INSTRUCTION TO FILL THE FORM Form No-19
Page 1 Sl. No 1,2,3 ,4,5,6,7,8 & 9 (You do not have to fill
the ECS CODE) Page 2 : Please mention DOB,DOJ and DOL Please sign
on the right side (Mentioned as Signature/left hand thump
impression of the Member ) and need to sign across the declaration
of non Employment. Mentioned as Signature/left hand thump
impression of the Member Please affix the Revenue stamp were ever
it is mentioned if PF has to be claimed outside Karnataka. In total
you need to put 3 signatures in the Form No-19 (Mentioned as
Signature/left hand thump impression of the member).
Form 10-C 1. Page1, please fill 1 (A) 2, 3, 4, 5,6,7,8 tick on
the option A (money) and not the option B (scheme certificate) and
Sl. No 9 is left blank. (Scheme certificate is an employee pension
scheme and as per this scheme, when an employee completes 55
yrs/9.5 years in the organisation, monthly pension is provided to
the employee by the RPFC).
2. Page No 2 Sl no 10 is left blank. SL. no 11 please put tick
mark on the option B and mention the bank details. SL. no 12 is
left as blank. Please sign on the right side (were it is mentioned
as Signature/left hand thump impression of the Member). Please
affix the Revenue stamp were ever it is mentioned if PF has to be
claimed outside Karnataka.
3. Page No 3, please leave it as blank.
In total you need to put 2 signatures in the Form-10C (Mentioned
as Signature/left hand thump impression of the
member).
Request you to please attach the filled PF form with the below
mentioned mandatory documents:
Cancelled Cheque with signature of claimant/employee photo copy
of the first page of the bank pass book or statement where name and
other details are
mentioned Government authorized address Proof Government
authorized ID proof
The address you can courier the filled form is as per below:
Provident Fund Team, MphasiS an HP Company, Bagmane World
Technology Center 3, 1st Floor B Block, Outer Ring Road,
Mahadevapura, Doddanekundi Village, Bangalore 560048. eMail:
[email protected]
Please write your employee number on the form and also send your
contact detail along with your form. Note: The amount would come in
two parts Employer contribution (8.33%) & Employee Contribution
(15.67%). Employees can apply for withdrawal after 60 days from the
date of leaving the organization. If the same is applied within 60
days then we have to keep the forms on hold until your settlement
is completed and the PF contribution of notice period is deposited
in the RPFC account. We have no control over the PF office
transactions. Therefore, we recommend that if you do not receive
the amount within 90 to 120 days from the date of submission,
contact the PF office directly. Incase of pending settlement in
RPFC or discrepancy in the amount credited the employee can lodge
the grievances in the newly launched "Employees Provident Fund
internet Grievance Management System (EPFiGMS) portal using the
link http://epfigms.gov.in/ along with the acknowledgment copy.
Employee applying for the PF Withdrawal after 3 years from the date
of leaving the service, need to provide the Affidavit Cum Indemnity
Bond (format enclosed) and submit along with the withdrawal
application to the PF Office.
