SSC
SSC
SSC
Request No.
: 16R032000276
Mobile No.
: 9677739939
Personal E-mail ID : TSASIDHAR@LTFINANCE.COM
Date of Receipt
:
PS No.
: 735944
(APPLICATION FOR WITHDRAWAL OF PROVIDENT FUND ACCUMULATION)
To,
The Board of Trustees,
LARSEN & TOUBRO OFFICERS AND SUPERVISORY STAFF PROVIDENT FUND,
Shared services Centre (Retirement Benefit Section),
4th Floor, Krislon house, Off Saki Vihar Road,
Saki Naka, Andheri (East),
Mumbai 400072
I hereby request you to pay me the amount standing to the credit of my provident fund account.
PS No.
735944
SASIDHAR T.P.
Permanent Address
ANNAMALAI NAGAR
ANNAMALAI NAGAR
KATPADI
KATPADI
VELLORE
VELLORE
TAMILNADU
TAMILNADU
Entity
LTF
Unit
LTF
Location
CHENNAI
Cadre
FL II
Dept. Code
A204470135
Date of Joining
02-APR-2008
PF Membership
Date
02-APR-2008
Date of Leaving
09-FEB-2015
Mode of Payment
NEFT
Bank Details
06941140000703
Bank Name
Bank Branch
VELLORE TAMILNADU
IFSC Code
HDFC0000694
PAN Number*
AWBPS6965R
I certify that the particulars given above are true to the best of my knowledge.
Place:
Date:
(*) In case this information is not properly filled up and necessary enclosures are not attached,
it will not be possible for us to issue the TDS Certificate.
Enclosure(s):
Sr. No.
Description
Place:
Date:
Affix Re. 1
Revenue
Stamp &
Sign
To,
The Board of Trustees,
LARSEN & TOUBRO OFFICERS AND SUPERVISORY STAFF PROVIDENT FUND
Mumbai - 400072
Place :
Date :
I, the applicant above named, do hereby a uthorize the trustees LARSEN & TOUBRO OFFICERS AND
SUPERVISORY STAFF PROVIDENT FUND to deduct and pay on my behalf to the company and/or to the LTKSPM
all such amounts as are due and payable by me to the company and/or to the LTKSPM towards the full and final
settlement of all my accounts with them.
Place :
Date :