To, Date : 17/01/2019
The Regional Provident Fund Commissioner,
Employees Provident Fund Organisation,
Regional Office , Noida
Dist- Gautam Budh Nagar ( UP)
Sub : Request for change of Member basic details in r/o …………...
With the reference we state that one of our employee Ms/Mr Tabassum bearing PF A/c No ……… & UAN No-………… want to withdrawal of his/her PF, however, at the time of vetting his/her claim for withdrawal/Pension following inconsistencies are observed.
Details As per PF Office Record As per Aadhar/Claim Form
Member’s Name ………. ……….
Father’s/Husband’s name ……… …………
Date of Birth ………….. ……………..
The reason for the above variation may be attributable to oversight/clerical mistake/typographic error on our part. In support of our statement, certified copies of wage register, containing member’s signature/Photo ID proof issued by Employer/any other document containing member’s signature is attached.
Beside, any of the following ID Proofs (as applicable) of the member are also enclosed in support of our statement (PAN card, Voter Identity card, Passport, Driving Licence, ESIC Card, Aadhar Card, Bank Pass book, Cancelled Cheque, Ration Card, any School/Education related certificate, Certificate issued by Registrar of Birth & Death, Copy Electricity/Water/Telephone Bill in the name of the Claiment, Letter from Recognized Public Servant verifying the identity and Residence of the member).
We, therefore request your good office to rectify the member’s name and/or father’s/husband’s name and/or Date of Birth of the member in your record and process the PF withdrawal / Pension request.
We, understand that this fact could and should have been brought to take notice of PF Office during the currency of the membership, however due to lack of awareness amongst the members, it was not brought to our notice, resultantly not permitting us to bring it to the notice of PF Office in time.
Whatever is stated herein above is true to the best of our knowledge. We also understand that making a false statement/representation amounts to violation of provisions of the EPF Act and attracts prosecution and other legal cases of fraud.
I/We further indemnify PF office that if the PF Withdrawal/ Pension benefit is processed in favor of any wrong person due to above rectification, I/We undertake to remit entire amount of Withdrawal/Pension with Penal interest and Damages as applicable thereon.
(Employer Signature with Stamp) ( Member’s Sigantue)