Nomination And Declaration Form PDF Details

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!

QuestionAnswer
Form NameNomination And Declaration Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namespf nomination and declaration form, unexempted exempted, part b eps para 18, form unexempted

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FORM -2 (REVISED)

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

Un-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.

Name of

Address

Nominee's

Date

Total amount

If the

the

 

relationship

of

of share of

nominee

Nominee

 

with the

Birth

accumulations

is a minor,

/

 

member

 

in Provident

Name &

 

 

Fund to

relationship

Nominees

 

 

 

 

 

 

Be paid to

& address

 

 

 

 

 

 

 

 

each

of the

 

 

 

 

nominee.

guardian

 

 

 

 

 

who may

 

 

 

 

 

receive the

 

 

 

 

 

amount

 

 

 

 

 

during the

 

 

 

 

 

minority of

 

 

 

 

 

nominee.

 

 

 

 

 

 

1

2

3

4

5

6

 

 

 

 

 

 

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

PART-B (EPS) (Para 18)

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.

S

Name & Address of the Family Member

Date Of

Relationship

Nor

 

 

Birth

with

.

 

 

 

member

 

 

 

 

 

 

Name

Address

 

 

 

 

 

 

 

1

2

3

4

5

 

 

 

 

 

1

 

 

 

 

2

 

 

 

 

3

 

 

 

 

4

 

 

 

 

5

 

 

 

 

 

 

 

 

 

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 16-2(a) (i) & (ii) in the event of my death without leaving any eligible family member for receiving pension.

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.