Epf Form 10D PDF Details

The Employee's Pension Scheme (EPS), 1995, plays a pivotal role in providing financial security to employees in their retirement years. Among its provisions, the APPLICATION FOR MONTHLY PENSION, widely known as Form 10-D(EPS), is a critical document that facilitates this mission. Designed with the aim of streamlining the process of pension claims, this form covers a broad spectrum of criteria including personal details of the claimant such as name, sex, marital status, and age; the specifics of their employment like the Employee Provident Fund (EPF) account number and the name and address of the establishment; details regarding the claimant's service departure; options for pension commutation and return of capital; and particulars related to nominees and family members. It also addresses cases involving the claimant's demise and provides sections for banking details essential for the pension disbursement. To ensure accuracy and comprehensiveness, the form mandates enclosures of relevant documents and emphasizes the importance of reading the accompanying instructions before filling it out. This form symbolizes a critical interface between employees and their entitlements under the EPS, 1995, highlighting the structured approach toward securing post-retirement benefits and laying down a straightforward path for beneficiaries to claim their rightful pensions.

QuestionAnswer
Form NameEpf Form 10D
Form Length7 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 45 sec
Other namesform 10d epf, form 10d in pf, epf form 10 d download pdf, epf form 10 pdf

Form Preview Example

Forward Office Use Only

Inward No.

APPLICATION FOR MONTHLY PENSION

FORM 10-D(EPS)

EMPLOYEE’S PENSION SCHEME, 1995

(Read INSTRUCTIONS before filling in this Form)

1.

By whom the pension is Claimed ?

2.

Type of Pension Claimed.

 

 

 

 

 

 

 

 

 

 

 

 

3.

(a) Member’ Name

:

 

 

 

 

 

 

 

 

(In Block Letters)

 

 

 

 

 

 

 

 

 

(b) Sex

:

 

 

 

 

 

 

 

 

(c) Marital Status

:

 

 

 

 

 

 

 

 

(d) Date of Birth/Age

:

 

 

 

 

 

 

 

 

(e) Parent/Spouse Name

:

 

 

 

 

 

 

 

4.

E.P.F. Account Number

:

 

RO SRO ESTABLISHMENT CODE NO.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Members’s Accounts No:

5.

Name & Address of the establishment

 

:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

in which the member was last employed

 

 

 

 

 

 

 

 

6.

Date of Leaving Service

:

 

 

 

 

 

 

 

7.

Reason for leaving Service

:

 

 

 

 

 

 

 

8.

Address for communication

:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PIN: ______________________

9.

Option for commutation of 1/3 of Quantum:

Yes

 

No

 

Amount

 

Pension (If option is for lesser)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

commutation indicate the quantum

 

 

 

 

 

 

 

 

 

 

 

 

 

10.Option of Return of Capital (Please refer Serial Number 10 of INSTRUCTIONS)

[Put a Tick ( )]

If Yes, indicate your choice of alternative

11.Mention your Nominee for Return of Capital

Name Relationship Date of Birth Address

12.Particulars of Family

Yes

1

:

:

:

:

:

:

No

2

 

3

 

 

 

SI. No.

Name

Date of

Relationship

Indicate against Minor

 

 

Birth/Age

with

 

 

 

 

 

Member

 

 

 

 

 

 

Guardian

Relationship

 

 

 

 

 

with Member

(1)

(2)

(3)

(4)

(5)

(6)

 

 

 

 

 

 

Note : If any child is physically handicapped, please indicate “DISABLED” below the name.

13.Date of death of Member (if applicable)

14.Details of Saving Bank Account Opened

(1)Name of the Bank

(2)Name of the Branch

(3)Full Post all Address

PIN CODE

SI.No

Name of the Claimants(S)

Saving Bank Accounts No.

14(A) If the claim is preferred by nominee, indicate his/her

(1)

Name

:

 

(2)

Relationship

:

 

 

with the deceased Member

 

15. Details of Scheme Certificate

Scheme Certificate

 

 

 

received & enclosed

Already in possession of the

Not Received

Member, if any

 

Not Applicable

If received, indicate:

 

 

SI. No

Scheme Certificate Control No.

Authority who issued the Scheme certificate

16. If Pension is being drawn

PPO No.

Under E.P.S., 1995

issued by

17.Documents enclosed

(Indicate as per the Instructions) 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

RO SRO

TO BE SUBMITTED IN DUPLICATE IN RESPECT OF

EACH PERSON ELIGIBLE FOR PENSION

Descriptive of Pensioner and

 

 

his/her Specimen Signature/Thumb impression

 

1.

Name of the Member

:

 

2.

E.P.F. Account Number

:

 

3.

Name of the Pensioner

:

 

4.

Father/Husband name

:

 

5.

Sex

:

 

6.

Nationality

:

 

7.

Religion

:

 

8.

Height

:

 

9.

Personal Marks of

:

1…………………………………………….

 

Identification

 

2…………………………………………….

10.

Speciment signature of Pensioner

:

1……………………………………………

 

 

 

2……………………………………………

 

 

 

3……………………………………………

10.(Only in the case of illiterate Claimant (Pensioner) Left Hand Finger Impression);

THUMB

INDEX

MIDDLE RING

SMALL

Signature

Name of attesting Authority Official Seal:

Place :

Date :

Certified that:

(i)I am not drawing Pension under Employees Pension Scheme, 1995:

(ii)The particulars given in this application are true and correct.

Signature of the applicant /

Left hand Thumb Impression

(TO BE FILLED IN BY THE EMPLOYER / AUTHORISED OFFICER OF THE ESTABLISHMENT)

Certified that:

(i)the particulars of the member are correct;

(ii)the particulars of Wages and Pension Contribution for the period of 12 months preceeding the date of leaving service are as under :-

(In case, the wages is not earned for all 12 months, the block of 12 months will commence backwards from the last drawn)

Year

Month

Wages

Pension

Details of period of non-

 

 

 

 

 

contributory service. If there is

 

 

 

 

 

no such period, indicate ‘Nil’

 

 

No of

Amount

 

Year

No.of days for which no

 

 

Days

 

 

 

wages were earned

(1)

(2)

(3)

(4)

(5)

(6)

(7)

 

 

 

 

 

 

 

Encls:

1.

Documents as given in the Instructions.

 

2.

Form of descriptive roll and specimen signature.

Signature of Employer/

Authorised Official of

The Establishment with

Seal & Date

(FOR OFFICE USE ONLY)

(PENSION SECTION / ACCOUNTS SECTION)

Certified that the particulars in the application have been verified with the relevant concerned documents. The claimant is eligible for Pension. The Input Data Sheet is placed below for approval.

Entered in Form 9/Form 3(PS), Master Ledger Card/Claim Inward Register

Form 2(R) enclosed along with the documents furnished by the claimant.

CLERK

S.S

A.A.O

A.P.F.C

DATE

DATE

DATE

DATE

FOR USE IN PENSION PRE-AUDIT CELL

The Input data sheet verified with reference to the application and the documents enclosed and found correct. P.P.O. may be generated through Computer.

CLERK

S.S

A.A.O

A.P.F.C(PENSION)

DATE

DATE

DATE

DATE

FOR USE IN PENSION DISBURSEMENT SECTION

P.P.O. No

Date of issue to the Bank

Intimation sent to the Claimant and also to Accounts Branch on

CLERK

S.S

A.A.O

A.P.F.C

DATE

DATE

DATE

DATE

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For you to fill out this PDF form, ensure that you enter the required information in every area:

1. The pf form 10d in word format requires particular details to be typed in. Make certain the next blanks are filled out:

Stage number 1 in filling in epf form 10 pdf

2. Immediately after this section is done, go on to type in the applicable information in all these: PIN, Option for commutation of of, Yes, Pension If option is for lesser, and Amount.

Writing section 2 of epf form 10 pdf

3. The next stage is easy - complete every one of the empty fields in Yes, of Capital, Option of Return of Capital, Please refer Serial Number of, Mention your Nominee for Return, Relationship, Date of Birth, Address, Name, Name, Date of BirthAge, Relationship, Indicate against Minor, with, and Member to complete this part.

epf form 10 pdf completion process explained (part 3)

4. The form's fourth paragraph comes with these particular form blanks to focus on: Relationship with Member, if applicable, DISABLED below the name, Note If any child is physically, Name of the Bank Name of the, Account Opened, and PIN CODE.

Step number 4 in filling out epf form 10 pdf

You can potentially make errors while completing the Note If any child is physically, for that reason be sure you go through it again prior to when you send it in.

5. While you come close to the completion of your document, you'll notice several extra requirements that must be fulfilled. Notably, SINo, Name of the ClaimantsS, Saving Bank Accounts No, Scheme Certificate received, Not Received, Not Applicable, indicate hisher, Name Relationship with the, A If the claim is preferred by, Already in possession of the, and Member if any must be done.

epf form 10 pdf conclusion process clarified (step 5)

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