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The Employees Provident Fund (EPF) form is an essential document for individuals seeking to manage their retirement savings within the framework established by the Employees' Provident Fund Scheme of 1952. This comprehensive form captures several key pieces of information critical for processing provident fund claims. For instance, the individual is required to provide their name and father's or husband’s name, depending on their marital status. Details about the factory or establishment where the individual was employed must also be included, alongside the account number linked to the EPF. The form asks for the date of leaving service and the reason behind it, ensuring that the processing authority has clarity on the context of the withdrawal. Moreover, a full postal address is essential for communication purposes. A section of the form addresses how the member prefers to receive their funds, offering options like a postal money order or an account payee cheque. The members may even need to provide a declaration of non-employment if they have recently left their job. It is noteworthy that verification by the employer is also a crucial part of the process, confirming that contributed amounts have been remitted as per regulations. Lastly, the form includes a receipt section once the fund has been successfully processed, serving as a record for both the member and the provident fund office. By understanding the intricacies of this form, individuals can navigate the EPF claiming process more effectively, ensuring they receive the benefits intended for their retirement planning.

Form Sample

Regn. No....................................

Employees' Provident Fund Scheme, 1952

Form-19

(Refer to instruction)

1.Name of the members in Block Letters.

2.Father's Name or (husband's Name in the case of married woman)

3.Name & Address of the Factory/Establishment in which the member was employed.

4. Account No.:…………………….DL.

/

5.Date of leaving service

6.Reason for leaving service

7.

Full Postal Address (in Block Address)

Shri/Smt./Kum

 

 

...................................................

 

 

 

S/O/W/O/D/O

 

 

....................................................

 

 

 

Pin :

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8.

Mode of remittance

Put a tick ( Ö ) in the box against the one opted

 

 

 

 

 

 

 

 

 

 

 

(a)By Postal Money Order at my cost.

(b)By account payee cheque sent Direct for credit to my S.B. A/c (Scheduled Bank/P.O.) Under intimation to me.

(

)

To the address given against item No. 7

(

)

S.B. Account No

 

 

Name of the Branch

 

 

Branch

 

 

Full address of the branch

(Advance Stamped Receipt furnished)

Certified that the particulars are true to the best of my knowledge.

Date of joining of Establishment.........................................................................

Date of Birth ......................................................................................................

Contribution for the Current Financial Year.

 

 

 

 

 

 

Period of

 

 

 

 

 

 

Period of break

 

Month

 

Contribution

break if any

 

Month

 

Contribution

 

if any

 

 

Employee

Employers

Total

 

 

 

Employee

Employers

 

Total

Month

Wages

 

 

 

 

 

 

 

Month

Wages

 

 

 

 

 

 

 

 

 

EPF

FP

EPF

FP

EPF

 

FP

 

 

EPF

FP

EPF

FP

EPF

 

FP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

( information to be furnished by the Employer if the Claim Form is Attested by the Employer)

Certified that the above contributions have been included in the regular monthly remittances.

The Applicant has signed/Thumb impressed before me.

............ .....................................................

Signature of Left/Right hand thumb impression of the member

Date......................................

Designation & Seal

Encl.

Declaration of non-employment

Note:- In the case of submission of application for settlement under clause (s) of sub-paragraph (i) and in clause (b) of sub-paragraph (2) of paragraph 69 of the EPF Scheme, 1952, the claim should be submitted after two months from the date of leaving service provided the member continues to remain unemployed in an establishment to which the Act applies.

Date

Signature or Left / Right hand thumb impression of the member

 

 

ADVANCE STAMPED RECEIPT (To be furnished only in case of 8 (b) above)

Received a sum of Rs. ....................(Rupees .......................................................... .......................... from

Regional Provident Fund Commissioner / Officer-in-Charge of Sub-Accounts Office ..........................................

by deposit in my Savings Bank account towards the settlement of my Provident Fund Account.

The space should be left blank which shall be filled in by Regional Provident Fund Commissioner/Officer in-Charge of S.A.O.

Affix 1/- Rupee

Revenue

Stamp

Signature orLeft / Right hand thumb impression of the member

(For the use of Commissioner's Office)

A/C Settled in part/Full Entered in F. 21-A/24/219 & withdrawal register.

 

Clerk

Section Supervisor

P.I.No.-------------------------------------------------------------------------

M.O./Cheque ----------------------------------

Account No. -----------------------------

Section

------------------------ passed for payment for Rs.-------------------

¼in words)-------------------------------------------------------------------------------------------------------------------------------

M.O. Commission (if any) AOC/APFC-----------------------------------

Net Amount to be paid by M.0……………………………Date………………..

 

(For use in Cash Section)

 

Paid by inclusion in Cheque No

............................

date

vide Cash Book (Bank) Account No.3 Debit Item No

HC

 

AC / RC

 

 

 

 

Remarks

 

Document Specifications

Fact Name Details
Form Type Employees' Provident Fund Scheme, 1952 - Form-19
Governing Law The EPF Scheme, 1952 governs this form.
Member Identification Requires the member's name in block letters.
Parent’s Information Includes father’s name or husband’s name for married women.
Employer Details Requires name and address of the employed factory or establishment.
Date of Leaving Must specify the date the member left service.
Remittance Mode Options include postal money order or account payee cheque.
Contribution Reporting Details on contributions for the current financial year must be provided.
Certification The form requires certification by the employer regarding contributions.

Steps to Filling Out Employees Provident Fund

Filling out the Employees Provident Fund form is an important step in accessing your funds. Ensure all your details are accurate and complete. Here are the steps to fill out the form correctly.

  1. Write your name in block letters in the space provided.
  2. In the next section, enter your father's name or your husband's name if you are a married woman.
  3. Provide the name and address of the factory or establishment where you were employed.
  4. Fill in your account number in the designated area.
  5. Indicate the date you left the service.
  6. State the reason for leaving the service.
  7. Complete your full postal address using block letters.
  8. Select your preferred mode of remittance by ticking the appropriate box:
    • By Postal Money Order at my cost.
    • By account payee cheque sent Direct for credit to my S.B. A/c.
  9. If applicable, fill in your bank account details for the cheque transfer, including the branch name and full address.
  10. Sign and date the form to certify that the information provided is true.
  11. If necessary, provide the contributions for the current financial year as specified.
  12. Obtain a signature from your employer or leave a thumb impression in the specified section.
  13. Complete the declaration of non-employment if applicable.

After you fill out the form, double-check all entries for accuracy. Ensure the employer’s section is signed if required. Once confirmed, submit it to the relevant authority for processing.

More About Employees Provident Fund

What is the Employees' Provident Fund form and who needs it?

The Employees' Provident Fund form is a crucial document for employees seeking to withdraw their provident fund savings after leaving their employment. This form must be completed by individuals who have been part of the Employees' Provident Fund Scheme, 1952 and have either terminated their employment or have become unemployed for an extended period.

What information is required on the form?

Essential details include the member's name, father's name (or husband’s name for married women), and the name and address of the establishment where employed. Additionally, you will need to provide your account number, the date of leaving service, reason for leaving, and your full postal address. The form also asks for information regarding your contributions for the current financial year.

How should I fill in the mode of remittance section?

For the mode of remittance, you must indicate your preferred option by placing a tick in the appropriate box. You can choose to receive your payment via Postal Money Order or by account payee cheque. If opting for a cheque, provide your Savings Bank account details along with the bank branch information.

What do I do if I am currently unemployed?

If you are unemployed, it is important to submit your application for settlement at least two months after leaving your job. The claim can only be processed if you maintain a continuous period of unemployment, in accordance with the provisions of the Employees' Provident Fund Scheme.

Is there an attestation required for the form?

Yes, the form requires attestation by the employer if the claim is to be processed under certain clauses. Your employer must certify that the contributions listed have been submitted regularly. This attestation serves to validate your employment details and contribution history.

What happens if I submit incorrect information?

Submitting incorrect information can delay the processing of your claim. To avoid complications, ensure all provided details are accurate and current. Inaccuracies may lead to your application being rejected or necessitate additional verification steps.

Can I track the status of my application?

Most offices provide a mechanism for tracking the status of your Provident Fund application. After submission, you may contact the relevant office or use their official website to get up-to-date information about your claim’s progress.

How long does it typically take to process the form?

Processing times can vary, but typically it takes a few weeks for claims to be processed and funds to be disbursed. Factors affecting the timeline include the completeness and accuracy of the application and overall processing load at the Provident Fund office.

What should I do if I encounter issues during the process?

If you face any issues, contact the regional Provident Fund office directly. They can provide guidance and assistance. It may also be helpful to consult with your former employer for additional support in resolving any discrepancies or problems.

Is there a specific deadline for submitting the form?

While there is no strict submission deadline, submitting your form as soon as possible after leaving employment is advisable. Remember that certain conditions apply regarding the timeline for those who remain unemployed, which can affect your eligibility for claiming benefits.

Common mistakes

  1. Neglecting to use block letters for the name: Many people forget to write their name and other details in block letters, which can lead to misunderstandings or errors in processing. Be clear and legible.

  2. Incorrectly filling in the father’s or husband’s name: Ensure that the correct name is provided based on your status. Mistakes here can cause delays or complications.

  3. Failing to include the correct address of the establishment: It's crucial to write the full and accurate address where you were employed. An incomplete or incorrect address could lead to issues with your application.

  4. Omitting the account number: This number is essential for processing your request. Check thoroughly to make sure you’ve included it.

  5. Not providing a reason for leaving service: A clear reason must be given for your departure. Lack of this information might hold up the process.

  6. Overlooking the mode of remittance: Remember to tick the appropriate box for how you want your funds sent to you. Failing to do so can lead to confusion and delays in receiving your money.

Documents used along the form

The Employees Provident Fund form is essential for employees seeking to access their retirement savings. Several accompanying documents are often required to complete the process effectively. Below is a list of frequently used forms and documents that support the submission of the Employees Provident Fund form.

  • Identity Proof: This document verifies the identity of the employee, typically in the form of a government-issued ID such as a driver's license or passport. It is crucial in confirming that the individual submitting the claim is indeed the rightful beneficiary.
  • Address Proof: Address verification documents help to establish the current residential address of the employee. Examples include utility bills or lease agreements, which provide a reliable confirmation of where the individual resides.
  • Bank Account Statement: This document is often required to confirm the details of the bank account into which the provident fund amount will be deposited. It should clearly display the account number, holder's name, and address associated with the account.
  • Employer's Certificate: A certificate from the employer may be necessary to validate the employment duration and other details. It serves as a confirmation that the employee was indeed part of the organization and that all contributions were made according to the regulations.
  • Declaration of Non-Employment: This form states that the individual has not been employed since leaving the previous job. It is often used to ensure that the claim for provident fund settlement is being filed correctly, especially if there is a waiting period to access the funds.

Gathering these documents when applying for the Employees Provident Fund is crucial for a seamless process. It is advisable to have all necessary files organized and ready for submission to avoid delays in access to funds intended for retirement support.

Similar forms

The Certificate of Eligibility form serves a function similar to the Employees Provident Fund (EPF) form. Both documents verify employment history and relevant contributions. The Certificate of Eligibility collects personal information and employment details, including the dates of employment and the reasons for leaving. By requiring the same level of transparency and authenticity, this form ensures that individuals can access their benefits just like the EPF form does for provident fund claims.

The Pension Claim Form is another document that's comparable to the EPF form. Both papers require detailed information about the member and their employment, including a declaration of non-employment if necessary. Just like the EPF form, the Pension Claim Form allows individuals to list their contributions and provides a method of remittance. The goal is similar: to ensure that members can claim their retirement benefits once they meet specific conditions.

The Social Security Administration (SSA) form shares similarities with the EPF form in that it seeks to gather detailed personal and employment information from individuals who wish to claim social security benefits. Both documents focus on accuracy in reporting past employment, with specific sections that require complete transparency regarding earnings and periods of employment. This helps facilitate timely benefit approvals for individuals navigating the bureaucracy of government programs.

The Unemployment Benefits Application form aligns closely with the EPF form regarding its purpose. Individuals seeking to claim unemployment benefits must provide similar employment history and reason for leave sections. Both documents also include a verification process, where employers may be called upon to confirm details. This structure ensures that only qualifying individuals receive benefits based on their work history.

The State Disability Insurance (SDI) claim form is akin to the EPF form as it collects information about employment history and contributions. Just as the EPF form does, the SDI claim form requires applicants to document their earnings and period of employment. This ensures that applicants are eligible for received benefits and can substantiate their claims should any questions arise.

The Workers' Compensation Claim form is another similar document. Both forms require detailed employment information and justification for requesting funds. While the EPF form is centered around retirement savings, the Workers' Compensation Claim form focuses on claims resulting from work-related injuries. Each document invokes an obligation for the employee to provide thorough and accurate information to support their claims.

The Tax Form W-2 represents another relevant comparison to the EPF form. While the W-2 form focuses on income reporting for tax purposes, both require accurate documentation of earnings and employment status. Each serves as a verification tool that helps ensure individuals receive the benefits they are entitled to. Thus, while different in aims, they still reflect an essential component of employment-related documentation.

The End of Service Benefit form shares important structural similarities with the EPF form, as both require the member's basic personal and employment information. Each form's goal is to facilitate financial transactions related to employment cessation, gathering data about service length and reason for leaving, thus establishing the necessary context for any financial claims. This similarity underscores the importance of gathering accurate data for the smooth processing of claims.

Finally, the Release of Claims form is another document that echoes the framework of the EPF form. Both documents require a member to confirm their personal information and the reasons for withdrawing from benefits or claims. By emphasizing transparency in the withdrawal process, both forms aim to reduce potential disputes and ensure that the parties involved understand their rights and obligations.

Dos and Don'ts

10 Things You Should Do:

  • Fill out your name in Block Letters clearly.
  • Provide your father's name or husband's name if you are married.
  • Include the full name and address of the factory or establishment where you worked.
  • Double-check your account number for accuracy.
  • Clearly state the date you left your job.
  • Provide your full postal address.
  • Tick the appropriate option for how you want your money remitted.
  • Ensure that your details are true and correctly stated.
  • Sign in the designated area to certify your information.
  • Keep a copy of the completed form for your records.

10 Things You Shouldn't Do:

  • Don't use abbreviations or informal language.
  • Do not forget to tick one of the remittance options.
  • Never leave any fields blank; fill in all required information.
  • Don't provide an incorrect or outdated address.
  • Avoid using pencil; always use a pen for clarity.
  • Do not sign without verifying all your details.
  • Don't submit the form if you are still employed.
  • Never rush through the form; take your time to ensure accuracy.
  • Don't forget to provide any necessary supporting documents.
  • Do not ignore any instructions provided in the form.

Misconceptions

  • Misconception: The Employees Provident Fund form is only for employees who have resigned.
  • This is not accurate. The form can be used by any employee who is leaving employment, whether through resignation, retirement, or termination. It facilitates the withdrawal of the provident fund contributions regardless of the reason for leaving.

  • Misconception: Once I submit the form, I will receive my funds immediately.
  • It is important to understand that processing can take time. The processing speed varies based on the local office’s workload and the completeness of the application submitted. Expect a waiting period, typically a few weeks.

  • Misconception: I don’t need to provide my employer with any information when filling out the form.
  • This is incorrect. Some sections of the form require verification and information from your employer. Their confirmation of contributions is crucial for the claim process.

  • Misconception: I can use any bank account for the remittance of my funds.
  • This is misleading. The form specifically requires you to provide details of your savings bank account where the funds will be credited. Ensure the account is active and in your name.

  • Misconception: I can submit the form anytime after leaving my job.
  • Actually, there are specific timelines to follow. For certain claims, it is advised to submit the form after two months from the date you left the job, especially if you remain unemployed during that time.

  • Misconception: My eligibility for the Provident Fund does not change if I have changed jobs multiple times.
  • This is not the case. Your eligibility for the fund remains intact as long as you have contributed to the scheme during your employment periods, but you must consolidate or transfer your accounts from previous employers to ensure proper claims.

Key takeaways

When filling out and using the Employees Provident Fund (EPF) form, careful attention to detail is essential. Below are some key takeaways to keep in mind:

  • Clear Identification: Always fill in your name in block letters. This ensures that your application is easily readable and processed without errors.
  • Correct Details: Include your father's name or, in the case of married women, your husband's name. Providing correct details helps in verifying your identity.
  • Accurate Employment Information: Specify the name and address of the factory or establishment where you were employed. This helps the authorities link your EPF account with the correct employer.
  • Reason for Leaving: Clearly state your reason for leaving the service. This information can be important for processing your claim.
  • Postal Address: Ensure your full postal address is provided in block letters. This is the address to which any communication or payment will be sent.
  • Choose Your Payment Method: Select how you prefer to receive your funds by marking the appropriate box. Your options may include payment via postal money order or direct bank transfer.
  • Declaration of Non-Employment: If you submit your claim based on being unemployed, do so after two months from your last working day. Confirm this by providing a declaration.

Taking these steps seriously will facilitate a smoother process when dealing with your Provident Fund claims.