Kuldeep PF New

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ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]

( Tracking ID: 10079774891205002 )


Claim Date : 17/06/2021
EMPLOYEES' PROVIDENT FUND SCHEME, 1952
(PARA 57)

(This form has been printed on the basis of Online Transfer Claim Form filled up by the member under Unified Portal for submission to the
employer.)

To,
The Regional P.F. Commissioner,
CHENNAI,
No. 37, Royapettah High Road, Opposite Swagat Hotel, Chennai

Sir,
I request that my Provident Fund balance along with my Pension Service Details may please be transferred to my present
account under intimation to me. My details are as under :

PART A : PERSONAL

1. Name : KULDEEP

2. Mobile Number : 7678331276

3. E-mail id : [email protected]

4. Bank Account Number : 103101530919

5. Bank IFSC : ICIC0001031

PART B : DETAILS OF PREVIOUS PF ACCOUNTS (WHICH IS TO BE TRANSFERRED)

1. PF Account No. (with EPFO : TNMAS00357910000432271

2. Name of the Establishment : RANDSTAD INDIA PRIVATE LIMITED

3. Address of the Establishment : RANDSTAD HOUSE,OLD NO 5&5A,NEW NO 9 PYCROFTS GARDEN


ROAD, CHENNAI 685
4. PF A/C No. held by : CHENNAI

5. Name of the Trust : NOT APPLICABLE

6. PF A/C No. in Trust : NOT APPLICABLE

7. Bank A/C No. of Trust : NOT APPLICABLE


8. IFS Code of the Bank Branch of
Trust where account is : NOT APPLICABLE

9. Member's Name : KULDEEP

10. Date of Birth : 10/09/1990

11. Father's/Spouse Name : RAM CHANDRA

12. Relationship : FATHER

13. Date of joining : 05/10/2015

14. Date of leaving : 29/02/2016


PART C : DETAILS OF PRESENT PF

1. PF Account No. (with EPFO : PYBOM11003580000019258

2. Name of the Establishment : BUNDL TECHNOLOGIES PRIVATE LIMITED

3. Address of the Establishment : 9TH FLOOR, TOWER D, IBC KNOWLEDGE P 4/1, BANNERGHATTA MD
RD, BANGALORE 656
4. PF A/C No. held by : SRO BOMMASANDRA

5. Name of the Trust : NOT APPLICABLE

6. PF A/C No. in Trust : NOT APPLICABLE

7. Bank A/C No. of Trust : NOT APPLICABLE


8. IFS Code of the Bank Branch of
Trust where account is : NOT APPLICABLE

9. Member's Name : KULDEEP

10. Date of Birth : 10/09/1990

11. Father's/Spouse Name : RAM CHANDRA

12. Relationship : FATHER

13. Date of joining : 01/10/2018

I, Certify that all the information given above are true to the best of my knowledge and I have ensured the correctness of
my present and previous account numbers.

Signature of the member

Note : Member should take a printout of this form and a signed copy of the same should be submitted to the Previous
Establishment i.e. RANDSTAD INDIA PRIVATE LIMITED

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