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    10127501657006008

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    prasanth prasanth
    The document is a UAN-based combined claim form submitted online for an Employees' Provident Fund (EPF) advance. [1] It provides details of the applicant such as name, UAN number, date of joining, PAN, and bank account. [2] The applicant is requesting an advance of Rs. 9,000 for illness and has certified that all seeded data in the UAN portal including bank details and Aadhaar number are correct. [3] The applicant has also requested that the payment be made to the bank account mentioned in the UAN portal.

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    © All Rights Reserved
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    10127501657006008

    Uploaded by

    prasanth prasanth
    27 views2 pages
    The document is a UAN-based combined claim form submitted online for an Employees' Provident Fund (EPF) advance. [1] It provides details of the applicant such as name, UAN number, date of joining, PAN, and bank account. [2] The applicant is requesting an advance of Rs. 9,000 for illness and has certified that all seeded data in the UAN portal including bank details and Aadhaar number are correct. [3] The applicant has also requested that the payment be made to the bank account mentioned in the UAN portal.

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    The document is a UAN-based combined claim form submitted online for an Employees' Provident Fund (EPF) advance. [1] It provides details of the applicant such as name, UAN number, date of joining, PAN, and bank account. [2] The applicant is requesting an advance of Rs. 9,000 for illness and has certified that all seeded data in the UAN portal including bank details and Aadhaar number are correct. [3] The applicant has also requested that the payment be made to the bank account mentioned in the UAN portal.

    Copyright:

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

    10127501657006008

    Uploaded by

    prasanth prasanth
    The document is a UAN-based combined claim form submitted online for an Employees' Provident Fund (EPF) advance. [1] It provides details of the applicant such as name, UAN number, date of joining, PAN, and bank account. [2] The applicant is requesting an advance of Rs. 9,000 for illness and has certified that all seeded data in the UAN portal including bank details and Aadhaar number are correct. [3] The applicant has also requested that the payment be made to the bank account mentioned in the UAN portal.

    Copyright:

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

    Submitted online at UAN e-seva portal on 2023-10-01 03:11:40 (IP Address:61.12.68.74) www.epfindia.gov.

    in

    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 - 8870027882
    1. I want to apply for PF Advance
    2. Universal Account Number(UAN) / ;wfuolZy [kkrk la[;k 101275016570
    3. Name of the member DIVAKAR U

    4. Date of Joining 08-Jan-2019


    5. Permanent Account number / LFkk;h [kkrk la[;k AMBPU4352Q

    6.a Purpose of Advance Illness

    6.b Amount of Advance (In Rs) 9000


    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 alanchery perumal koil


    street,uthiramerur,KANCHEEPURAM,TAMI
    L NADU-603107

    Father/Husband/Spouse Name: C UDHAYAKUMAR Date Of Birth: 03-Jul-1996


    Bank Account Number 32344403717 Bank IFSC Code SBIN0010510
    Bank Details STATE BANK OF INDIA,UTHIRAMERUR
    Aadhaar 89XXXXXXXX25
    Member ID TBTAM16310290000010370
    *Certified that the particulars are true to the best of my knowledge, 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 Aadhaar number to
    be correct. Please make the payment in the bank account mentioned in the UAN Portal. A cancelled cheque
    (containing member's name, bank account number and IFS Code) is attached herewith. In case the amount is used for
    any purpose other than stated in column (6) above, I am liable to return the entire amount with penal interest.
    * —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 - 101275016570 Tracking ID - 10127501657006008

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