Submitted online at UAN e-seva portal on 2023-04-06 13:33:20 (IP
Address:106.213.29.168)
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 9779774233
1.
I want to apply for
PF Final Settlement
2.
Universal Account Number(UAN) / ;wfuolZy [kkrk la[;k
101620484386
3.
Name of the member
RISHAV CHAWLA
4.
Date of Joining
01-Sep-2020
5.
Date of Leaving Service/ NksM+us dk fnukad
30-Nov-2021
6.
Reason of Leaving Service/ lsok NksM+us dk dkj.k
CESSATION (SHORT SERVICE) - Any other
reason
7.
Permanent Account number / LFkk;h [kkrk la[;k
BLWPC9419D
8.
Payee Address
439dera sahib manimajra
chandigarh,chandigarh,CHANDIGARH,CHA
NDIGARH-160101
* eSa çekf.kr djrk gw¡ fd eSaus ;w , ,u iksVZy ij lhM MkVk dks Hkyh Hkk¡fr ns[k fy;k gS rFkk QkeZ u- 11( u;k ) cSad [kkrk fooj.k vkSj vk/kkj
la[;k lfgr lHkh MkVk lgh ik;k x;k gSA
* 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 Aadhar Number to be correct
Father/Husband/Spouse Name: ANIL KUMAR
Date Of Birth: 06-Sep-1997
Bank Account Number
4425001700002492
Bank IFSC Code
PUNB0442500
Bank Details
PUNJAB NATIONAL BANK,CHANDIGARH,SECTOR-8C,DAV SCHOL
Aadhaar
99XXXXXXXX59
Member ID
DLCPM00358810000056326
* —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 -
101620484386
Tracking ID -
10162048438601002