SlideShare a Scribd company logo
1 of 4
Download to read offline
JOINT DECLARATION FOR HIGHER PENSION
(For Serving Employees)
The Regional PF Commissioner, Date:………..
Regional Office,
……………………………
……………………………
Dear Sir/Madam,
Sub: Joint Application/Option under paragraph 11 (3) of the EPS, 1995, as well as
under paragraph 11(4) of the EPS, 2014 for contributing to pension scheme on
higher salary/basic wages in view of the judicial directions of the Hon’ble Supreme
Court in the following matters:
1. The EPFO & Anr. Etc. vs. Sunil Kumar B & Ors., SPJ (C) Nos. 8658-8659 of
2019
2. R C Gupta and others vs. Regional PF Commissioner and others in Civil
Appeal No(s) 10013-10014 of 2016 arising out of SLP No. 33032-33033 of
2015, 2017 LLR 86 (SC)
3. Since no format for the joint option has been provided by EPFO and same is
also not available on EPFO’s website.
4. We (employee and employer) are, hereby submitting the joint option form as
required under erstwhile Para 11(3) & Para 11(4) of Employees’ Pension
Scheme – 1995 for claiming pension on higher wages instead of wage ceiling
limit
5. The particulars of the applicant are as under:
1 Name of the Establishment
2 Establishment ID
3 Name of the Employee
4 UAN
5 EPF/EPS Member ID
6 Mobile No. (linked to EPF)
7 Email ID (linked to EPF)
8 Aadhar No.
Declaration by the Employee
1. I, ……………………………………………………………………………………………, being an employee
of the un-exempted establishment as well as member of the EPFS, 1952 & EPS,
1995, hereby opt to contribute to the pension fund on higher/actual basic wages
and exercising option as per paragraph 11(3) of the EPS, 1995 read along with
paragraph 11(4) of the EPS, 2014.
2. I, hereby exercise my higher pension option as per the latest Supreme Court’s
Judgement (supra) as per paragraph 11(3) & 11(4) of EPS, 1995 read along with
paragraph 26(6) of the EPF Scheme, 1952 for deduction of the EPF contribution
on actual salary/basic wages as per Section 6 of the EPF & Misc. Provisions Act,
1952.
3. I further hereby authorize the EPFO that for the previous period of my
employment (member of the fund), the PF contribution which was deducted for
earlier period on actual basic wages/salary or statutory ceiling limit and
subsequently, the same was remitted in Account No. 01 and Account No. 10 (up
to the statutory limit i.e., Rs. 6,500/- or Rs. 15,000/-), be adjusted by debit/credit
system (i.e., from Account No. 01 to Account No. 10.), wherever applicable.
4. I also make self-declaration that during my service in previous organizations,
there was deduction on full salary/statutory ceiling limit towards PF. The details
are as under:
Sl.
No.
Name of the
Organization
Name of
the trust
OR
concerned
PF office
Period of Service
Previous
employment
details are
attached.
From To
(Pl. furnish as applicable, else strike off the rest rows)
Place:
Date: Signature of Employee
I,
Undertaking by the Employer
being the authorized signatory as per Form 5A of M/s.
, that above said employee of this establishment with PF A/c. No.
&
UAN during his/her service, as an
employer have deducted his/her EPF on actual salary i.e., more than statutory limit
every month during his/her service period in this establishment and remitted the
same as per paragraph 38 of the EPFS, 1952 along with administrative charges in
compliance of the paragraph 26(6) of the EPFS, 1952 in the member’s account every
month.
Place:
Date: Signature with Office Seal
Annexure – 2A
ANNEXURE – to indicate every previous organization in
which the employee was a member of EPS’95
(separate sheet for each employment)
Sl.
No. Particulars Details
1 Employee Name
2 Establishment Name
3 Establishment Address
4
Establishment ID /
Establishment PF Code
5
PF Account is held by:
(Name of EPF Office / PF
Trust)
6 EPF Member ID
7 EPS No.
6 Date of Joining
7 Date of Exit
9 UAN, if any
10
PF deducted on actual
salary / statutory ceiling
limit
I hereby certify that the above details provided by me are correct and to the
best of my knowledge.
Signature of the employee
Name:
Date:
Place:

More Related Content

Similar to joint option.pdf

Kerala Govt Employes- application for PF
Kerala Govt Employes- application for PFKerala Govt Employes- application for PF
Kerala Govt Employes- application for PFCollectorate Malappuram
 
Rti-app-for-pf-transfer
Rti-app-for-pf-transferRti-app-for-pf-transfer
Rti-app-for-pf-transferSatheesh S
 
Payment of Gratuity Act, 1972
Payment of Gratuity Act, 1972Payment of Gratuity Act, 1972
Payment of Gratuity Act, 1972Sheetal Wagh
 
Chapter 2: Incorporation
Chapter 2: IncorporationChapter 2: Incorporation
Chapter 2: IncorporationBold Kiln
 
Statutory requirement
Statutory requirementStatutory requirement
Statutory requirementVishal Joshi
 
Employment agreement
Employment agreementEmployment agreement
Employment agreementLuther Akyoo
 
sims197
sims197sims197
sims197R4T3z
 
sims203
sims203sims203
sims203R4T3z
 
Compliance ppt
Compliance pptCompliance ppt
Compliance pptAlok Yadav
 
Aanand vilas application-form
Aanand vilas application-formAanand vilas application-form
Aanand vilas application-formlandandhomesncr
 
Application form-for-regular-pension-and-graduaity
Application form-for-regular-pension-and-graduaityApplication form-for-regular-pension-and-graduaity
Application form-for-regular-pension-and-graduaityM.Ramzan Burfat
 
NLRC Law Report No. VI. June 2013.
NLRC Law Report No. VI. June 2013.NLRC Law Report No. VI. June 2013.
NLRC Law Report No. VI. June 2013.PoL Sangalang
 
chapter ii, sec. 3 of companies act, 2013
chapter ii, sec. 3 of companies act, 2013chapter ii, sec. 3 of companies act, 2013
chapter ii, sec. 3 of companies act, 2013ACS Shalu Saraf
 

Similar to joint option.pdf (20)

Testing
TestingTesting
Testing
 
Kerala Govt Employes- application for PF
Kerala Govt Employes- application for PFKerala Govt Employes- application for PF
Kerala Govt Employes- application for PF
 
Rti-app-for-pf-transfer
Rti-app-for-pf-transferRti-app-for-pf-transfer
Rti-app-for-pf-transfer
 
13revised
13revised13revised
13revised
 
Nps presentation
Nps presentationNps presentation
Nps presentation
 
Payment of Gratuity Act, 1972
Payment of Gratuity Act, 1972Payment of Gratuity Act, 1972
Payment of Gratuity Act, 1972
 
Chapter 2: Incorporation
Chapter 2: IncorporationChapter 2: Incorporation
Chapter 2: Incorporation
 
Statutory requirement
Statutory requirementStatutory requirement
Statutory requirement
 
Nca rules chapter2
Nca rules chapter2Nca rules chapter2
Nca rules chapter2
 
Pf details
Pf detailsPf details
Pf details
 
Employment agreement
Employment agreementEmployment agreement
Employment agreement
 
sims197
sims197sims197
sims197
 
BIR Form 2316.pdf
BIR Form 2316.pdfBIR Form 2316.pdf
BIR Form 2316.pdf
 
sims203
sims203sims203
sims203
 
Compliance ppt
Compliance pptCompliance ppt
Compliance ppt
 
Aanand vilas application-form
Aanand vilas application-formAanand vilas application-form
Aanand vilas application-form
 
Application form-for-regular-pension-and-graduaity
Application form-for-regular-pension-and-graduaityApplication form-for-regular-pension-and-graduaity
Application form-for-regular-pension-and-graduaity
 
NLRC Law Report No. VI. June 2013.
NLRC Law Report No. VI. June 2013.NLRC Law Report No. VI. June 2013.
NLRC Law Report No. VI. June 2013.
 
Employees Provident Fund
Employees Provident FundEmployees Provident Fund
Employees Provident Fund
 
chapter ii, sec. 3 of companies act, 2013
chapter ii, sec. 3 of companies act, 2013chapter ii, sec. 3 of companies act, 2013
chapter ii, sec. 3 of companies act, 2013
 

Recently uploaded

Call Girls Miyapur 7001305949 all area service COD available Any Time
Call Girls Miyapur 7001305949 all area service COD available Any TimeCall Girls Miyapur 7001305949 all area service COD available Any Time
Call Girls Miyapur 7001305949 all area service COD available Any Timedelhimodelshub1
 
BEST Call Girls In Old Faridabad ✨ 9773824855 ✨ Escorts Service In Delhi Ncr,
BEST Call Girls In Old Faridabad ✨ 9773824855 ✨ Escorts Service In Delhi Ncr,BEST Call Girls In Old Faridabad ✨ 9773824855 ✨ Escorts Service In Delhi Ncr,
BEST Call Girls In Old Faridabad ✨ 9773824855 ✨ Escorts Service In Delhi Ncr,noida100girls
 
Investment analysis and portfolio management
Investment analysis and portfolio managementInvestment analysis and portfolio management
Investment analysis and portfolio managementJunaidKhan750825
 
Case study on tata clothing brand zudio in detail
Case study on tata clothing brand zudio in detailCase study on tata clothing brand zudio in detail
Case study on tata clothing brand zudio in detailAriel592675
 
Progress Report - Oracle Database Analyst Summit
Progress  Report - Oracle Database Analyst SummitProgress  Report - Oracle Database Analyst Summit
Progress Report - Oracle Database Analyst SummitHolger Mueller
 
Call Girls In Kishangarh Delhi ❤️8860477959 Good Looking Escorts In 24/7 Delh...
Call Girls In Kishangarh Delhi ❤️8860477959 Good Looking Escorts In 24/7 Delh...Call Girls In Kishangarh Delhi ❤️8860477959 Good Looking Escorts In 24/7 Delh...
Call Girls In Kishangarh Delhi ❤️8860477959 Good Looking Escorts In 24/7 Delh...lizamodels9
 
FULL ENJOY - 9953040155 Call Girls in Chhatarpur | Delhi
FULL ENJOY - 9953040155 Call Girls in Chhatarpur | DelhiFULL ENJOY - 9953040155 Call Girls in Chhatarpur | Delhi
FULL ENJOY - 9953040155 Call Girls in Chhatarpur | DelhiMalviyaNagarCallGirl
 
Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...
Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...
Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...lizamodels9
 
Call Girls In Radisson Blu Hotel New Delhi Paschim Vihar ❤️8860477959 Escorts...
Call Girls In Radisson Blu Hotel New Delhi Paschim Vihar ❤️8860477959 Escorts...Call Girls In Radisson Blu Hotel New Delhi Paschim Vihar ❤️8860477959 Escorts...
Call Girls In Radisson Blu Hotel New Delhi Paschim Vihar ❤️8860477959 Escorts...lizamodels9
 
Call Girls In ⇛⇛Chhatarpur⇚⇚. Brings Offer Delhi Contact Us 8377877756
Call Girls In ⇛⇛Chhatarpur⇚⇚. Brings Offer Delhi Contact Us 8377877756Call Girls In ⇛⇛Chhatarpur⇚⇚. Brings Offer Delhi Contact Us 8377877756
Call Girls In ⇛⇛Chhatarpur⇚⇚. Brings Offer Delhi Contact Us 8377877756dollysharma2066
 
Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...
Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...
Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...lizamodels9
 
Islamabad Escorts | Call 03274100048 | Escort Service in Islamabad
Islamabad Escorts | Call 03274100048 | Escort Service in IslamabadIslamabad Escorts | Call 03274100048 | Escort Service in Islamabad
Islamabad Escorts | Call 03274100048 | Escort Service in IslamabadAyesha Khan
 
Keppel Ltd. 1Q 2024 Business Update Presentation Slides
Keppel Ltd. 1Q 2024 Business Update  Presentation SlidesKeppel Ltd. 1Q 2024 Business Update  Presentation Slides
Keppel Ltd. 1Q 2024 Business Update Presentation SlidesKeppelCorporation
 
NewBase 22 April 2024 Energy News issue - 1718 by Khaled Al Awadi (AutoRe...
NewBase  22 April  2024  Energy News issue - 1718 by Khaled Al Awadi  (AutoRe...NewBase  22 April  2024  Energy News issue - 1718 by Khaled Al Awadi  (AutoRe...
NewBase 22 April 2024 Energy News issue - 1718 by Khaled Al Awadi (AutoRe...Khaled Al Awadi
 
(8264348440) 🔝 Call Girls In Mahipalpur 🔝 Delhi NCR
(8264348440) 🔝 Call Girls In Mahipalpur 🔝 Delhi NCR(8264348440) 🔝 Call Girls In Mahipalpur 🔝 Delhi NCR
(8264348440) 🔝 Call Girls In Mahipalpur 🔝 Delhi NCRsoniya singh
 
Pitch Deck Teardown: NOQX's $200k Pre-seed deck
Pitch Deck Teardown: NOQX's $200k Pre-seed deckPitch Deck Teardown: NOQX's $200k Pre-seed deck
Pitch Deck Teardown: NOQX's $200k Pre-seed deckHajeJanKamps
 
(8264348440) 🔝 Call Girls In Keshav Puram 🔝 Delhi NCR
(8264348440) 🔝 Call Girls In Keshav Puram 🔝 Delhi NCR(8264348440) 🔝 Call Girls In Keshav Puram 🔝 Delhi NCR
(8264348440) 🔝 Call Girls In Keshav Puram 🔝 Delhi NCRsoniya singh
 
VIP Call Girl Jamshedpur Aashi 8250192130 Independent Escort Service Jamshedpur
VIP Call Girl Jamshedpur Aashi 8250192130 Independent Escort Service JamshedpurVIP Call Girl Jamshedpur Aashi 8250192130 Independent Escort Service Jamshedpur
VIP Call Girl Jamshedpur Aashi 8250192130 Independent Escort Service JamshedpurSuhani Kapoor
 
The CMO Survey - Highlights and Insights Report - Spring 2024
The CMO Survey - Highlights and Insights Report - Spring 2024The CMO Survey - Highlights and Insights Report - Spring 2024
The CMO Survey - Highlights and Insights Report - Spring 2024christinemoorman
 
Intro to BCG's Carbon Emissions Benchmark_vF.pdf
Intro to BCG's Carbon Emissions Benchmark_vF.pdfIntro to BCG's Carbon Emissions Benchmark_vF.pdf
Intro to BCG's Carbon Emissions Benchmark_vF.pdfpollardmorgan
 

Recently uploaded (20)

Call Girls Miyapur 7001305949 all area service COD available Any Time
Call Girls Miyapur 7001305949 all area service COD available Any TimeCall Girls Miyapur 7001305949 all area service COD available Any Time
Call Girls Miyapur 7001305949 all area service COD available Any Time
 
BEST Call Girls In Old Faridabad ✨ 9773824855 ✨ Escorts Service In Delhi Ncr,
BEST Call Girls In Old Faridabad ✨ 9773824855 ✨ Escorts Service In Delhi Ncr,BEST Call Girls In Old Faridabad ✨ 9773824855 ✨ Escorts Service In Delhi Ncr,
BEST Call Girls In Old Faridabad ✨ 9773824855 ✨ Escorts Service In Delhi Ncr,
 
Investment analysis and portfolio management
Investment analysis and portfolio managementInvestment analysis and portfolio management
Investment analysis and portfolio management
 
Case study on tata clothing brand zudio in detail
Case study on tata clothing brand zudio in detailCase study on tata clothing brand zudio in detail
Case study on tata clothing brand zudio in detail
 
Progress Report - Oracle Database Analyst Summit
Progress  Report - Oracle Database Analyst SummitProgress  Report - Oracle Database Analyst Summit
Progress Report - Oracle Database Analyst Summit
 
Call Girls In Kishangarh Delhi ❤️8860477959 Good Looking Escorts In 24/7 Delh...
Call Girls In Kishangarh Delhi ❤️8860477959 Good Looking Escorts In 24/7 Delh...Call Girls In Kishangarh Delhi ❤️8860477959 Good Looking Escorts In 24/7 Delh...
Call Girls In Kishangarh Delhi ❤️8860477959 Good Looking Escorts In 24/7 Delh...
 
FULL ENJOY - 9953040155 Call Girls in Chhatarpur | Delhi
FULL ENJOY - 9953040155 Call Girls in Chhatarpur | DelhiFULL ENJOY - 9953040155 Call Girls in Chhatarpur | Delhi
FULL ENJOY - 9953040155 Call Girls in Chhatarpur | Delhi
 
Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...
Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...
Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...
 
Call Girls In Radisson Blu Hotel New Delhi Paschim Vihar ❤️8860477959 Escorts...
Call Girls In Radisson Blu Hotel New Delhi Paschim Vihar ❤️8860477959 Escorts...Call Girls In Radisson Blu Hotel New Delhi Paschim Vihar ❤️8860477959 Escorts...
Call Girls In Radisson Blu Hotel New Delhi Paschim Vihar ❤️8860477959 Escorts...
 
Call Girls In ⇛⇛Chhatarpur⇚⇚. Brings Offer Delhi Contact Us 8377877756
Call Girls In ⇛⇛Chhatarpur⇚⇚. Brings Offer Delhi Contact Us 8377877756Call Girls In ⇛⇛Chhatarpur⇚⇚. Brings Offer Delhi Contact Us 8377877756
Call Girls In ⇛⇛Chhatarpur⇚⇚. Brings Offer Delhi Contact Us 8377877756
 
Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...
Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...
Call Girls In Sikandarpur Gurgaon ❤️8860477959_Russian 100% Genuine Escorts I...
 
Islamabad Escorts | Call 03274100048 | Escort Service in Islamabad
Islamabad Escorts | Call 03274100048 | Escort Service in IslamabadIslamabad Escorts | Call 03274100048 | Escort Service in Islamabad
Islamabad Escorts | Call 03274100048 | Escort Service in Islamabad
 
Keppel Ltd. 1Q 2024 Business Update Presentation Slides
Keppel Ltd. 1Q 2024 Business Update  Presentation SlidesKeppel Ltd. 1Q 2024 Business Update  Presentation Slides
Keppel Ltd. 1Q 2024 Business Update Presentation Slides
 
NewBase 22 April 2024 Energy News issue - 1718 by Khaled Al Awadi (AutoRe...
NewBase  22 April  2024  Energy News issue - 1718 by Khaled Al Awadi  (AutoRe...NewBase  22 April  2024  Energy News issue - 1718 by Khaled Al Awadi  (AutoRe...
NewBase 22 April 2024 Energy News issue - 1718 by Khaled Al Awadi (AutoRe...
 
(8264348440) 🔝 Call Girls In Mahipalpur 🔝 Delhi NCR
(8264348440) 🔝 Call Girls In Mahipalpur 🔝 Delhi NCR(8264348440) 🔝 Call Girls In Mahipalpur 🔝 Delhi NCR
(8264348440) 🔝 Call Girls In Mahipalpur 🔝 Delhi NCR
 
Pitch Deck Teardown: NOQX's $200k Pre-seed deck
Pitch Deck Teardown: NOQX's $200k Pre-seed deckPitch Deck Teardown: NOQX's $200k Pre-seed deck
Pitch Deck Teardown: NOQX's $200k Pre-seed deck
 
(8264348440) 🔝 Call Girls In Keshav Puram 🔝 Delhi NCR
(8264348440) 🔝 Call Girls In Keshav Puram 🔝 Delhi NCR(8264348440) 🔝 Call Girls In Keshav Puram 🔝 Delhi NCR
(8264348440) 🔝 Call Girls In Keshav Puram 🔝 Delhi NCR
 
VIP Call Girl Jamshedpur Aashi 8250192130 Independent Escort Service Jamshedpur
VIP Call Girl Jamshedpur Aashi 8250192130 Independent Escort Service JamshedpurVIP Call Girl Jamshedpur Aashi 8250192130 Independent Escort Service Jamshedpur
VIP Call Girl Jamshedpur Aashi 8250192130 Independent Escort Service Jamshedpur
 
The CMO Survey - Highlights and Insights Report - Spring 2024
The CMO Survey - Highlights and Insights Report - Spring 2024The CMO Survey - Highlights and Insights Report - Spring 2024
The CMO Survey - Highlights and Insights Report - Spring 2024
 
Intro to BCG's Carbon Emissions Benchmark_vF.pdf
Intro to BCG's Carbon Emissions Benchmark_vF.pdfIntro to BCG's Carbon Emissions Benchmark_vF.pdf
Intro to BCG's Carbon Emissions Benchmark_vF.pdf
 

joint option.pdf

  • 1. JOINT DECLARATION FOR HIGHER PENSION (For Serving Employees) The Regional PF Commissioner, Date:……….. Regional Office, …………………………… …………………………… Dear Sir/Madam, Sub: Joint Application/Option under paragraph 11 (3) of the EPS, 1995, as well as under paragraph 11(4) of the EPS, 2014 for contributing to pension scheme on higher salary/basic wages in view of the judicial directions of the Hon’ble Supreme Court in the following matters: 1. The EPFO & Anr. Etc. vs. Sunil Kumar B & Ors., SPJ (C) Nos. 8658-8659 of 2019 2. R C Gupta and others vs. Regional PF Commissioner and others in Civil Appeal No(s) 10013-10014 of 2016 arising out of SLP No. 33032-33033 of 2015, 2017 LLR 86 (SC) 3. Since no format for the joint option has been provided by EPFO and same is also not available on EPFO’s website. 4. We (employee and employer) are, hereby submitting the joint option form as required under erstwhile Para 11(3) & Para 11(4) of Employees’ Pension Scheme – 1995 for claiming pension on higher wages instead of wage ceiling limit 5. The particulars of the applicant are as under: 1 Name of the Establishment 2 Establishment ID 3 Name of the Employee 4 UAN 5 EPF/EPS Member ID 6 Mobile No. (linked to EPF) 7 Email ID (linked to EPF) 8 Aadhar No.
  • 2. Declaration by the Employee 1. I, ……………………………………………………………………………………………, being an employee of the un-exempted establishment as well as member of the EPFS, 1952 & EPS, 1995, hereby opt to contribute to the pension fund on higher/actual basic wages and exercising option as per paragraph 11(3) of the EPS, 1995 read along with paragraph 11(4) of the EPS, 2014. 2. I, hereby exercise my higher pension option as per the latest Supreme Court’s Judgement (supra) as per paragraph 11(3) & 11(4) of EPS, 1995 read along with paragraph 26(6) of the EPF Scheme, 1952 for deduction of the EPF contribution on actual salary/basic wages as per Section 6 of the EPF & Misc. Provisions Act, 1952. 3. I further hereby authorize the EPFO that for the previous period of my employment (member of the fund), the PF contribution which was deducted for earlier period on actual basic wages/salary or statutory ceiling limit and subsequently, the same was remitted in Account No. 01 and Account No. 10 (up to the statutory limit i.e., Rs. 6,500/- or Rs. 15,000/-), be adjusted by debit/credit system (i.e., from Account No. 01 to Account No. 10.), wherever applicable. 4. I also make self-declaration that during my service in previous organizations, there was deduction on full salary/statutory ceiling limit towards PF. The details are as under: Sl. No. Name of the Organization Name of the trust OR concerned PF office Period of Service Previous employment details are attached. From To (Pl. furnish as applicable, else strike off the rest rows) Place: Date: Signature of Employee
  • 3. I, Undertaking by the Employer being the authorized signatory as per Form 5A of M/s. , that above said employee of this establishment with PF A/c. No. & UAN during his/her service, as an employer have deducted his/her EPF on actual salary i.e., more than statutory limit every month during his/her service period in this establishment and remitted the same as per paragraph 38 of the EPFS, 1952 along with administrative charges in compliance of the paragraph 26(6) of the EPFS, 1952 in the member’s account every month. Place: Date: Signature with Office Seal
  • 4. Annexure – 2A ANNEXURE – to indicate every previous organization in which the employee was a member of EPS’95 (separate sheet for each employment) Sl. No. Particulars Details 1 Employee Name 2 Establishment Name 3 Establishment Address 4 Establishment ID / Establishment PF Code 5 PF Account is held by: (Name of EPF Office / PF Trust) 6 EPF Member ID 7 EPS No. 6 Date of Joining 7 Date of Exit 9 UAN, if any 10 PF deducted on actual salary / statutory ceiling limit I hereby certify that the above details provided by me are correct and to the best of my knowledge. Signature of the employee Name: Date: Place: