VIEWS: 7 PAGES: 1 POSTED ON: 10/8/2011
Central Provident Fund Board For Official Use Only 79 Robinson Road, CPF Building, Singapore 068897 Serial No. Website: www.cpf.gov.sg CPF Call Centre: 1800-227 1188 FORM 3B CentRal PROvident Fund BOaRd nOtiCe OF RevOCatiOn OF nOMinatiOnS This form may take about 5 minutes to complete (To be completed by member. Please read the instructions carefully before completing the form.) NAME OF CPF MEMBER AS IN NRIC / Passport (IN BLOCK LETTERS) SINGAPORE NRIC NO./CPF A/C NO. S/T I hereby revoke the previous nomination made by me. *Signed by the abovenamed member/The right thumbprint ) of the abovenamed member was affixed ) __________________________________________ ) Signature/right thumbprint of member *(a) in the presence of the 2 witnesses below; ) OR ) DATE _____________________________________ *(b) after the contents have been read over and explained ) to *him / her in the _________________*language / dialect ) Telephone No.: (H) __________________________ by ______________________________________ (Name) ) (O) __________________________ __________________________ (*NRIC/Passport No.) in the (Hp) _________________________ presence of 2 witnesses below. ) Email Address: _____________________________ Note: the 2 witnesses must be at least 21 years old (unless they are employees of the Board) and must not be the member. 1) Name of Witness (in BLOCK letters) ________________ 2) Name of Witness (in BLOCK letters) ________________ ______________________________________________ ______________________________________________ *NRIC (for Singaporeans and Permanent Residents of *NRIC (for Singaporeans and Permanent Residents of Singapore) / ___________________________________ Singapore) / ___________________________________ Passport No. (for foreigners) ______________________ Passport No. (for foreigners) _____________________ Address ______________________________________ Address _____________________________________ _____________________________________________ _____________________________________________ Email Address __________________________________ Email Address _________________________________ Signature of Witness ____________________________ Signature of Witness ___________________________ Telephone No. _________________________________ Telephone No. ________________________________ *Delete as appropriate Revised in April 2009
"Notice of Revocation of Nominations Central Provident Fund Board"