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Revised Form 13

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Revised Form 13
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  TRANSFER CLAIM FORM CLAIM ID FORM 13 (REVISED) (For EPFO Use only)   (PARA 57)  To,To, The Regional P F Commissioner,Trust Name: Ofce Name: Ofce Aress:  Trust Aress:  ! (Please see instruction )(in case the PF A#C is $ith E%em&te Esta'lishment) Sir,  reuest that my &ro*ient +un 'alance along $ith my &ension ser*ice etails may &lease 'etrans+erre to my &resent account uner intimation to me -y etails are as uner: PART A: PERSONAL INFORMATION . /Name: 0 /  !   -o'ile num'er: 1 2an3 A#C num'er: 4 E5mail i: ! 6 F7 coe o+ 2an3 'ranch: PART B: DETAILS OF PREVIOUS ACCOUNT (WHICH IS TO BE TRANSFERRED) 1. /PF Account No : In case the previous establishment is exempted Provident Fund Scheme,1952 Pension Fun Account No : ! 2. /Name an Aress o+ the &re*ious esta'lishment: !  3. /PF Account is hel 'y: (Name o+ EPF Ofce# PF Trust) 4. /8ate o+ 2irth: (#mm#yyyy)1 /8ate o+ 9oining :  !(#mm#yyyy)6 /8ate o+ lea*ing: (#mm#yyyy) PART C: DETAILS OF PRESENT ACCOUNT 1. /PF Account No : In case the present establishment is exempted Provident Fund Scheme,1952 Pension Fun Account No :  2. /Name an Aress o+ the &resent esta'lishment:  3. /Account is hel 'y: (Name o+ EPF Ofce # PF Trust) 4. /8ate o+ 9oining : (#mm#yyyy) 5. Name o+ Trust (to $hom +uns are to 'e &ai in case o+ &resent esta'lishment 'eing e%em&te uner EPF 7cheme, .;10) : 6. Em&loyee coe uner the Trust: ! ( * indicates mandatory felds)( # Strike o i not applicable) I, Ceri! #$ $%% #e i&!'r$i'& i*e& $+'*e i r-e ' #e +e '!  .&'/%e0e $&0 I #$*e e&-re0 #e 'rre&e '!  2ree& $&0 2re*i'-$'-& &-+erSi&$-re '! #eMe+er D$e:   IMPORTANT: Member has the option to get the claim orm attested by  present or previous employer. n case o attestation by the    previous employer! time taken in settlement ill be relatively less. Certi<e that  ha*e *eri<e the ata in Part 2 in res&ect o+ the mem'er mentione in Part A o+ this +orm an the signature o+ the mem'er Si&$-re '! Pre*i'- E2%' er 7eal o+ the Esta'lishment D$e:  OR Certi<e that  ha*e *eri<e the ata in Part C in res&ect o+ the mem'er mentione in Part A o+ this +orm Si&$-re '! Pree& E2%' er 7eal o+ the Esta'lishment D$e: INSTRUCTIONS AND 4UIDELINES 1.  The 2an3 A#C etails are +or *eri<cation &ur&ose e*en i+ the Fun istrans+erre to the EPFO Ofce#Trust maintaining the &resent account num'er 2. n case the Pre*ious Account $as maintaine 'y PF Trust o+ the e%em&teesta'lishment, the mem'er shoul su'mit a Trans+er Claim Form =Form5. (Re*ise)> to the Trust $hile sening another Trans+er Claim Form =Form5. (Re*ise)> to the PF Ofce +or trans+erring the ser*ice etails uner thePension Fun to the ne$ account 3.  The Form shoul 'e su'mitte to that PF Ofce uner $hich &re*ious or the&resent account is maintaine, e&ening u&on as to $hich em&loyer hasatteste the claim (n case the claim is atteste 'y the &resent em&loyer,claim shoul 'e su'mitte $ith the PF Ofce uner $hich the &resent accountis maintaine, an so on)  4.  The mo'ile num'er ($here*er &ro*ie) o+ the mem'er $oul 'e use +orsening an 7-7 alert in+orming him#her the &rocessing o+ his#her claim an isnon5manatory +or Physical +orm

73.pdf

Jul 23, 2017
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