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    Part A: Personal

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    adiyogi594

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    © All Rights Reserved
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    Part A: Personal

    Uploaded by

    adiyogi594
    4 views2 pages

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    4 views2 pages

    Part A: Personal

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    adiyogi594

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    © All Rights Reserved
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    of 2

    ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]

    ( Tracking ID: 10074273279205007 )


    Claim Date : 05/02/2024
    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,
    DELHI (NORTH),
    28, Community Centre, Wazirpur Industrial Area, Delhi

    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 : AVINASH KUMAR PANDEY

    2. Mobile Number : 8745821360

    3. E-mail id : [email protected]

    4. Bank Account Number : 12130100030148

    5. Bank IFSC : BARB0GONDAX

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

    1. PF Account No. (with EPFO : DLCPM16250210000010876

    2. Name of the Establishment : BLUE JAY FINLEASE LIMITED

    3. Address of the Establishment : FLAT NO. 1201-C, ANTRIKSH BHAWAN, 22, KASTURBA GANDHI MARG,
    DELHI 187
    4. PF A/C No. held by : DELHI (NORTH)

    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 : AVINASH KUMAR PANDEY

    10. Date of Birth : 19/10/1995

    11. Father's/Spouse Name : RADHEYSHYAM

    12. Relationship : FATHER

    13. Date of joining : 21/02/2022

    14. Date of leaving : 10/06/2022


    PART C : DETAILS OF PRESENT PF

    1. PF Account No. (with EPFO : GNGGN14613030000010833

    2. Name of the Establishment : SOUNDRISE HEARING SOLUTIONS PRIVATE LIMITED

    3. Address of the Establishment : UNIT NO.206, 2ND FLOOR IRIS TECH PARK, SECTOR-48, SOHNA
    ROAD,GURGAON GURGAON 179
    4. PF A/C No. held by : RO GURGAON

    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 : AVINASH KUMAR PANDEY

    10. Date of Birth : 19/10/1995

    11. Father's/Spouse Name : RADHEYSHYAM

    12. Relationship : FATHER

    13. Date of joining : 04/09/2023

    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 Present
    Establishment i.e. SOUNDRISE HEARING SOLUTIONS PRIVATE LIMITED

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