View stunning SlideShares in full-screen with the new iOS app!Introducing SlideShare for AndroidExplore all your favorite topics in the SlideShare appGet the SlideShare app to Save for Later — even offline
View stunning SlideShares in full-screen with the new Android app!View stunning SlideShares in full-screen with the new iOS app!
FORM NO.- 3 (IF)
(FOR EXEMPTED ESTABLISHMENT ONLY)
THE EMPLOYEES' DEPOSIT LINKED INSURANCE SCHEME, 1976
RETURN OF THE MEMBERS OF INSURANCE FUND LEAVING SERVICE DURING THE MONTH OF
NAME & ADDRESS OF ESTABLISHMENT :
CODE NO. OF THE ESTABLISHMENT :
SL. ACCOUNT NAME OF THE MEMBER FATHER'S NAME OR DATE OF REASON FOR REMARKS
NO. NO (IN BLOCK CAPITALS) HUSBAND'S NAME ( IN CASE LEAVING LEAVING
OF MARRIED WOMAN ) SERVICE SERVICE
(1) (2) (3) (4) (5) (6) (7)
Date: SIGNATURE OF THE EMPLOYER
STAMP OF THE ESTABLISHMENT
NOTE : In case of death of a member, while in service, furnish :-
(a) Date of payment of PF dues.
(b) Amount Paid.
(c) To Whom Paid? ( In shares, if any ).
LEFT EDLI_3_IF_ _EKL_ Page 1