Epf New Declaration Form 31 H – Fill Out and Use This PDF

SPMCIL EMPLOYEES PROVIDENT FUND TRUST

Declaration Form 31 H

Declaration from to be submitted along with application Form 31 for purchase of a dwelling site/house/flat or for construction of a dwelling house or for addition/alteration of the dwelling house.

1	Name of the E.P.F. Member
2	Father / Husband’s name
3	Employees Provident Fund A/C No.
4	Permanent address
5	Complete address of the dwelling site
	/dwelling house or flat or house under
	construction for which withdrawal is
	applied or,
	- Name & address of the owner
		of plot/house from whom
		purchased /agreement
		executed.
	-	Survey no/plot	no/khatta	no/
		Registration number and		the
		year of the title deed
	-	Boundary
		East:
		West:
		North:
		South
	-	Area of site and	/ house.
6	Name of authority who approved site
	plan with reference no. and date.
7	Whether copy of agreement for
	purchase / allotment letter, in case of
	purchase is enclosed.
8	Estimate of value of property / house /
	flate or estimated cost of construction
	/ addition / alteration.
9	Whether withdrawal for housing was
	availed previously, if so the amount,
	date of sanction, purpose etc.
10	Permission/license		no.	for
	construction issued by local authority
	with name of local body in the area of
	construction.

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SPMCIL EMPLOYEES PROVIDENT FUND TRUST

	Declaration Form 31 H
	Declaration & undertaking
(1) I		s/o, d/o, w/o		do

hereby solemnly declare that the information furnished above are true to the best of my knowledge and the above mentioned *(dwelling site of dwelling house / flat or house under construction) is free from all encumbrances. I also declare that I am not purchasing a share in joint property or constructing a house on a site owned jointly except with the spouse. I undertake that the *house / site / flat is registered / will be registered in my name / my spouse (name)__________________________(give name

of *wife / husband) / or jointly in the name of my spouse________________

(give name) and myself.

(2)I hereby undertake to submit a copy of Registered* deed /allotment letter / Possession memo / construction completion certificate immediately on receipt / completion /within one year whichever is earlier.

(3)I also undertake to produce the above documents whenever demanded by the sanctioning authority for future verification.

(4)I understand that as per the provision of Employees Provident Fund Scheme 1952, I am liable to refund the entire amount of withdrawal in lump sum with penal interest in case the amount is used for any purpose other than the purpose stated in the application. I authorize the Regional Provident Fund Commissioner to recover the amount sanctioned with penal interest @ 2% p.a. from my wages in case I fail to produce copy of the registered purchase * deed / completion certificate within *six months / twelve months after the withdrawal of the amount, as the case may be.

Date:
(	)

(Signature of EPF Member with name thereunder) Present address:

I certify that I have verified the above particulars and have read out the content of the declaration of Shri.Smt. ______________________ and he / she has signed / thumb

impressed before me.

Employer signature ________________________

________________________

Establishment seal & date

Name & Designation of employer

*Strike out inapplicable words / phrases

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