As an employee, familiarizing yourself with the nomination and declaration processes is essential for meeting expectations. Having all of your paperwork in order is one of the key factors for successfully staying on track with payroll obligations and legal requirements. Whether you are a new hire or an existing employee, understanding what goes into nominating and declaring for different roles can help ensure that you receive the most accurate payment on time, every time. Read this post to learn more about nomination and declaration forms — from what they involve to when and how to fill them out!
Question | Answer |
---|---|
Form Name | Nomination And Declaration Form |
Form Length | 3 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 45 sec |
Other names | pf nomination and declaration form, unexempted exempted, part b eps para 18, form unexempted |
Form is available free of cost
FORM
A/C. Group No. __________
NOMINATION AND DECLARATION FORM FOR UNEXEMPTED /
EXEMPTED ESTABLISHMENTS
___________________________________________________________________
Declaration and Nomination Form under the employees' Provident Funds (EPF) and
Employees' Pension Scheme (EPS)
(Paragraph 33 & 61(1) of the Employees' Provident Fund Scheme, 1952 & Paragraph 18 of the
Employees' Pension Scheme, 1995)
Name(In Block Letters):
Father's/Husband Name :
Date Of Birth :
Sex : Male
Female
Marital Status : |
Married |
Date Of Joining in EPF '52 :
Date Of Joining in E.P.F. '71/E.P.S. '95
Permanent & Temporary Address :
Account No. :
PART - A (EPF)
I hereby nominate the person(s) cancel the nomination made by me previously and nominate the person(s), mentioned below to receive the amount standing to my credit in the Employees' Provident Fund, in the event of my death.
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guardian |
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AS PER
ABOVE
MENTIONED
1.* Certified that I have no family as defined in Para. 2(g) of the Employees' Provident Fund Scheme, 1952 and should I acquire a family hereafter, the above nomination should be deemed as cancelled.
2.* Certified that may father / mother is/are dependent upon me.
Signature or Thumb impression of the subscriber
* Strike out whichever is not applicable
I hereby furnish below particulars of the members of my family who would be eligible to receive widow /children Pension in the event of my death.
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1.** Certified that I have no family as defined in Para 2(vii) of the Employees' Pension Scheme, 1995 and should I acquire a family hereafter I shall furnish particulars thereon in the above form.
I hereby nominate the following person for receiving the monthly widow pension admissible under Para
Name and Address of the Nominee
Date Of Birth
Relationship with member
Date:Signature or Thumb impression of the subscriber
** Strike out whichever is not applicable
CERTIFICATE BY EMPLOYER
Certified that the above declaration has been signed / thumb impressed
before me by Shri / Smt. / Kum. _________________________________________
employed in my establishment after he/she has read the entries / entries have been read over to him/her by me and got confirmed by him/her.
Place: Signature of the employer or other authorized
Officers of the establishment
Dated: Designation
Name & Address of Factory / Establishment and Rubber Stamp thereof.