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Withdraw Provident Fund dues on leaving service/ retirement/ termination 1.0.0

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About This File

To be submitted by a member to withdraw his Provident Fund dues on leaving service/ retirement/ termination

WHO CAN APPLY:

  • Members of the fund after leaving service under conditions mentioned against 3 below. In case of the death of the member, the family members/nominee/legal heir should apply through Form 20.

GENERAL INSTRUCTIONS

  • Members who mention their mobile number on the form will get SMS alerts on different stages of the approval of their claim form. The members can also visit the epfindia.gov.in website to view the status of their claims through the link, Know Your Claim Status.
  • All the columns in the form should be filled in BLOCK LETTERS without any overwriting.
  • Against the column, “Reason for leaving service” indicate the one applicable
    • (a) Retired from service after attaining the age of 55 year/Attained the age of 55 years.
    • (b) Retired on account of permanent and total incapacity for work due to Bodily/Mental infirmity.
    • (c) Retired under voluntary retirement scheme
    • (d) Migrating from India for permanent settlement abroad/taking up employment abroad.
    • (e) Retrenched from service
    • (f) Discharged from service on receiving compensation under the Industrial Dispute Act, 1947.
    • (g) Resigned-(not employed in any factory to which the Employees’ Provident Funds Scheme applies).

If the reason for leaving is (f) or (g) above, the claim form should be submitted after 2 months waiting period from the date of leaving and the members should sign the certificate about non employment under any establishment where he is having another PF Account. If the member is already employed in another establishment to which the Act applies, he/she should apply in Form 13 for transfer of his/her account.

ATTESTATION OF CLAIM FORM

The application should be submitted through the employer under whom the member was last employed. In case the claim is through a form downloaded from the epfindia website, all pages should be signed by the claimant as well as the employer.

In case of a closed establishment whose Authorised Signatory/Employer is not available, the claimant may forward the claims duly signed in the presence of any of the following authorized official and got attested over his official seal. Magistrate/ Gazetted Officer/Post or Sub-Post Master/President of Village Union/ President of the Village Panchayat where there is no Union Board/Chairman or Secretary or Member of the Municipal or District Local Board/Member of Parliament/Legislative Assembly/Member of Central Board of Trustees/Regional Committee of Employees’ Provident Fund/Manager of the Bank in which the Saving Bank Account is maintained/Head of any recognized educational Institution

DOCUMENTS TO BE ENCLOSED

A copy of the blank/cancelled cheque having the account number and IFS Code of the branch clearly visible so that the payment may be made in the correct account and through electronic mode for faster credit.

A medical certificate from the ESI or if the employee is not covered under the ESI Scheme, the medical Officer designated by the Establishment should be attached - if the member retired on account of permanent and total incapacity (reason for leaving b, mentioned above) due to bodily or mental infirmity,

Copy of Visa, Passport Journey Ticket - In case of migration from India for permanent settlement abroad (reason for leaving d mentioned above).

Offer of appointment letter and Copy of Visa, Passport Journey Ticket - In case of taking up employment abroad.

Form19_instructions_Eng.pdf

SampleForm19_English.pdf




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