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    The Employees' Pension Scheme

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    H C Aasif Lone
    The document is a declaration and nomination form under the Employees' Provident Fund Scheme and Employees' Pension Scheme filled out by Khurshid Ahmad Sheikh providing personal details such as name, date of birth, address, UAN number, and dates of joining the pension schemes. In Part A, he nominates his wife Hamida Begum to receive the full amount standing in his provident fund account upon his death. In Part B, he provides details of his wife as the sole eligible family member to receive widow pension under the Employees' Pension Scheme in the event of his death.

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    © All Rights Reserved
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    The Employees' Pension Scheme

    Uploaded by

    H C Aasif Lone
    30 views2 pages
    The document is a declaration and nomination form under the Employees' Provident Fund Scheme and Employees' Pension Scheme filled out by Khurshid Ahmad Sheikh providing personal details such as name, date of birth, address, UAN number, and dates of joining the pension schemes. In Part A, he nominates his wife Hamida Begum to receive the full amount standing in his provident fund account upon his death. In Part B, he provides details of his wife as the sole eligible family member to receive widow pension under the Employees' Pension Scheme in the event of his death.

    Original Description:

    Nomination

    Original Title

    e-Nomination

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    The document is a declaration and nomination form under the Employees' Provident Fund Scheme and Employees' Pension Scheme filled out by Khurshid Ahmad Sheikh providing personal details such as name, date of birth, address, UAN number, and dates of joining the pension schemes. In Part A, he nominates his wife Hamida Begum to receive the full amount standing in his provident fund account upon his death. In Part B, he provides details of his wife as the sole eligible family member to receive widow pension under the Employees' Pension Scheme in the event of his death.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    30 views2 pages

    The Employees' Pension Scheme

    Uploaded by

    H C Aasif Lone
    The document is a declaration and nomination form under the Employees' Provident Fund Scheme and Employees' Pension Scheme filled out by Khurshid Ahmad Sheikh providing personal details such as name, date of birth, address, UAN number, and dates of joining the pension schemes. In Part A, he nominates his wife Hamida Begum to receive the full amount standing in his provident fund account upon his death. In Part B, he provides details of his wife as the sole eligible family member to receive widow pension under the Employees' Pension Scheme in the event of his death.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    The Employees' Pension Scheme,

    FORM 2
    EMPLOYEES' PROVIDENT FUNDS SCHEME, 1952
    [Paragraphs 33 AND 61(1)]
    EMPLOYEES' PENSION SCHEME, 1995
    [Paragraphs 18]

    DECLARATION AND NOMINATION FORM UNDER THE EMPLOYEES' PROVIDENT FUNDS


    SCHEME AND EMPLOYEES' PENSION SCHEME

    1. UAN : 101568954374
    2. Name (in block letters) : KHURSHID AHMAD SHEIKH
    3. Father's / Husband's Name : HABIB ULLAH SHEIKH
    4. Date of Birth : 02/04/1980
    5. Gender : MALE
    6. Marital Status : MARRIED

    7. Address (Permanent) : Nadihal, bandipur, bandipore, BANDIPORE, JAMMU AND KASHMIR,


    193502
    8. Address (Temporary) : Nadihal, bandipur, bandipore, BANDIPORE, JAMMU AND KASHMIR,
    193502
    9. (A) Date of Joining of EPF Scheme, : 01/03/2020
    (B) Date of Joining of EPF Scheme, : --
    (C) Date of Joining of EPF Scheme, : 01/03/2020

    PART A (EPF)
    I hereby nominate 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

    If the Nominee is
    Total amount or minor, name and
    Nominees's share of relationship and
    Name of the
    relationship with accumulations in address of the
    Nominee / Nominees Address Date of Birth
    the Member Provident Fund to guardian who may
    be paid to each receive the amont
    nominee during the minority of
    nominee
    (1) (2) (3) (4) (5) (6)

    Nadihal, bandipore, Wife 03/06/1982 100% --


    BANDIPORE,
    HAMIDA BEGUM
    BANDIPORE, JAMMU
    AADHAAR: XXXX
    AND KASHMIR, 193502
    XXXX 3133
    Bank A/c:
    1166218XXXX
    IFSC: SBIN0001362

    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 dependant upon me.

    (Signature is not required as the document is to be digitally signed)


    The Employees' Pension Scheme,

    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:

    Relationship with
    Sl. No. Name of the Family members Address Date of Birth
    the member
    (1) (2) (3) (4) (5)

    1 Nadihal, bandipore, BANDIPORE, 03/06/1982 Wife


    HAMIDA BEGUM BANDIPORE, JAMMU AND
    AADHAAR: XXXX XXXX 3133 KASHMIR, 193502
    Bank A/c: 1166218XXXX
    IFSC: SBIN0001362

    *Certified that I have no family as defined in Para 2(vii) of the 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 person for receiving the monthly widow pension admissible under
    para 16(2)(a)(i) and (ii) in the event of my death without leaving any eligible family member for receiving

    Relationship with the member


    Name and Address of the Nominee Date of Birth

    -- -- --

    Date : 11-Dec-2021

    (Signature is not required as the document is to be digitally signed)

    Signature Not
    Verified
    Signed by :
    Date : 11/12/2021 09:35:25
    Reason : eSign Service
    Location : India

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