This is venkat from Bangalore. I have received the Form 10 C from my previous employer. They have asked me to submit the same to Employee Provident Fund Organisation (EPFO), Bangalore.
They asked me to submit the Form 10C along with the affidavit in a non-judicial stamp paper. I'm not familiar of this affidavit.
Can anyone help me on the following queries.
1) Sample affidavit format to submit Form 10C.
2) Procedure to file the Form10C to EPFO.
Thanks in advance for your help.

From India, Bangalore
Dear Venkat,
Affidavit to this effect is only required when there is a gap of more than 2 years, it is very simple declaring your personal information (name, father's name, address), then details of your previous employer(employer name, address and pf no.) then state that have nither applied nor withdrawn this pension amount earlier. If any information found false later on , you will be sole responsibilble.
Procedure to deposit is again simple, just go to EPFO and deposit.

From India, Delhi
Thanks Naresh for your quick reply.

The Form 10C is more than 2 years old. Hence i have to submit the affidavit for this.

I have few more queries on some part of the affidavit.

"I state that i have left the serivce on ..date of releiving......... on ..personal... grounds. But, I had not preferred the claim application for sanction of EPF and other benefits earlier on account of ......................" (Reason for non-submission to be mentioned here).

I was a contract employee and got permanent role in my company. The pension is for the contract period. Since i got Form 10C after two years, i have to state the reason for non-submission here. Please help me on this.

At the end of bond, there are two solvent sureties sign is needed in front of metropolitan magistrate. Should i have to get the signature from the sureties or it will be taken care by EPFO office.

Here is the statement at the end:
We, the below mentioned, do hereby undertake to indemnity the central board of trustees, EPFO in the case of need of terms of this Bond and bind ourselves severally and jointly liable to indemnify, the said CBT.

Thanks in advance for your answers Naresh.

From India, Bangalore
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