INDIAN ALUMINIUM COMPANY, LIMITED JUNIOR EMPLOYEES’ PROVIDENT FUND

1 P.C. SEN SARANI, KOLKATA 700 071

Date:

The Board of Trustees

M/s Indian Aluminium Company, Limited

Junior Employees’ Provident Fund

1 P. C. Sen Sarani

Kolkata 700 071

Re: Provident Fund Account No.

Sub: Provident Fund Accumulations

Dear Sir:

This is to inform you that I/Mr……………………………..……………..had resigned/retired/separated from the services of the Company on and would now request you to settle my/his provident fund accumulations with your esteemed fund for the reason as ticked below:.

(a)On account of the death of Mr/Ms. …………………….. on …………………………..(copy of death certificate enclosed);

(b)On retirement from service after attaining the age of years;

(c)On retirement on account of permanent and total incapacity for work due to bodily or

mental infirmity duly certified by a registered medical practitioner;

(d)On account of resignation/retirement from service for migrating abroad (copy of visa and passport enclosed);

(e)On account of termination of service owing to mass retrenchment or total invalidation;

(f)On not being employed in any factory or other establishment to which the EPF & MP Act 1952 applies after termination of service for a continuous period of not less than two months immediately preceding the date on making an application for withdrawal;

(g)On account of termination of service under a voluntary scheme of retirement framed by the Company.

(h)As my account with the Fund will be considered an inoperative account in terms of notification number G.S.R. 25(E) dated 15th January, 2011.

Given below are the bank particulars that may be required for settlement of PF accumulations through RTGS/NEFT mode or for issuing an account payee cheque with bank particulars for preventing fraudulent encashment:

Bank Name
Branch Address
Account Number
Type Of Account / Savings/Current
MICR. No
IFSC Code of the Branch of the Bank for doing RTGS/NEFT

I/We also enclose a copy of the bank pass book/statement & a blank cheque or a certificate from the concerned Bank Manager for doing the RTGS/NEFT.

I/We also undertake to provide such documents or proofs as may be required for settlement of my/our claim as per the Rules of the Fund and certify that the reason as cited above is/are true to my/our knowledge.

Thanking you,

Yours truly,

Signature of the member

Name of the member:

Address :

Or

Signature of the nominee/legal heir

Name of the nominee/legal heir:

Address :

(Strike off whichever is not applicable)

Encl.: As stated above

ADVANCE STAMPED RECEIPT

Received a sum of Rs* ………………….(Rupees*………………………………………………………………………….……………..………………………………………………………only) from the Board of Trustees of M/s. Indian Aluminium Company, Limited Junior Employees Provident Fund (‘The Fund’) towards full and final settlement of my Provident Fund accumulations so maintained by the Fund / Provident Fund accumulations of Late…………………………………….………………..with the Fund (strike off whichever is not applicable).

* (To be filled in by the Funds Section) Signature of the member/nominee/legal heir

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