HRC/Payroll/Forms/07/Version 0.

FORM NO. 13 (REVISED)

The Employees Provident Funds Scheme, 1952 Para (57)

Application for Transfer of EPF Accounts
NOTE : (i) To be submitted by the member to the present employer for onward transmission to the Commissioner, EPF by whom the transfer to be effected. (ii) In case the PF transfer is due from the P.F. Trust of an exempted establishment the application should be sent directly by the employer to the P.F. Trust of the exempted establishment with a copy RPFC concerned for details of the Employees Pension membership. To, The Commissioner, Employees Provident Fund, __________________ To, M/s______________________________ ______________________________ ______________________________ To be filled in if note (ii) above is not applicable Sir, I request that my Provident Fund balance along with the Membership details in Employees Pension Funds may please be transferred to my present account under intimation to me. Necessary particulars are furnished below: 1. Name 2. Fathers Name/Husbands name in case of married women 3. Name & Address of previous Employer :_________________________________ :_________________________________ _________________________________ _________________________________ _________________________________ 4. EPF account number with the previous employer 5. By whom the PF account of the previous establishment is kept :_________________________________ :_________________________________

:RPFC at_________________________ Name of the P.F. Trust_______________ _________________________________

6. Pension Fund Account Number with the previous employer (if allotted as Separate one) 7. Date of leaving service with previous employer 8. Date of joining the present employer :_________________________________ :_________________________________ : ________________________________

Date : ____________

X Signature or *left/right hand thumb Impression of the member

HRC/Payroll/Forms/07/Version 0.1

To be filled in by the present employer 9. Name and Address of the Establishment : ABB Limited, Maneja, Vadodara-390 013, Gujarat. 10. EPF Code & Account No. allotted to the member 11. Pension Fund Account No. allotted to the member separately, if any 12. By whom the EPF Account of the member in the present Establishment is maintained : GJ/1854/_________________________ :GJ/1854/________________________

:Being an Exempted Establishment______ ABB India Employees Provident Fund -__ Trust, Maneja, Vadodara 390 013, Gujarat.

13. By whom the Pension Fund A/c of the member in the present establishment is maintained

:RPFC, Bhavishyanidhi_Bhawan, Akota,__ Vadodara-390 020, Gujarat._____________

14. In whose favour cheque is to be drawn, i.e. payee PF Trust Bank A/c Details: Name Bank & Branch Name Account Number IFSC/NEFT Code

: ABB India Employees Provident Fund__ Trust, Payable at Vadodara_____________

: : : :

ABB India Employees Provident Fund Trust ICICI Bank Limited, Vadodara-390007 000301024592 ICIC0000003

Date: ____________ Signature of Employer / Authorized Official with Office Seal For the use in PF Office Only A Sum of Rs.________________(Rupees in words__________________________________ _____________________________) is authorized for transfer vide Annexure, K (Revised). Transfer proceeds to be sent along with Annexure K (Revised). Membership details under Pension fund forwarded to PF Regional Office / Sub-Regional Office at ____________________________________________________________________ Transfer intimation copy of Annexure K (Revised) to the member placed below: P.I. No. Scroll No. Clerk Section Supervisor A.A.O. A.P.F.C.

Paid by Cheque No. _________________dated_________________

Cashier/Clerk

Section Supervisor

A.A.O.

A.P.F.C.