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Form of Application For Final Payment of General Provident Fund Balance
Form of Application For Final Payment of General Provident Fund Balance
7. i) Date of Retirement :
or
ii) Date of resignation
or
iii) Date of voluntary Retirement
or
iv) Date of dismissal/removal/Compulsory retirement/invalidation
2.
18. Certified that no amount was withdrawn/the following amounts were withdrawn from
his/her provident fund account during the 12 months immediately preceding the date of
his/her quitting service/proceeding on leave preparatory to retirement or there-after
for payment of insurance premia or for the purchase of a new policy
1. Policy No. and Name of Insurance Company
2. Sum Assured
3. Particulars of Premia paid form G.P.F.
Yours faithfully,
Station: SIGNATURE
With date and Designation
Date : Official Mobile /Phone No.
DDO ID:
ANNEXURE
TRANSFER OF BALANCE:
I. Date of absorption :
II. is absorption on permanent basis :
III. is absorption without breaks in service :
IV. in case of break in service whether it is limited to
joining time allowed on transfer :
V. Is the absorption with the approval of State :
Government
VI. Accounts Officer to whom the balance as to :
be transferred and the new G.P.F. Account
No. allotted by him
FW APPLICATION INSTRUCTIONS