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1. ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]
( Tracking ID: 10013047169905005 )
Claim Date : 27/01/2023
EMPLOYEES' PROVIDENT FUND SCHEME, 1952
(PARA 57)
:
Bank Account Number
PART A : PERSONAL
2.
Name
3.
Mobile Number
: 40416522213
:
4.
9420324300
:
Bank IFSC
E-mail id
SBIN0013666
DATTATRAYA NAMDEV TAKALE
:
5.
1.
dattatrayatakale74@gmail.com
The Regional P.F. Commissioner,
2-3rd Flr,Pune Cant. Board Blding, Near Golibar Maidan, Camp, Pune
(This form has been printed on the basis of Online Transfer Claim Form filled up by the member under Unified Portal for submission to the
employer.)
I request that my Provident Fund balance along with my Pension Service Details may please be transferred to my present
account under intimation to me. My details are as under :
PUNE,
To,
Sir,
2.
:
Address of the Establishment
PART B : DETAILS OF PREVIOUS PF ACCOUNTS (WHICH IS TO BE TRANSFERRED)
3.
PF Account No. (with EPFO
:
Name of the Establishment
PUPUN17086210000010070
1.
MAHINDRA AND MAHINDRA LIMITED TWO WHEELER DIVISION
:
D1 BLOCK PLOT NO 18 2 PART MIDC CHINCHWAD PUNE 601
PF A/C No. held by
4. : PUNE
NOT APPLICABLE
5.
NOT APPLICABLE
:
PF A/C No. in Trust
Bank A/C No. of Trust :
:
7.
6.
Name of the Trust
NOT APPLICABLE
IFS Code of the Bank Branch of
Trust where account is
10.
Member's Name
01/06/1963
:
Date of Birth
: NOT APPLICABLE
8.
:
9. DATTATRAYA NAMDEV TAKALE
:
TAKALE NAMDEV GOVIND
11.Father's/Spouse Name
:
:
12. :
31/05/2020
14.
FATHER
Relationship
13.
Date of leaving
Date of joining 01/02/2018

2. MAHINDRA INTEGRATED BUSINESS SOLUTIONS PVT LTD
Father's/Spouse Name
:
Address of the Establishment
Member's Name
PF Account No. (with EPFO
Date of Birth
:
:
: 01/06/1963
:
5.
:
:
DATTATRAYA NAMDEV TAKALE
Relationship
:
9.
1.
TAKALE NAMDEV GOVIND
Name of the Establishment
12.
:
Name of the Trust
NOT APPLICABLE
PF A/C No. in Trust
PART C : DETAILS OF PRESENT PF
6.
MAHINDRA INFORMATION TECH CENTRE, AKURLI ROAD, KANDIVALI (E)
598
10.
3.
2.
NOT APPLICABLE
KDMAL02139140000016849
11.
FATHER
Date of joining :
13. 01/06/2020
:
Bank A/C No. of Trust
8.
: NOT APPLICABLE
7.
NOT APPLICABLE
IFS Code of the Bank Branch of
Trust where account is
PF A/C No. held by RO MALAD (KANDIVALI)
4. :
Signature of the member
Note : Member should take a printout of this form and a signed copy of the same should be submitted to the Present
Establishment i.e. MAHINDRA INTEGRATED BUSINESS SOLUTIONS PVT LTD
I, Certify that all the information given above are true to the best of my knowledge and I have ensured the correctness of
my present and previous account numbers.