The document is a joint declaration letter from an employee or ex-employee and their employer to the Regional Provident Fund Commissioner regarding corrections to the employee's PF/EPS account details. It provides the employee's UAN and Aadhar numbers and indicates whether their name, father/husband's name, relation, PF/EPS account number, date of birth, date of joining, and date of leaving are correct or wrong according to the employer's records. It also includes a self-attested copy of the employee's ID proof like PAN card or Aadhar card attested by the employer to support any necessary corrections.

1. To, DATE:
The Regional Provident Fund Commissioner
Employees Provident Fund Organization
Regional Office, Delhi South
EPFO Complex, Sec-23, Dwarka
New Delhi – 110 075.
Sub: Joint Declaration by the Member and Employer
Dear Sir/Madam,
I_________________ am /was an Employee/Ex-Employee of M/.s_________________
furnishing below herewith correct details with aforesaid establishment.
UAN: Aadhar:
Particulars Correct Wrong
Name
Father/Husband Name
Relation
PF/EPS ACCCOUNT
NUMBER
Date of Birth
DD/MM/YYYY
Date of Joining
DDMMYYYY
Date of Leaving
DDMMYYYY
Gender (M/F)
The reason for variation in Name/DOB is explained in the employer’s forwarding letter dated___
I am also enclosing herewith self-attested copy of ID Proof (PAN Card/Aadhar card-the same is
approved in KYC). The same is attested by the Employer/EX-employer.
*Aadhar should be approved in KYC for Member Name & DOB Corrections. If for any
reason Aadhar is not seeded, reason for the same should be mentioned in the forwarding letter.
An early action in this regard will be highly appreciated.
Your Faithfully,
Name & Signature of Applicant: Name of authorized Signatory