931 KHURJA

STATEMENT OF EPF RECOVERY :JUNE-2010

EPF A/c No.

K M SSOCI TES

Shop No.10 Manibhadra Complex Nr. Vibhaji School Jamnagar 361001

EPF Code No. GJ/75374

SITE NAME : GUJARAT REGION

RmksName of EmployeeEPF Recovery

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Sl.

No. Basic @ 12% 3.67% 8.33% TOTAL

STATEMENT OF EPF RECOVERY :JUNE-2010

EPF A/c No.

K M SSOCI TES

Shop No.10 Manibhadra Complex Nr. Vibhaji School Jamnagar 361001

EPF Code No. GJ/75374

SITE NAME : GUJARAT REGION

RmksName of EmployeeEPF Recovery

59 227 RAJIV GAUTAM 3795 455 139 316 911 KHURJA

60 228 MANJESH PAL 3795 455 139 316 911 KHURJA

61 229 BHUPENDRA ARYA 1606 193 59 134 385 KHURJA

62 230 PANKAJ KUMAR SHARMA 3357 403 123 280 806 KHURJA

63 310 HARENADAR SAH 2627 315 96 219 630 KHURJA

64 311 SANJAY KUMAR SINGH 4327 519 159 360 1038 KHURJA

65 312 HEMCHANDRA GAUTAM 4161 499 153 347 999 KHURJA

66 314 PANKAJ KUMAR 4803 576 176 400 1153 KHURJA

67 315 RAM PRAKESH 4434 532 163 369 1064 KHURJA

68 316 AJAY KUMAR 4249 510 156 354 1020 KHURJA

69 317 PRAMOD KUMAR 3649 438 134 304 876 KHURJA

70 318 RAMPAL 3994 479 147 333 959 KHURJA

71 319 RAVI SANKER DUBEY 3510 421 129 292 842 KHURJA

72 320 PAWAN KUMAR 4327 519 159 360 1038 KHURJA

73 321 KAMAL ASRAF 4803 576 176 400 1153 KHURJA

74 322 ASHOK KUMAR 3795 455 139 316 911 KHURJA

75 323 VINESH SINGH 4327 519 159 360 1038 KHURJA

76 324 AJAY KUMAR 4161 499 153 347 999 KHURJA

77 325 TEHARA HUSSAIN 4064 488 149 339 975 KHURJA

78 326 PARSHU RAM 3325 399 122 277 798 KHURJA

79 327 RAKESH KUMAR DHAKAD 4327 519 159 360 1038 KHURJA

80 328 MAHENDER KUMAR PANDEY 3994 479 147 333 959 KHURJA

81 329 VIKAS SINGH 3994 479 147 333 959 KHURJA

82 330 RAVI PRAKASH TIWARI 3795 455 139 316 911 KHURJA

83 331 GOPAL SINGH 4803 576 176 400 1153 KHURJA

84 332 RAJAN SINGH 4161 499 153 347 999 KHURJA

85 333 BACHCHAN BABU 4803 576 176 400 1153 KHURJA

86 334 VINOD CHAUHAN 3879 465 142 323 931 KHURJA

87 335 AMRIT LAL 4327 519 159 360 1038 KHURJA88 336 RAVI RANJAN DUBEY 730 88 27 61 175 KHURJA

89 450 JAY PRAKASH CHOUHAN 4327 519 159 360 1038 KHURJA

90 451 PRATAP SINGH 3503 420 129 292 841 KHURJA

91 452 DAVBUSHNAN SHUKLA 4327 519 159 360 1038 KHURJA

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Sl.No. Basic @ 12% 3.67% 8.33% TOTAL

STATEMENT OF EPF RECOVERY :JUNE-2010

EPF A/c No.

K M SSOCI TES

Shop No.10 Manibhadra Complex Nr. Vibhaji School Jamnagar 361001

EPF Code No. GJ/75374

SITE NAME : GUJARAT REGION

RmksName of Employee EPF Recovery

124

602 PRAVEEN KUMAR 4327 519 159 360 1038 KHURJA

125 603 KAMLESH KUMAR 2481 298 91 207 595 KHURJA

126 604 GOVARDHAN SINGH 1831 220 67 153 439 KHURJA

127 605 RAHUL PATHAK 1847 222 68 154 443 KHURJA

128 606 GOURAV SHARMA 1293 155 47 108 310 KHURJA

129 607 ANSHUL GARG 1498 180 55 125 360 KHURJA

466194 55943 17109 38834 111887GRAND TOTAL

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4/60

Sl.

No. Basic @ 12% 3.67% 8.33%

1 2 3 4 5

1 62 BHARAT LAL BARTHWAL 4618 554 169 385

2 65 AMIT KUMAR SHARMA 4161 499 153 347

3 174 RAJU SINGH 2496 300 92 208

4 69 SURESH KUMAR GAUTAM 4327 519 159 360

5 73 MD. MUSTAFA ANSARI 4803 576 176 400

6 77 RAMCHANDER YADAV 3325 399 122 277

7 78 AJIJ KHAN 2771 333 102 231

8 79 RAJU CHAUHAN 4803 576 176 400

9 183 RAMBABU SHARMA 3994 479 147 333

10 184 VED PAL 4249 510 156 354

11 187 VIRENDRA KUMAR 4434 532 163 36912 188 ANISH 3795 455 139 316

13 189 GOPAL SINGH 369 44 14 31

14 190 RAMBABU PANDIT 4803 576 176 400

15 193 RAMESH CHAND GAUTAM 4803 576 176 400

16 196 SANTASHWAR TIWARI 4803 576 176 400

17 198 KRISHNA NAND 3357 403 123 280

18 200 PRADEEP KUMAR MISHRA 4327 519 159 360

19 201 MD. YASEEN 4803 576 176 400

20 202 SHISH RAM SAGAR 4249 510 156 354

21 206 PANKAJ KUMAR SISODA 4803 576 176 400

22 211 ROHIT KUMAR SHARMA 4161 499 153 347

23 214 SUNIL THAKUR 3795 455 139 316

Name of Employee

STATEMENT OF EPF RECOVERY JUNE-2010

SITE NAME : KHURJA

EPF Recovery

EPF A/c No.

Shop No.10 Manibhadra Complex Nr. Vibhaji School Jamnagar 361001

K M SSOCI TES

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45 450 JAY PRAKASH CHOUHAN 4327 519 159 360

46 451 PRATAP SINGH 3503 420 129 292

47 452 DAVBUSHNAN SHUKLA 4327 519 159 360

48 453 DHIRENDAR SINGH 3661 439 134 305

49 455 SUNIL KUMAR SINGH 3795 455 139 316

50 457 AUNISH BHARDWAJ 4618 554 169 385

51 458 UDAY BHAN SINGH 4803 576 176 400

52 459 DINESH DUBEY 1831 220 67 153

53 460 RAVI KANT MISHRA 4327 519 159 360

54 461 PROMOD KUMAR SHARMA 4803 576 176 400

55 462 SAJAL KUMAR RAI 4327 519 159 360

56 60 SATENDRA KUMAR 3795 455 139 316

57 63 MUKESH KUMAR 3661 439 134 30558 64 SHASHI KANT MISHRA 4803 576 176 400

59 68 CHANDAN KUAMAR PANDEY 2163 260 79 180

60 70 ARUN TIWARI 185 22 7 15

61 72 BIPLAB MISHRA 3994 479 147 333

62 80 RAHUL KUMAR RAI 4161 499 153 347

63 81 GAUTAM KARMAKAR 2627 315 96 219

64 177 KISAN SWROOP SHARMA 1478 177 54 123

65 180 SHIV CHAN SAHU 4434 532 163 369

66 182 RAJESH KUMAR RAI 4161 499 153 347

67 185 AKASH 3795 455 139 316

68 186 GORAKH SAH 2481 298 91 207

69 191 SANJIV SAHA 3994 479 147 333

70 194 SHASHI KANT SINGH 2829 339 104 236

71 195 SHASHI KUMAR 3879 465 142 323

72 197 ANJANI PANDEY 4618 554 169 385

73 203 DILEEP KUMAR PANDEY 2217 266 81 185

74 204 MANISH PANDEY 3795 455 139 31675 207 PARMANAND SINGH 4064 488 149 339

76 208 BALMIKIKI UPADHAYAY 3795 455 139 316

77 230 PANKAJ KUMAR SHARMA 3357 403 123 280

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99 463 HANUMANT RAM VAISH 4161 499 153 347

100 464 FAISAL KHALIL 4327 519 159 360

101 465 NAND KISHOR SHARMA 3325 399 122 277

102 466 DINESH VISHWAKARMA 3661 439 134 305

103 467 DHARMENDRA KUMAR YADAV 4327 519 159 360

104 468 SHIV KUMAR SHARMA 4327 519 159 360

105 469 DAUDAYAL SINGH TARKAR 4161 499 153 347

106 470 RAJ KUMAR MEHTA 4803 576 176 400

107 471 BAIDYANATH PRASAD 2217 266 81 185

108 472 MR.SANJAY SINGH 4803 576 176 400

109 473 AJAY KUMAR MANDAL 3795 455 139 316

110 474 SATISH KUMAR SINGH 4327 519 159 360

111 475 BIJENDRA SINGH NIRWAN 3994 479 147 333112 591 RAJKUMAR SHARMA 3795 455 139 316

113 592 VINOD KUMAR 2481 298 91 207

114 593 AMAR DEEP UPADHYAY 1752 210 64 146

115 594 SHATRUDHAN CHOUDHARY 2163 260 79 180

116 595 RAMESHAR D. SAROJ 1997 240 73 166

117 596 ABHISHEKH SINGH 1663 200 61 139

118 597 SUBHASH CHOUDHRY 1168 140 43 97

119 598 MOHMD UMAR 1478 177 54 123

120 599 VIJENDRA SINGH 876 105 32 73

121 600 ASHOK KUMAR 369 44 14 31

122 601 BHAGWAN WALA 4803 576 176 400

123 602 PRAVEEN KUMAR 4327 519 159 360

124 603 KAMLESH KUMAR 2481 298 91 207

125 604 GOVARDHAN SINGH 1831 220 67 153

126 605 RAHUL PATHAK 1847 222 68 154

127 606 GOURAV SHARMA 1293 155 47 108

128 607 ANSHUL GARG 1498 180 55 125466194 55943 17109 38834

13.61 63449.003 Total 119392

TOTAL

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9/60

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12/60

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13/60

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TOTAL

6

1108 KHURJA

999 KHURJA

599 KHURJA

1038 KHURJA

1153 KHURJA

798 KHURJA

665 KHURJA

1153 KHURJA

959 KHURJA

1020 KHURJA

1064 KHURJA911 KHURJA

89 KHURJA

1153 KHURJA

1153 KHURJA

1153 KHURJA

806 KHURJA

1038 KHURJA

1153 KHURJA

1020 KHURJA

1153 KHURJA

999 KHURJA

911 KHURJA

EPF Code No. GJ/75374

Rmks

8/10/2019 PF form v.xls

16/60

1038 KHURJA

841 KHURJA

1038 KHURJA

879 KHURJA

911 KHURJA1108 KHURJA

1153 KHURJA

439 KHURJA

1038 KHURJA

1153 KHURJA

1038 KHURJA

911 KHURJA

879 KHURJA

1153 KHURJA

519 KHURJA

44 KHURJA

959 KHURJA

999 KHURJA

630 KHURJA

355 KHURJA 09.06.2010

1064 KHURJA

999 KHURJA911 KHURJA

595 KHURJA

959 KHURJA

679 KHURJA

931 KHURJA

1108 KHURJA

532 KHURJA

911 KHURJA975 KHURJA

911 KHURJA

806 KHURJA

8/10/2019 PF form v.xls

17/60

999 KHURJA

1038 KHURJA

798 KHURJA

879 KHURJA

1038 KHURJA1038 KHURJA

999 KHURJA

1153 KHURJA

532 KHURJA

1153 KHURJA

911 KHURJA

1038 KHURJA

959 KHURJA

911 KHURJA

595 KHURJA

420 KHURJA

519 KHURJA

479 KHURJA

399 KHURJA

280 KHURJA

355 KHURJA

210 KHURJA89 KHURJA

1153 KHURJA

1038 KHURJA

595 KHURJA

439 KHURJA

443 KHURJA

310 KHURJA

360 KHURJA111887

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FORM-05

(to be sent to Commissioner with Form-2)

Sl EPF Name of the Employee Date of Ttl prd

No. Account No. Elgblty of servce

EMPOYEES PROVIDENT FUND SCHEME, 1952

{Para 36(2)(b)}

Return of employee qualifying for membership of Employee's Provident Fund for the first time during the month of JUNE-2010

Name & Address of the Establishment : K.M.ASSOCIATES, Shop No. 10 Manibhara Complex, Near Vibhaji School Jamnagar 361001

Father's/husband's Name Age Sex Rmks

SITE NAME: GUJARAT REGION

Code No. of the Establishment : GJ/75374

9 GJ/RJT/75374/591 RAJKUMAR SHARMA RAMNIWAS SHARMA 24 M 01.06.2010 1 MONTH KHURJA

10 GJ/RJT/75374/592 VINOD KUMAR CHHOTAN SINGH 01.03.1983 M 09.06.2010 1 MONTH KHURJA

11 GJ/RJT/75374/593 AMAR DEEP UPADHYAY SATISH SHARMA 28.11.1991 M 16.06.2010 1 MONTH KHURJA

12 GJ/RJT/75374/594 SHATRUDHAN CHOUDHARY RAJENDRA CHOUDHRY 05.06.1972 M 16.04.2010 3 MONTH KHURJA

13 GJ/RJT/75374/595 RAMESHAR D. SAROJ SHRI DEVIDEEN SAROJ 10.10.1959 M 17.06.2010 1 MONTH KHURJA

14 GJ/RJT/75374/596 ABHISHEKH SINGH RAMNARESH SINGH 10.04.1987 M 21.06.2010 1 MONTH KHURJA

15 GJ/RJT/75374/597 SUBHASH CHOUDHRY CHANDRABEER SINGH 01.01.1975 M 22.06.2010 1 MONTH KHURJA

16 GJ/RJT/75374/598 MOHMD UMAR LT. IMDAD ALI 21.01.1986 M 22.06.2010 1 MONTH KHURJA

17 GJ/RJT/75374/599 VIJENDRA SINGH CHIRANJI LAL 10.07.1983 M 24.06.2010 1 MONTH KHURJA

18 GJ/RJT/75374/600 ASHOK KUMAR RAM SARAN 20.08.1979 M 29.06.2010 1 MONTH KHURJA

19 GJ/RJT/75374/601 BHAGWAN WALA SHRI NADHAB WALA 25.04.1986 M 01.06.2010 1 MONTH KHURJA

20 GJ/RJT/75374/602 PRAVEEN KUMAR MAHENDRA SINGH 01.07.1985 M 01.06.2010 1 MONTH KHURJA

21 GJ/RJT/75374/603 KAMLESH KUMAR SHIVSHANKER RAM 20.09.1987 M 11.06.2010 1 MONTH KHURJA

22 GJ/RJT/75374/604 GOVARDHAN SINGH RAM KUVAR SINGH 10.01.1986 M 18.06.2010 1 MONTH KHURJA

23 GJ/RJT/75374/605 RAHUL PATHAK LT. SRI D.S. PATHAK 01.09.1979 M 18.06.2010 1 MONTH KHURJA

24 GJ/RJT/75374/606 GOURAV SHARMA RAM PRATAP SHARMA 19.07.1984 M 21.06.2010 1 MONTH KHURJA

25 GJ/RJT/75374/607 ANSHUL GARG SHRI VIJAY GARG 02.07.1988 M 18.06.2010 1 MONTH KHURJA

Page 26 of 60

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(to be sent to Commissioner with Form-2)

Sl EPF Name of the Employee Date of Ttl prd

No. Account No. Elgblty of servce

1 GJ/RJT/75374/583 VIJAY KUMAR KANNAYA PRASAD 01.01.1967 M 01.06.2010 1 MONTH

(to be sent to Commissioner with Form-2)

Sl EPF Name of the Employee Date of Ttl prd

No. Account No. Elgblty of servce

1 GJ/RJT/75374/584 P.MUTHU PANDI S.PERIYA MUNIYANDI 24 M 2-Jun-10

2 GJ/RJT/75374/585 A.R.RAMESH A.V.RATHINA VEL 41 M 2-Jun-10

EMPOYEES PROVIDENT FUND SCHEME, 1952

{Para 36(2)(b)}

Return of employee qualifying for membership of Employee's Provident Fund for the first time during the month of JUNE-2010

Name & Address of the Establishment : K.M.ASSOCIATES, Shop No. 10 Manibhara Complex, Near Vibhaji School Jamnagar 361001

SITE NAME: UREN CRUSHER

Age Sex

Code No. of the Establishment

Return of employee qualifying for membership of Employee's Provident Fund for the first time during the month of JUNE-2010

Father's/husband's Name Age Sex

EMPOYEES PROVIDENT FUND SCHEME, 1952

{Para 36(2)(b)}

Name & Address of the Establishment : K.M.ASSOCIATES, Shop No. 10 Manibhara Complex, Near Vibhaji School Jamnagar 361001

SITE NAME: TRIVENDRAM

Code No. of the Establishment

Father's/husband's Name

Page 27 of 60

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(to be sent to Commissioner with Form-2)

Sl EPF Name of the Employee Date of Ttl prd

No. Account No. Elgblty of servce

1 GJ/RJT/75374/586 MD MOBIN MD HASIM 43 M 01.06.2010 1 MONTH

2 GJ/RJT/75374/587 NEETU SINGH KARAN SINGH 25 M 10.06.2010 1 MONTH

3 GJ/RJT/75374/588 VIKAS SINGH VIKRAM SINGH 22 M 21.06.2010 1 MONTH

4 GJ/RJT/75374/589 SANTOSH PRASAD BADLU PRASAD 26 M 22.06.2010 1 MONTH5 GJ/RJT/75374/590 PARAM HANS YADAV FUL CHAND YADAV 26 M 29.06.2010 1 MONTH

(to be sent to Commissioner with Form-2)

Sl EPF Name of the Employee Date of Ttl prd

No. Account No. Elgblty of servce

1 GJ/RJT/75374/591 RAJKUMAR SHARMA RAMNIWAS SHARMA 24 M 01.06.2010

2 GJ/RJT/75374/592 VINOD KUMAR CHHOTAN SINGH 01.03.1983 M 09.06.2010

3 GJ/RJT/75374/593 AMAR DEEP UPADHYAY SATISH SHARMA 28.11.1991 M 16.06.2010

Code No. of the Establishment

Age Sex

EMPOYEES PROVIDENT FUND SCHEME, 1952

Name & Address of the Establishment : K.M.ASSOCIATES, Shop No. 10 Manibhara Complex, Near Vibhaji School Jamnagar 361001

SITE NAME: KHURJA

Father's/husband's Name SexAge

EMPOYEES PROVIDENT FUND SCHEME, 1952

{Para 36(2)(b)}

Return of employee qualifying for membership of Employee's Provident Fund for the first time during the month of JUNE-2010

Code No. of the Establishment

Name & Address of the Establishment : K.M.ASSOCIATES, Shop No. 10 Manibhara Complex, Near Vibhaji School Jamnagar 361001

SITE NAME: GODREJ

{Para 36(2)(b)}

Return of employee qualifying for membership of Employee's Provident Fund for the first time during the month of JUNE-2010

Father's/husband's Name

Page 28 of 60

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4 GJ/RJT/75374/594 SHATRUDHAN CHOUDHARY RAJENDRA CHOUDHRY 05.06.1972 M 16.04.2010

5 GJ/RJT/75374/595 RAMESHAR D. SAROJ SHRI DEVIDEEN SAROJ 10.10.1959 M 17.06.2010

Page 29 of 60

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6 GJ/RJT/75374/596 ABHISHEKH SINGH RAMNARESH SINGH 10.04.1987 M 21.06.2010

7 GJ/RJT/75374/597 SUBHASH CHOUDHRY CHANDRABEER SINGH 01.01.1975 M 22.06.2010

8 GJ/RJT/75374/598 MOHMD UMAR LT. IMDAD ALI 21.01.1986 M 22.06.2010

9 GJ/RJT/75374/599 VIJENDRA SINGH CHIRANJI LAL 10.07.1983 M 24.06.2010

10 GJ/RJT/75374/600 ASHOK KUMAR RAM SARAN 20.08.1979 M 29.06.201011 GJ/RJT/75374/601 BHAGWAN WALA SHRI NADHAB WALA 25.04.1986 M 01.06.2010

12 GJ/RJT/75374/602 PRAVEEN KUMAR MAHENDRA SINGH 01.07.1985 M 01.06.2010

13 GJ/RJT/75374/603 KAMLESH KUMAR SHIVSHANKER RAM 20.09.1987 M 11.06.2010

14 GJ/RJT/75374/604 GOVARDHAN SINGH RAM KUVAR SINGH 10.01.1986 M 18.06.2010

15 GJ/RJT/75374/605 RAHUL PATHAK LT. SRI D.S. PATHAK 01.09.1979 M 18.06.2010

16 GJ/RJT/75374/606 GOURAV SHARMA RAM PRATAP SHARMA 19.07.1984 M 21.06.2010

17 GJ/RJT/75374/607 ANSHUL GARG SHRI VIJAY GARG 02.07.1988 M 18.06.2010

(to be sent to Commissioner with Form-2)

Sl EPF Name of the Employee Date of Ttl prd

No. Account No. Elgblty of servce1 GJ/RJT/75374/608 BHARAT SINGH ABHIMANYU SINGH 27 M 01.06.2010 1 MONTH

2 GJ/RJT/75374/609 NAVEEN PAL SATYA PAL 23 M 01.06.2010 1 MONTH

3 GJ/RJT/75374/610 MANOJ KUMAR BHGAWANA RAM 24 M 02.06.2010 1 MONTH

4 GJ/RJT/75374/611 CHANDRA BHAN SINGH BUDDHPAL SINGH 28 M 04.06.2010 1 MONTH

5 GJ/RJT/75374/612 ASHISH KUMAR VISHMBHAR SINGH 20 M 07.06.2010 1 MONTH

6 GJ/RJT/75374/613 ANIL KUMAR OM PRAKASH 40 M 10.06.2010 1 MONTH

7 GJ/RJT/75374/614 PRADEEP KUMAR RAGHUNATH 32 M 10.06.2010 1 MONTH

8 GJ/RJT/75374/615 BHIM SINGH RAM SOBHIT 36 M 11.06.2010 1 MONTH

Return of employee qualifying for membership of Employee's Provident Fund for the first time during the month of JUNE-2010

Code No. of the Establishment

Father's/husband's Name

{Para 36(2)(b)}

Name & Address of the Establishment : K.M.ASSOCIATES, Shop No. 10 Manibhara Complex, Near Vibhaji School Jamnagar 361001

Age Sex

EMPOYEES PROVIDENT FUND SCHEME, 1952

SITE NAME:MANESWAR

Page 30 of 60

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9 GJ/RJT/75374/616 HARI SANKAR PANDAY HIRAMAN PANDAY 48 M 11.06.2010 1 MONTH

10 GJ/RJT/75374/617 BIKRAM MAHTO NARESH MAHTO 25 M 12.06.2010 1 MONTH

11 GJ/RJT/75374/618 VIJAY KUMAR SINGH RAJ BAHADUR SINGH 26 M 15.06.2010 1 MONTH

12 GJ/RJT/75374/619 VIPIN KUMAR MISHRA MANI KANT MISHRA 23 M 15.06.2010 1 MONTH

13 GJ/RJT/75374/620 MANOJ KUMAR CHHAJU RAM 23 M 15.06.2010 1 MONTH14 GJ/RJT/75374/621 RAJA RAM DUBEY UMAKANT DUBEY 35 M 16.06.2010 1 MONTH

15 GJ/RJT/75374/622 BRUNDABAN KAHAL SINGH DEVRAJ KAHAL SINGH 30 M 16.06.2010 1 MONTH

Page 31 of 60

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16 GJ/RJT/75374/623 BATA KRISHNA OJHA NABAGHANA OJHA 37 M 16.06.2010 1 MONTH

17 GJ/RJT/75374/624 SUNIL KUMAR MAHENDRA SINGH 21 M 17.06.2010 1 MONTH

18 GJ/RJT/75374/625 PREM NARAYAN MISHRA RAM KHILARI MISHRA 29 M 26.06.2010 1 MONTH

19 GJ/RJT/75374/626 DAYAMAY MANDAL NADIYA MANDAL 26 M 17.06.2010 1 MONTH

(to be sent to Commissioner with Form-2)

Sl EPF Name of the Employee Date of Ttl prd

No. Account No. Elgblty of servce

1 GJ/RJT/75374/627 MANOJ YADAV RAM YADAV 37 M 6/3/2010

2 GJ/RJT/75374/628 DEEPAK KERKETTA JULUS KERKETTA 29 M 6/3/2010

3 GJ/RJT/75374/629 AWADHESH VERMA SANKAR VERMA 28 M 6/11/2010

4 GJ/RJT/75374/630 KAMTA SINGH SUNDER SINGH 39 M 6/12/2010

5 GJ/RJT/75374/631 SATPAL BISHAN SINGH 41 M 6/16/2010

6 GJ/RJT/75374/632 VINAY KR. UPADHAYA AWADESH UPADHAYA 25 M 6/23/2010

7 GJ/RJT/75374/633 DEVINDER SINGH LAKHBIR SINGH 19 M 6/25/2010

8 GJ/RJT/75374/634 LOW KUMAR PANDEY GORAKHNATH PANDEY 22 M 6/29/20109 GJ/RJT/75374/635 RAVINDER KUMAR RAM JIT RAM 44 M 6/29/2010

Code No. of the Establishment

EMPOYEES PROVIDENT FUND SCHEME, 1952

Father's/husband's Name Sex

Return of employee qualifying for membership of Employee's Provident Fund for the first time during the month of JUNE-2010

Name & Address of the Establishment : K.M.ASSOCIATES, Shop No. 10 Manibhara Complex, Near Vibhaji School Jamnagar 361001

SITE NAME:SAMALKHA

Age

{Para 36(2)(b)}

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Sl EPF Name of the Employee Date of Ttl prd

No. Account No. Elgblty of servce

1 GJ/RJT/75374/636 RATISH KUMAR SINGH DEVNATH SINGH 35 M 01.06.2010 1 MONTH

2 GJ/RJT/75374/637 JAGADA NAND MISHRA MEDHA NAND MISHRA 40 M 01.06.2010 1 MONTH

3 GJ/RJT/75374/638 RASAL BISWASH RAMENDRA NATH 38 M 01.06.2010 1 MONTH

4 GJ/RJT/75374/639 UDAY RAJ MORYA SATISH CHANDRA MORYA 23 M 01.06.2010 1 MONTH5 GJ/RJT/75374/640 P.SHANMUGARAJ V.PITCHIAH 26 M 01.06.2010 1 MONTH

6 GJ/RJT/75374/641 A.RAMKI AYYODYA RAM 23 M 01.06.2010 1 MONTH

7 GJ/RJT/75374/642 SHYAM SUNDAR NILKANTH SINGH 40 M 01.06.2010 1 MONTH

8 GJ/RJT/75374/643 SAILESH BORICHA RAMESH BHAI 20 M 01.06.2010 1 MONTH

9 GJ/RJT/75374/644 V.NATRAJ VIRAPPAN 45 M 01.06.2010 1 MONTH

10 GJ/RJT/75374/645 PARMAR MAHENDRA KANAK SINGH 20 M 01.06.2010 1 MONTH

11 GJ/RJT/75374/646 MURUGAN R T.RAJENRAN 26 M 01.06.2010 1 MONTH

12 GJ/RJT/75374/647 VAGELA JITENDRA SINGH ARJUN SINGH 21 M 05.06.2010 1 MONTH

13 GJ/RJT/75374/648 TUNTUN SINGH GULAB SHAH 44 M 09.06.2010 1 MONTH

14 GJ/RJT/75374/649 BARAD BHAV SINH BARAD BHIKHA BHAI 34 M 16.06.2010 1 MONTH15 GJ/RJT/75374/650 ARMAN KHAN AIYAKAT KHAN 21 M 16.06.2010 1 MONTH

16 GJ/RJT/75374/651 PRAVIN KUMAR TIWARI ANAND SANKAR TIWARI 27 M 16.06.2010 1 MONTH

17 GJ/RJT/75374/652 MD.SALIM ANSARI MD.ALIMUDDIN ANSARI 22 M 16.06.2010 1 MONTH

18 GJ/RJT/75374/653 VANKAR ASHOK KUMAR KARASAN BHAI 26 M 21.06.2010 1 MONTH

19 GJ/RJT/75374/654 CHUDASAMA LALJEE KHODA BHAI CHUDASAMA 25 M 14.06.2010 1 MONTH

Code No. of the Establishment

Father's/husband's Name

SITE NAME:GANDHINAGAR

Name & Address of the Establishment : K.M.ASSOCIATES, Shop No. 10 Manibhara Complex, Near Vibhaji School Jamnagar 361001

EMPOYEES PROVIDENT FUND SCHEME, 1952

{Para 36(2)(b)}

Return of employee qualifying for membership of Employee's Provident Fund for the first time during the month of JUNE-2010

EMPOYEES PROVIDENT FUND SCHEME, 1952

Age Sex

{Para 36(2)(b)}

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Sl EPF Name of the Employee Date of Ttl prd

No. Account No. Elgblty of servce

1 GJ/RJT/75374/655 R SELVAGANDHI M RAMANATHAN 26 M 01.06.2010

2 GJ/RJTJ/75374/656 PICHAYA Y. CHINNAIAN 30 M 02.06.2010

3 GJ/RJT/75374/657 D M SENTHIL NATHAN D MOHANACHARI 25 M 02.06.2010

4 GJ/RJT/75374/658 R SEKAR M RAJI 41 M 03.06.2010

5 GJ/RJT/75374/659 V JEYAKUMAR VASAHAR 28 M 04.06.2010

6 GJ/RJT/75374/660 B SURESH BHASKAR 26 M 04.06.20107 GJ/RJT/75374/661 V SELVAKUMAR J VELLASAMY 24 M 07.06.2010

8 GJ/RJT/75374/662 SUKDEV MANDAL DEENABANDA MANDAL 26 M 07.06.2010

9 GJ/RJT/75374/663 VENKATA KRISHNA BHUSHANAM 36 M 07.06.2010

10 GJ/RJT/75374/664 C K RAJENDIRAN G KUPPUSAMY 45 M 09.06.2010

Father's/husband's Name

Name & Address of the Establishment : K.M.ASSOCIATES, Shop No. 10 Manibhara Complex, Near Vibhaji School Jamnagar 361001SITE NAME:CTS SIRUSERI

Code No. of the Establishment

Return of employee qualifying for membership of Employee's Provident Fund for the first time during the month of JUNE-2010

SexAge

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11 GJ/RJT/75374/665 C GNANASEKAR R CHOCKALINGAM 40 M 09.06.2010

12 GJ/RJT/75374/666 R ARIVAZHAGAN K RAJAGOPALAN 26 M 09.06.2010

13 GJ/RJT/75374/667 K N MAHARAJAN K NALLAKANNU 25 M 09.06.2010

14 GJ/RJT/75374/668 P RADHAKRISHNAN N PALANI 30 M 09.06.2010

15 GJ/RJT/75374/669 I DAVID RAJU S ASIRWADHAM 42 M 09.06.201016 GJ/RJT/75374/670 R SRIDAR R G K MURTHI 34 M 10.06.2010

17 GJ/RJT/75374/671 SANGAMLAL YADAV GAYADEEN YADAV 41 M 10.06.2010

18 GJ/RJT/75374/672 P PALSAMY PERIYASAMY 51 M 11.06.2010

19 GJ/RJT/75374/673 C KANNAN S SINNATHAMBI 28 M 14.06.2010

20 GJ/RJT/75374/674 D THRINATH D DHILARH 52 M 14.06.2010

21 GJ/RJT/75374/675 S KASI R SANKAR 36 M 14.06.2010

22 GJ/RJT/75374/676 N SANTHOSH KUMAR S NAGAPPAN 20 M 14.06.2010

23 GJ/RJT/75374/677 V PRAKASH M VICTOR 25 M 16.06.2010

24 GJ/RJT/75374/678 V SELVARAJ K VENKATESAN 25 M 16.06.2010

25 GJ/RJT/75374/679 K G MAHADEVAN K GANTHI 32 M 16.06.201026 GJ/RJT/75374/680 ASHOK KUMAR S BADMANABASAMY 19 M 21.06.2010

27 GJ/RJT/75374/681 N SOWRIRAJAN NAGARATHINAM 42 M 23.06.2010

28 GJ/RJT/75374/682 N RAMKUMAR NEELA MAHAKANNAN 20 M 26.06.2010

29 GJ/RJT/75374/683 DEV PRADHAN KASABA PRADHAN 28 M 23.06.2010

30 GJ/RJT/75374/684 T SEKAR K TAVASU 41 M 23.06.2010

31 GJ/RJT/75374/685 RAMBHAVAN YADAV CHHEDILAL YADAV 25 M 23.06.2010

32 GJ/RJT/75374/686 M HARIHARA SUDHAN K MARI MUTHU 20 M 24.06.2010

33 GJ/RJT/75374/687 M ANUMUTHU K MUNUSAMY 45 M 24.06.2010

34 GJ/RJT/75374/688 M VENKATA RAMESH M VENKATESWARA RAO 27 M 25.06.2010

35 GJ/RJT/75374/689 J SUNDAR V JAYAPAL 27 M 25.06.201036 GJ/RJT/75374/690 A SELVARAJ ARUMUGAM 49 M 26.06.2010

37 GJ/RJT/75374/691 P MAHESHWARAN PERIYASAMY 27 M 26.06.2010

38 GJ/RJT/75374/692 R CHIDAMBARAM RAMANATHAN 29 M 26.06.2010

39 GJ/RJT/75374/693 P SRINIVASAN C V PATTAGI 36 M 26.06.2010

40 GJ/RJT/75374/694 A RAJA E ARJUNAN 30 M 26.06.2010

41 GJ/RJT/75374/695 GOBINDA JENA KRISHNA PRASAD 26 M 28.06.2010

42 GJ/RJT/75374/696 M B DILNAVAJ M D NISHAR 19 M 28.06.2010

43 GJ/RJT/75374/697 K ELUMALAI K KATHAVARAIYAN 23 M 28.06.2010

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44 GJ/RJT/75374/698 SUSHANTA MANDAL SUREN MANDAL 34 M 29.06.2010

45 GJ/RJT/75374/699 M TAMILSELVAN MURUGESAN 19 M 30.06.2010

46 GJ/RJT/75374/700 M OBULESH M P OBULESH 27 M 30.06.2010

47 GJ/RJT/75374/701 S K BABA PAKRUDDIN SIKHANDER BASHA 26 M 30.06.2010

48 GJ/RJT/75374/702 PARTHIBAN RAMAKRISHNAN 27 M 01.06.2010

(to be sent to Commissioner with Form-2)

Sl EPF Name of the Employee Date of Ttl prd

No. Account No. Elgblty of servce

1 GJ/RJT/75374/703 DINESH SINGH 1979 M 01.06.2010

2 GJ/RJT/75374/704 NARAYAN MAJHI KALU MAJHI 1969 M 01.06.2010

3 GJ/RJT/75374/705 SUNAKAR JENA BHARATH JENA 1966 M 01.06.2010

4 GJ/RJT/75374/706 DHIRENDRA K.SHARMA RAM MURTHI SHARMA 1980 M 02.06.2010

5 GJ/RJT/75374/707 GANESH KISHOR MEHER KISHOR GOPAL MEHER 1985 M 03.06.2010

6 GJ/RJT/75374/708 PATIL RAMAKANT DATTATREY DATTATREY JANU PATIL 1987 M 03.06.20107 GJ/RJT/75374/709 JAGADISH TRIPATHY DIGAMBER TRIPATHY 1982 M 04.06.2010

8 GJ/RJT/75374/710 SACHITANANDA TRIPATHY RAMAKANTA TRIPATHY 1983 M 04.06.2010

9 GJ/RJT/75374/711 NITIN PRAKASH MORE PRAKASH MORE 1986 M 07.06.2010

10 GJ/RJT/75374/712 N.S.WAGHMARE S.M.WAGMARE 1977 M 08.06.2010

11 GJ/RJT/75374/713 BABLU ANSARI J.H.ANSARI 1976 M 08.06.2010

12 GJ/RJT/75374/714 MD.SIBGATULLAH SHAIKH KALIMULLAH SHAIKH 1981 M 08.06.2010

13 GJ/RJT/75374/715 MD.MUSTUFA MD.ILIYAS 1982 M 08.06.2010

14 GJ/RJT/75374/716 MD.JAFARALAM MD.ASIM 1986 M 08.06.2010

EMPOYEES PROVIDENT FUND SCHEME, 1952

Father's/husband's Name Age Sex

Code No. of the Establishment

SITE NAME:ORCHID CROWNName & Address of the Establishment : K.M.ASSOCIATES, Shop No. 10 Manibhara Complex, Near Vibhaji School Jamnagar 361001

Return of employee qualifying for membership of Employee's Provident Fund for the first time during the month of JUNE-2010

{Para 36(2)(b)}

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15 GJ/RJT/75374/717 SANGHARATNA BHALERAO DHANARAJ 1989 M 09.06.2010

16 GJ/RJT/75374/718 RAVI GAIKWARD DEV DAS GAIKWARD 1990 M 09.06.2010

17 GJ/RJT/75374/719 RAVI BHANDARI LINGAYYA BHANDARI 1978 M 09.06.2010

18 GJ/RJT/75374/720 PRAKASH NARAYAN WADKAR NARAYAN M.WADKAR 1980 M 09.06.2010

19 GJ/RJT/75374/721 ABHAY KHILAR GOBINDA KHILAR 1984 M 10.06.201020 GJ/RJT/75374/722 MD.KHADIR MD.MUSLIM 1986 M 10.06.2010

21 GJ/RJT/75374/723 SHUDODHAN NAMDEV RAUT NAMDEV RAUT 1988 M 10.06.2010

22 GJ/RJT/75374/724 VIJAY PANDURANG GHORPADE PANDURANG K.GHORPADE 1985 M 11.06.2010

23 GJ/RJT/75374/725 SAGAR VENKAT JADHAV VENKAT RAMU JADHAV 1986 M 11.06.2010

24 GJ/RJT/75374/726 SRINIVAS ROUT DUKHISHYAM ROUT 1982 M 14.06.2010

25 GJ/RJT/75374/727 ASHOK BISWAS NARESH CHANDRA BISWAS 1969 M 14.06.2010

26 GJ/RJT/75374/728 KALIPADA BISWAS NARESH CHANDRA BISWAS 1977 M 14.06.2010

27 GJ/RJT/75374/729 KANAI DHALI SHIBU DHALI 1989 M 14.06.2010

28 GJ/RJT/75374/730 NARENDRA KISAN RAO BADGE KISHAN RAO BADGE 1986 M 15.06.2010

29 GJ/RJT/75374/731 LALBHADUR MAURYA GIRIDHARILAL MAURYA 1985 M 15.06.201030 GJ/RJT/75374/732 RAVINDRA KUMAR BARAL SISIR KUMAR BARAL 1977 M 15.06.2010

31 GJ/RJT/75374/733 PRADIPTA KUMAR PUHAN RAMCHANDRA PUHAN 1972 M 15.06.2010

32 GJ/RJT/75374/734 SHIVRAJ ARJUN BHALERAO ARJUN BHALERAO 1982 M 15.06.2010

33 GJ/RJT/75374/735 MEHTRE BABU DAMAJI DAMAJI MEHTRE 1981 M 15.06.2010

34 GJ/RJT/75374/736 P.MUNIKRISHNAN RAO VENKETESH IU 1985 M 15.06.2010

35 GJ/RJT/75374/737 BALLAL AHMAD MD.YASIN ANSARI 1978 M 16.06.2010

36 GJ/RJT/75374/738 MD.SHAMIM KHAN MD.RAFI KHAN 1977 M 17.06.2010

37 GJ/RJT/75374/739 GAIKWARD KISWAR SHYAMRAO SHYAMRAO 1988 M 21.06.2010

38 GJ/RJT/75374/740 BHALERAO ANTI VISHWNATH VISWANATH 1985 M 21.06.2010

39 GJ/RJT/75374/741 GAIKWARD ARVIND SHANKAR SHANKAR GAIKWARD 1984 M 21.06.201040 GJ/RJT/75374/742 MERLA BHASKAR MERLA KRISHNA 1980 M 21.06.2010

41 GJ/RJT/75374/743 MANILAL MANDAL SRI SHRISTIDHAR MANDAL 1987 M 22.06.2010

42 GJ/RJT/75374/744 AJAY KUMAR DUBEY RAM SHANKAR DUBEY 1980 M 22.06.2010

43 GJ/RJT/75374/745 MOHAMMAD RAHMAN MAHAMMAD QUADIR 1981 M 23.06.2010

44 GJ/RJT/75374/746 VARISH ANSARI SULTAN ANSARI 1984 M 23.06.2010

45 GJ/RJT/75374/747 ARUN B.SINGH B.V.SINGH 1980 M 29.06.2010

46 GJ/RJT/75374/748 ABHIJIT VIJAY SINGH PAWAR VIJAY SINGH PAWAR 1989 M 29.06.2010

47 GJ/RJT/75374/749 KUMAR JAY SINGH RAGHUNANDA SINGH 1968 M 30.06.2010

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FORM-05

FORM-05

FORM-05

Rmks

: GJ/75374

Rmks

: GJ/75374

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FORM-05

: GJ/75374

Rmks

: GJ/75374

Rmks

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FORM-05

Rmks

: GJ/75374

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FORM-05

FORM-05

: GJ/75374

Rmks

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FORM-05

: GJ/75374

Rmks

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: GJ/75374

Rmks

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FORM-05

Rmks

: GJ/75374

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Sl EPF Name of the Employee Father's/ Date of Reason for Rmks.

No. account no. Husband's Name Leaving Service leaving Service

1 2 HARINATH CHOUHAN RAMAKANT 23.05.2010 RESIGNED UREN CRUSHER

2 114 NAVDEEP SINGH SATPAL SINGH 02.06.2010 RESIGNED GODREJ

3 209 Rakesh Kumar Singh Chandrika singh 01.06.2010 RESIGNED KHURJA

4 210 DHANANJAY KUMAR MALL NAND KUMAR MALL 01.06.2010 RESIGNED KHURJA

5 75 MOHIN AHMAD ABDUL AHMAD 02.06.2010 RESIGNED KHURJA

6 177 KISAN SWROOP SHARMA SHYAM SUNDER SHARMA 09.06.2010 RESIGNED KHURJA

7 237 DANVEER SANTRAM 30.05.2010 RESIGNED MANISWAR

8 337 SANJAY PD. KAPILDEV PRASAD 31.05.2010 RESIGNED MANISWAR

9 495 BIRENDRA PRATAP SINGH RAJENDRA PRASAD SINGH 01.06.2010 RESIGNED MANISWAR

10 250 FIRAN VISHWEKARMA FATUA VISHWAKARMA 07.05.2010 RESIGNED GANDHINAGAR

11 261 RAJPUT GULAB SINGH TOP SINGH 07.05.2010 RESIGNED GANDHINAGAR

12 379 PRASHANT SHREEVASTAV RAJESH KUMAR SHREEVASTAV 31.05.2010 RESIGNED GANDHINAGAR

13 381 BALMIKI SAHU DANDASI SAHU 07.05.2010 RESIGNED GANDHINAGAR14 384 BILBAL NARESH KUMAR MAN SINGH BHAI 05.05.2010 RESIGNED GANDHINAGAR

15 386 PANKIL M. SHAH MAHENDRA KUMAR SHAH 08.05.2010 RESIGNED GANDHINAGAR

16 534 RAMESH KANDLE NAMDEV KANDLE 14.06.2010 RESIGNED GANDHINAGAR

17 389 V.SUBRAMANIAN VEMBIAH 30.06.2010 RESIGNED CTS SIRUSERI

18 393 N.BALAJI NATARAJAN 05.06.2010 RESIGNED CTS SIRUSERI

19 403 JAGDISH LAHU KADAV LAHU V.KADAV 30.06.2010 RESIGNED ORCHID CROWN

20 408 ARUN P.KARADE PANDHARINATH KARADE 30.06.2010 RESIGNED ORCHID CROWN

21 566 RAJAYYA M.MANDALA MALAYYA V.MANDALA 30.06.2010 RESIGNED ORCHID CROWN

22 582 SHIVSANKAR DUBEY SANGA PRASAD DUBEY 30.06.2010 RESIGNED ORCHID CROWN

FORM-10EMPOYEES PROVIDENT FUND SCHEME, 1952

Name & Address Of The Establishment : K.M.Associates , Shop No.10 Manibhadra Complex Nr.Vibhaji School , Jamnagar - 361 001

SITE NAME : UREN CRUSHER

Code No. of the Establishment :GJ/75374

{Para 36(2)(a) & (b)}

Return of the members leaving service during the month of JUNE-2010

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50/60

Sl EPF Name of the Employee Father's/ Date of Reason for Rmks.

No. account no. Husband's Name Leaving Service leaving Service

1 2 HARINATH CHOUHAN RAMAKANT 23.05.2010

{Para 36(2)(a) & (b)}

Return of the members leaving service during the month of JUNE-2010

A request for the reduction from the account of a member dismissed for serious wilful misconduct should be reserved by the following certificate.

FORM-10

Stamp of the Factory/Establishment

EMPOYEES PROVIDENT FUND SCHEME, 1952

Code No. of the Establishment :GJ/75374

Please state whether the member is (a) Retiring under para 10 (69) (1) or (b) of the scheme (b) leaving India for permanent settlement abroad (c) Retrenchment (d)ordinarily dismissed for serious & wilful misconduct (e) discharged (f) resigning from service (g) taking up employment elsewhere (the name & address of the

employer should be stated (h) Death.

Name & Address Of The Establishment : K.M.Associates , Shop No.10 Manibhadra Complex Nr.Vibhaji School , Jamnagar - 361 001

SITE NAME : UREN CRUSHER

Certified that the member mentioned at Sl. No. ________ Shri. ________________________ was dismissed for serious and wilful misconduct.

Compensation of Rs. _______________________________________ under the Indistrial Dispute Act, 1977.

Certified that the member mentioned at Sl. No. ________ Shri. ___________________________________ was paid not paid retrenchment.

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Sl EPF Name of the Employee Father's/ Date of Reason for Rmks.

No. account no. Husband's Name Leaving Service leaving Service

Certified that the member mentioned at Sl. No. ________ Shri. ________________________ was dismissed for serious and wilful misconduct.

Certified that the member mentioned at Sl. No. ________ Shri. ___________________________________ was paid not paid retrenchment.

FORM-10

{Para 36(2)(a) & (b)}

Name & Address Of The Establishment : K.M.Associates , Shop No.10 Manibhadra Complex Nr.Vibhaji School , Jamnagar - 361 001

Return of the members leaving service during the month of JUNE-2010

NIL

Code No. of the Establishment :GJ/75374

SITE NAME : TRIVENDRAM

Stamp of the Factory/Establishment

EMPOYEES PROVIDENT FUND SCHEME, 1952

Please state whether the member is (a) Retiring under para 10 (69) (1) or (b) of the scheme (b) leaving India for permanent settlement abroad (c)

Retrenchment (d) ordinarily dismissed for serious & wilful misconduct (e) discharged (f) resigning from service (g) taking up employment elsewhere (the

name & address of the employer should be stated (h) Death.

A request for the reduction from the account of a member dismissed for serious wilful misconduct should be reserved by the following certificate.

Compensation of Rs. _______________________________________ under the Indistrial Dispute Act, 1977.

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Sl EPF Name of the Employee Father's/ Date of Reason for Rmks.

No. account no. Husband's Name Leaving Service leaving Service

1 114 NAVDEEP SINGH SATPAL SINGH 02.06.2010

{Para 36(2)(a) & (b)}

EMPOYEES PROVIDENT FUND SCHEME, 1952

FORM-10

A request for the reduction from the account of a member dismissed for serious wilful misconduct should be reserved by the following certificate.

Compensation of Rs. _______________________________________ under the Indistrial Dispute Act, 1977.

Stamp of the Factory/Establishment

Certified that the member mentioned at Sl. No. ________ Shri. ___________________________________ was paid not paid retrenchment.

Certified that the member mentioned at Sl. No. ________ Shri. ________________________ was dismissed for serious and wilful misconduct.

Please state whether the member is (a) Retiring under para 10 (69) (1) or (b) of the scheme (b) leaving India for permanent settlement abroad (c) Retrenchment (d)

ordinarily dismissed for serious & wilful misconduct (e) discharged (f) resigning from service (g) taking up employment elsewhere (the name & address of the

employer should be stated (h) Death.

Name & Address Of The Establishment : K.M.Associates , Shop No.10 Manibhadra Complex Nr.Vibhaji School , Jamnagar - 361 001

Code No. of the Establishment :GJ/75374

Return of the members leaving service during the month of JUNE-2010

SITE NAME : GODREJ

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Sl EPF Name of the Employee Father's/ Date of Reason for Rmks.

No. account no. Husband's Name Leaving Service leaving Service

1 GJ/RJT/75374/209 Rakesh Kumar Singh Chandrika singh 01.06.2010 RESIGNED

2 GJ/RJT/75374/210 DHANANJAY KUMAR MALL NAND KUMAR MALL 01.06.2010 RESIGNED

3 GJ/RJT/75374/75 MOHIN AHMAD ABDUL AHMAD 02.06.2010 RESIGNED

4 GJ/RJT/75374/177 KISAN SWROOP SHARMA SHYAM SUNDER SHARMA 09.06.2010 RESIGNED

Stamp of the Factory/Establishment

Please state whether the member is (a) Retiring under para 10 (69) (1) or (b) of the scheme (b) leaving India for permanent settlement abroad (c) Retrenchment (d)

ordinarily dismissed for serious & wilful misconduct (e) discharged (f) resigning from service (g) taking up employment elsewhere (the name & address of the

employer should be stated (h) Death.

Return of the members leaving service during the month of JUNE-2010

Name & Address Of The Establishment : K.M.Associates , Shop No.10 Manibhadra Complex Nr.Vibhaji School , Jamnagar - 361 001

SITE NAME : KHURJA

A request for the reduction from the account of a member dismissed for serious wilful misconduct should be reserved by the following certificate.

Certified that the member mentioned at Sl. No. ________ Shri. ________________________ was dismissed for serious and wilful misconduct.

Certified that the member mentioned at Sl. No. ________ Shri. ___________________________________ was paid not paid retrenchment.Compensation of Rs. _______________________________________ under the Indistrial Dispute Act, 1977.

Code No. of the Establishment :GJ/75374

EMPOYEES PROVIDENT FUND SCHEME, 1952

FORM-10

{Para 36(2)(a) & (b)}

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Sl EPF Name of the Employee Father's/ Date of Reason for Rmks.

No. account no. Husband's Name Leaving Service leaving Service

1 237 DANVEER SANTRAM 30.05.2010

2 337 SANJAY PD. KAPILDEV PRASAD 31.05.2010

3 495 BIRENDRA PRATAP SINGH RAJENDRA PRASAD SINGH 01.06.2010

Stamp of the Factory/Establishment

Compensation of Rs. _______________________________________ under the Indistrial Dispute Act, 1977.

SITE NAME : MANISWAR

Please state whether the member is (a) Retiring under para 10 (69) (1) or (b) of the scheme (b) leaving India for permanent settlement abroad (c) Retrenchment (d)ordinarily dismissed for serious & wilful misconduct (e) discharged (f) resigning from service (g) taking up employment elsewhere (the name & address of the

employer should be stated (h) Death.

Certified that the member mentioned at Sl. No. ________ Shri. ___________________________________ was paid not paid retrenchment.

EMPOYEES PROVIDENT FUND SCHEME, 1952

{Para 36(2)(a) & (b)}

Return of the members leaving service during the month of JUNE-2010

Certified that the member mentioned at Sl. No. ________ Shri. ________________________ was dismissed for serious and wilful misconduct.

A request for the reduction from the account of a member dismissed for serious wilful misconduct should be reserved by the following certificate.

FORM-10

Name & Address Of The Establishment : K.M.Associates , Shop No.10 Manibhadra Complex Nr.Vibhaji School , Jamnagar - 361 001

Code No. of the Establishment :GJ/75374

FORM-10

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Sl EPF Name of the Employee Father's/ Date of Reason for Rmks.

No. account no. Husband's Name Leaving Service leaving Service

1 250 FIRAN VISHWEKARMA FATUA VISHWAKARMA 07.05.2010

2 261 RAJPUT GULAB SINGH TOP SINGH 07.05.2010

3 379 PRASHANT SHREEVASTAV RAJESH KUMAR SHREEVASTAV 31.05.2010

4 381 BALMIKI SAHU DANDASI SAHU 07.05.2010

5 384 BILBAL NARESH KUMAR MAN SINGH BHAI 05.05.20106 386 PANKIL M. SHAH MAHENDRA KUMAR SHAH 08.05.2010

7 534 RAMESH KANDLE NAMDEV KANDLE 14.06.2010

Certified that the member mentioned at Sl. No. ________ Shri. ___________________________________ was paid not paid retrenchment.

Stamp of the Factory/Establishment

Return of the members leaving service during the month of JUNE-2010

SITE NAME : GANDHINAGAR

Please state whether the member is (a) Retiring under para 10 (69) (1) or (b) of the scheme (b) leaving India for permanent settlement abroad (c) Retrenchment (d)

ordinarily dismissed for serious & wilful misconduct (e) discharged (f) resigning from service (g) taking up employment elsewhere (the name & address of the

employer should be stated (h) Death.

A request for the reduction from the account of a member dismissed for serious wilful misconduct should be reserved by the following certificate.

Certified that the member mentioned at Sl. No. ________ Shri. ________________________ was dismissed for serious and wilful misconduct.

Compensation of Rs. _______________________________________ under the Indistrial Dispute Act, 1977.

Code No. of the Establishment :GJ/75374

EMPOYEES PROVIDENT FUND SCHEME, 1952

Name & Address Of The Establishment : K.M.Associates , Shop No.10 Manibhadra Complex Nr.Vibhaji School , Jamnagar - 361 001

{Para 36(2)(a) & (b)}

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Sl EPF Name of the Employee Father's/ Date of Reason for Rmks.

No. account no. Husband's Name Leaving Service leaving Service

Name & Address Of The Establishment : K.M.Associates , Shop No.10 Manibhadra Complex Nr.Vibhaji School , Jamnagar - 361 001

Compensation of Rs. _______________________________________ under the Indistrial Dispute Act, 1977.

FORM-10

Please state whether the member is (a) Retiring under para 10 (69) (1) or (b) of the scheme (b) leaving India for permanent settlement abroad (c) Retrenchment (d)

ordinarily dismissed for serious & wilful misconduct (e) discharged (f) resigning from service (g) taking up employment elsewhere (the name & address of the

employer should be stated (h) Death.

Return of the members leaving service during the month of JUNE-2010

Code No. of the Establishment :GJ/75374

EMPOYEES PROVIDENT FUND SCHEME, 1952

SITE NAME : SAMALKHA

NIL

Stamp of the Factory/Establishment

A request for the reduction from the account of a member dismissed for serious wilful misconduct should be reserved by the following certificate.

Certified that the member mentioned at Sl. No. ________ Shri. ________________________ was dismissed for serious and wilful misconduct.

Certified that the member mentioned at Sl. No. ________ Shri. ___________________________________ was paid not paid retrenchment.

{Para 36(2)(a) & (b)}

EMPOYEES PROVIDENT FUND SCHEME, 1952

FORM-10

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Sl EPF Name of the Employee Father's/ Date of Reason for Rmks.

No. account no. Husband's Name Leaving Service leaving Service

1 389 V.SUBRAMANIAN VEMBIAH 30.06.2010

2 393 N.BALAJI NATARAJAN 05.06.2010

Name & Address Of The Establishment : K.M.Associates , Shop No.10 Manibhadra Complex Nr.Vibhaji School , Jamnagar - 361 001

Code No. of the Establishment :GJ/75374

SITE NAME : CTS SIRUSERI

{Para 36(2)(a) & (b)}

Return of the members leaving service during the month of JUNE-2010

Certified that the member mentioned at Sl. No. ________ Shri. ___________________________________ was paid not paid retrenchment.

Compensation of Rs. _______________________________________ under the Indistrial Dispute Act, 1977.

Stamp of the Factory/Establishment

FORM-10

Please state whether the member is (a) Retiring under para 10 (69) (1) or (b) of the scheme (b) leaving India for permanent settlement abroad (c) Retrenchment (d)

A request for the reduction from the account of a member dismissed for serious wilful misconduct should be reserved by the following certificate.

Certified that the member mentioned at Sl. No. ________ Shri. ________________________ was dismissed for serious and wilful misconduct.

EMPOYEES PROVIDENT FUND SCHEME, 1952

{Para 36(2)(a) & (b)}

Return of the members leaving service during the month of JUNE-2010

Name & Address Of The Establishment : K.M.Associates , Shop No.10 Manibhadra Complex Nr.Vibhaji School , Jamnagar - 361 001

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Sl EPF Name of the Employee Father's/ Date of Reason for Rmks.

No. account no. Husband's Name Leaving Service leaving Service

1 403 JAGDISH LAHU KADAV LAHU V.KADAV 30.06.10

2 408 ARUN P.KARADE PANDHARINATH KARADE 30.06.10

3 566 RAJAYYA M.MANDALA MALAYYA V.MANDALA 30.06.10

4 582 SHIVSANKAR DUBEY SANGA PRASAD DUBEY 30.06.10

SITE NAME : ORCHID CROWN

Compensation of Rs. _______________________________________ under the Indistrial Dispute Act, 1977.

Code No. of the Establishment :GJ/75374

Stamp of the Factory/Establishment

Please state whether the member is (a) Retiring under para 10 (69) (1) or (b) of the scheme (b) leaving India for permanent settlement abroad (c) Retrenchment (d)

A request for the reduction from the account of a member dismissed for serious wilful misconduct should be reserved by the following certificate.

Certified that the member mentioned at Sl. No. ________ Shri. ________________________ was dismissed for serious and wilful misconduct.

Certified that the member mentioned at Sl. No. ________ Shri. ___________________________________ was paid not paid retrenchment.

FORM-05

h )

EMPOYEES PROVIDENT FUND SCHEME, 1952

{Para 36(2)(b)}

Return of employee qualifying for membership of Employee's Provident Fund for the first time during the month of ______________________

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mmissioner with Form-2)

__________________________________________________________________

Sl EPF Name of the Employee Date of Ttl prd

No. Account No. Elgblty of servce

1 SAVAN SINGH CHIRANGI SINGH 1/15/1986 M

2 RAJESH SINGH RAMHARSH SINGH 1/15/1986 M

3 KRISHNAKANT PANDEY BABBAN PANDEY 1/15/1972 M

4 RAMSARIKHAN RAJVANSHI 8/20/1962 M

5 RAMNARAYAN RAJBHAR PACHAN 1/1/1973 M

6 PRAMOD SINGH RAMCHARITRA 8/15/1986 M

7 ANIL SINGH PRADUMMAN 9/20/1990 M

8 UDAYVAN SINGH RAMLAGAN 7/13/1974 M

9 PRADEEP SINGH RAMASHISH 1/20/1977 M

10 MUNNA VERMA HARILAL SHAH 2/1/1985 M

11 RAJKISHOR MAHATO DHRUPLAL 9/18/1977 M

12 SATENDRA YADAV HANSNATH 4/17/1989 M

13 RAVINDRA KUSHWAHA PRABHUNATH 6/10/1985 M

14 JAIPRAKASH BHAGAT RAMAYAN 7/12/1986 M15 AJAY YADAV HANSNATH 9/13/1974 M

16 RAHUL YADAV RAMAKANT 5/15/1995 M

17 JAIRAM YADAV VANSHRAJ 9/18/1976 M

18 BRIJANAND PRASAD MUKTINATH 3/11/1980 M

19 TULSI RAM FULENA RAM 10/12/1983 M

20 JITENDRA RAM FULENA RAM 11/13/1986 M

Father's/husband's Name Date of Birth Sex Rmks

Name & Address of the Establishment : ___________________________________________________________________________________________

SITE NAME:Code No. of the Establishment :

Page 59 of 60

FORM-05

i i ith F 2)

EMPOYEES PROVIDENT FUND SCHEME, 1952

{Para 36(2)(b)}

Return of employee qualifying for membership of Employee's Provident Fund for the first time during the month of ______________________

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mmissioner with Form-2)

__________________________________________________________________

Sl EPF Name of the Employee Date of Ttl prd

No. Account No. Elgblty of servceFather's/husband's Name Date of Birth Sex Rmks

Name & Address of the Establishment : ___________________________________________________________________________________________

SITE NAME:Code No. of the Establishment :

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