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    The document is a claim form submitted online through the UAN e-seva portal by an individual named Sunil Dobhal seeking a PF advance of Rs. 15,000 from his UAN account number 100515653054 for the purpose of dealing with the outbreak of the COVID-19 pandemic. The form provides Dobhal's personal details like father's name, date of birth, bank account number, IFSC code and Aadhaar number as available in the UAN portal.

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    The document is a claim form submitted online through the UAN e-seva portal by an individual named Sunil Dobhal seeking a PF advance of Rs. 15,000 from his UAN account number 100515653054 for the purpose of dealing with the outbreak of the COVID-19 pandemic. The form provides Dobhal's personal details like father's name, date of birth, bank account number, IFSC code and Aadhaar number as available in the UAN portal.

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    The document is a claim form submitted online through the UAN e-seva portal by an individual named Sunil Dobhal seeking a PF advance of Rs. 15,000 from his UAN account number 100515653054 for the purpose of dealing with the outbreak of the COVID-19 pandemic. The form provides Dobhal's personal details like father's name, date of birth, bank account number, IFSC code and Aadhaar number as available in the UAN portal.

    Copyright:

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

    PDF Download

    Uploaded by

    K K
    The document is a claim form submitted online through the UAN e-seva portal by an individual named Sunil Dobhal seeking a PF advance of Rs. 15,000 from his UAN account number 100515653054 for the purpose of dealing with the outbreak of the COVID-19 pandemic. The form provides Dobhal's personal details like father's name, date of birth, bank account number, IFSC code and Aadhaar number as available in the UAN portal.

    Copyright:

    © All Rights Reserved
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    Download as pdf or txt
    of 2

    Submitted online at UAN e-seva portal on 2022-09-05 10:01:16 (IP www.epfindia.gov.

    in
    Address:132.154.24.16)

    deZpkjh Hkfo"; fuf/k ;kstuk] 1952


    EMPLOYEES' PROVIDENT FUND SCHEME,1952
    EMPLOYEES' Pension Scheme,1995
    UAN Based Combined Claim Form 19/10C WB/31 for Advances/PF Final Settlement/Pension Fund Withdrawal
    (mu ekeyksa esa ykxw tgka QkeZ 11(u;k)esa deZpkjh dk iwjk fooj.k] vk/kkj la[;k vkSj cSad [kkrk la[;k ;w-,-,u- iksVZy vkSj ij
    miyC/k gS rFkk ;w-,-,u- esa lfØ; gSA)
    (Applicable in cases where employee's complete details in Form 11(New),Aadhaar Number and Bank
    Accounts details are available on UAN Portal and UAN has been activated.)
    Mobile Number / eksckby uacj - 7060208561
    1. I want to apply for PF Advance
    2. Universal Account Number(UAN) / ;wfuolZy [kkrk la[;k 100515653054
    3. Name of the member SUNIL DOBHAL

    4. Date of Joining 01-Sep-2020


    5. Permanent Account number / LFkk;h [kkrk la[;k DJTPD9873H

    6.a Purpose of Advance OUTBREAK OF PANDEMIC (COVID-19)

    6.b Amount of Advance (In Rs) 15000


    7 In case of Advance for purpose of Site/House/Flat Not Applicable

    8 Bankers details for Electronic Payment (Only for the Advance if payable to Not Applicable
    third party)

    9. Payee Address Nigam road


    Selaqui,Dehradun,DEHRADUN,UTTARAKHA
    ND-248197

    * eSa çekf.kr djrk gw¡ fd eSaus ;w , ,u iksVZy ij lhM MkVk dks Hkyh Hkk¡fr ns[k fy;k gS rFkk QkeZ u- 11( u;k ) cSad [kkrk fooj.k vkSj vk/kkj
    la[;k lfgr lHkh MkVk lgh ik;k x;k gSA
    * I certify that I have gone through the data seeded in UAN Portal and found all data including Form No.11
    (New) , bank account details and Aadhar Number to be correct
    Father/Husband/Spouse Name: BRIJMOHAN DOBHAL Date Of Birth: 12-Jun-1988
    Bank Account Number 705416510000115 Bank IFSC Code BKID0007054
    Bank Details BANK OF INDIA,SELAQUI
    Aadhaar 64XXXXXXXX49
    Member ID UKDDN00340190000026058
    * —i;k ;w-,-,u-iksVZy ij n'kkZ, x, cSad [kkrs esa Hkqxrku djsaA
    * Please make payment in the bank account mentioned in the UAN portal .
    UAN - 100515653054 Tracking ID - 10051565305406016

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