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Form 5 & 10

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					THE EMPLOYEE’S PROVIDENT FUND SCHEME, 1952 [ PARAGRAPH 36 (2) (A) ] AND THE EMPLOYEE’S PENSION SCHEME, 1995 [ Para 20 (4) ]
the month of_____________________ (To be sent to the Commissioner with Form No. 2 (EPF & FPS)

Gr. No. XVII

Form - 5

Return of employee’s qualifying for membership of Employee’s Provident fund, Employees Pension Fund and Employees’ Deposit Linked Insurance Fund for the first time during

Name and address of the Factory / Establishment: Aneesh Engineeers, 3, Aman Park Society, Nr. St. Xavier’s School, Kalol (N.G.) – 382721 Code No. GJ/AH/25014 Sr. No. Account No. Name of the Employee (In Block Capitals) Father’s name (or husband’s name in the case of married woman) 4 Date of Birth Sex Date Joining the Fund Total period of previous service as on the date of joining the Fund (Enclose Scheme certificate if applicable) 8 Remarks

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Signature of Employer or other authorized officer of the Factory / Estt. For Aneesh Engineeers

Date______________________

Proprietor

THE EMPLOYEE’S PROVIDENT FUND SCHEME, 1952 [ PARAGRAPH 36 (2) (a) & (b) ] AND THE EMPLOYEE’S PENSION SCHEME, 1995 [ Para 20 (2) ]
Return of members leaving Service during the month of _________________________ (To be sent to the Commissioner with form No. 2 (EPF & FPS)

Gr. No. XVII

Form - 10

Name and address of the Factory / Establishment: Aneesh Engineeers, 3, Aman Park Society, Nr. St. Xavier’s School, Kalol (N.G.) – 382721 Code No.: GJ/AH/25014 Sr. Account No. Name of the Member Father’s name (or husband’s name in the Date of Leaving Reason for Remarks No. (In Block Capitals) case of married woman) Service Leaving Service * 1 2 3 4 5 6 7

Signature of Employer or other authorized officer For Aneesh Engineeers

Date______________________ 

Proprietor

Please state whether the member is (a) retiring according to para (69) (1) (a) or (b) of the Scheme. (b) leaving India for permanent settlement abroad (c) retrenchment (d) Pt. & total disablement due to employment injury (e) discharged (f) resigning from or leaving service (g) taking up employment elsewhere (The name and address or the Employers should be stated.) (h) death (i) attained the age of 58 years. Certified that the member mentioned at Serial No._____________ Shri_________________________________________________________ Was paid/not paid retrenchment Compensation of Rs. ____________ under the Industrial dispute Act, 1947 Signature of the Employer


				
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Description: Form 5 & 10 for Provident Fund