Reason for leaving (should be same as in form 10C.

PF WITHDRAWL FORM 19-PROCESS CHART

Employee/Candidate Full Name

Father’s Name/Husband Name (Full)

Leave Blank/Manpower registered office (Delhi-Connaught Place)

PF Account No: DL/24754/______

LWD as per mail from Client

Employee Code & Mobile No

Employee Residential Address

Employee Name

Employee’s Father/Husband Name

Bank A/c No given on the cheque leaf

Full address of the bank as given on the cheque leaf along with other details required on the form (IFSC Code mandatory)

Employee date of birth.

Format to be followed: DD/MM/YYYY

Actual Date of joining the client.

Format to be followed: DD/MM/YYYY

Employee Signature Note: Signature should match with the bank cheque

Employee Signature Note: Signature should match with the bank cheque

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PF WITHDRAWL FORM 10C-PROCESS CHART

Employee Signature Note: Signature should match with the bank cheque. Revenue stamp to be attached should be cross-signed across the box/revenue stamp.

Employee Code & Mobile No

Employee/Candidate Full Name

Employee/Candidate Full Name

Employee date of birth. Format to be followed: DD/MM/YY

Employee/Candidate husband Name (Optional)

Leave Blank/Manpower registered office (Delhi)

Reason and date for leaving (should be same as in form 19)

Pf A/c No-DL/24754

Employee/Candidate Residential Address

Tick this box (No)

Nominee(s) details to be given

Employee PF A/c No

Tick This Box

Fill “No”

Bank A/c No as given on the cheque

Full address of the bank as given on the cheque leaf along with other details required on the form. (IFSC Code mandatory)

Employee Signature Note: Signature should match with the bank cheque and those made in form 19

Employee Signature Note: Signature should match with the bank cheque and those made in form 19 and cheque

Employee Signature Note: Signature should match with the bank cheque and other signatures. Revenue stamp to be attached should be cross-signed across the box/revenue stamp. (Refer to pt 4)

I M P O R T A N T:-

1. All the forms are to be filled neatly without any overwriting

2. The cancel Bank cheque leaf to be attached with the forms should have the following important details clearly

visible:-

Bank account No

IFSC Code

Full address of the bank

Employee/Candidate signature(The signature should be the same as those done in the forms given above)

3. In case employee is submitting bank statement/bank passbook (1st page)-all pages are to be signed by the

employee/candidate.

4. The address given in the cheque should be filled same as it is on the forms when filling up bank details.

5. Revenue stamps are to be fixed where required and then cross-signed.

6. Please make sure that your full & final settlement (F & F) from Manpower is done.

7. All cuttings should be attested by employee/employer

8. In case of female members (Married case only), they should attach with claim form a letter certifying that after

marriage her name changed and using husband name instead of father’s name.

9. Documents like PAN Card, Photograph, Driving License, Passport etc should not be attached along with the form.

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