Instructions for a member while sending application to Employees' Provident Fund Organization:
Use the appropriate form for claiming Provident Fund Pension, withdrawal benefit/scheme certificate, Employees' Deposit Linked Insurance benefit, etc. as given below :-
Form-19 : To claim final settlement of Provident Fund by a member.
Form-20 : To claim Provident Fund by nominee/legal heir on death of the member.
Form-10-D : To claim pension. (In duplicate : If within state, In triplicate : If outside state.)
Form-10-C : To claim withdrawal benefit/scheme certificate under Employees' Pension Scheme '95.
Form-5IF : To claim assurance benefit under Employees' Deposit Linked Insurance '76 by nominee/legal heir of a member.
Form-31 : To claim temporary withdrawal/advance under Employees' Provident Fund scheme
Form-13 : To effect transfer of Provident Fund/Pension from one A/C to another.
Ensure that all columns of the application are filled completely.
Information in the application form relating to name, a/c no. should agree with the details
available with Employees' Provident Fund Organization; which were furnished by the employer at the time of enrolling to Provident Fund.
Application should be signed by the member/claimant.
It should be attested by the former employer. In case attestation by the former employer is not possible, it should be got attested by any other authorized official specified with application form.
Application for final settlement can be sent by a member on completion of 2 months from the date of leaving service, if the reason for leaving service is other than superannuation, medical ground, retrenchment and V.R.S./ Female members getting married etc.
Desired mode of payment can be given legibly, if the amount involved is more than Rs. 2000/-. The amount will sent by deposit in payees' bank a/c. To facilitate this, Bank a/c no., name and address of the bank should be furnished. An advance stamped receipt should also accompany this application.
Application may be supported by the return Form-10, showing the details of leaving service and details of contribution for the year in Form-3A, if not sent earlier by the employer.
Specific additional requirements:
A) Death cases:
Nominee/legal heir should apply in Form-20 /Form-10-D /Form-5IF.
If the member has not executed any nomination, application should be supported by certificate of family members issued by employer/revenue official/sworn in an affidavit by the family/ member/legal certificate from a court of law.
Death certificate of the member.
Certificate of the employer stating whether the death was while in service of the member or not.
B) Pension cases:
Joint photograph of member/spouse or the claimant should accompany the application.
Option for return of capital/commutation should be specified clearly.
Details of non-contributory period during the service, wages/salary for last 12 months should also accompany, if not already sent.
Details of the branch of the specified bank may be given legibly.
Date of birth certificates of children
In case of death away from service, an undertaking by the claimant to the effect that the member was not working / had not worked in any other covered establishment after exit from the establishment on the basis of which pension is being claimed.