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ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]

( Tracking ID: 10057109216905001 )


Claim Date : 08/04/2019
EMPLOYEES' PROVIDENT FUND SCHEME, 1952
(PARA 57)

(This form has been printed on the basis of Online Transfer Claim Form filled up by the member under Unified Portal for submission to the
employer.)

To,
The Regional P.F. Commissioner,
HYDERABAD,
Bhavishyanidhi Bhawan, No. 3-4-763, Barkatpura Chaman, Hyderabad

Sir,
I request that my Provident Fund balance along with my Pension Service Details may please be transferred to my present
account under intimation to me. My details are as under :

PART A : PERSONAL INFORMATION

1. Name : BASAM VENKATA RAMI REDDY

2. Mobile Number : 9966439100

3. E-mail id : rami222cgl@gmail.com

4. Bank Account Number : 32573386460

5. Bank IFSC : SBIN0002770

PART B : DETAILS OF PREVIOUS PF ACCOUNTS (WHICH IS TO BE TRANSFERRED)

1. PF Account No. (with EPFO office) : APHYD00564360000003794

2. Name of the Establishment : BROADRIDGE FINANCIAL SOLUTIONS(INDIA)PVT LTD

3. Address of the Establishment : SURVEY NO.64, HI-TECH CITY, SERILINGAMPALLY MANDAL ADJACENT
TO CYBER TOWERS, 617
4. PF A/C No. held by : HYDERABAD

5. Name of the Trust : NOT APPLICABLE

6. PF A/C No. in Trust : NOT APPLICABLE

7. Bank A/C No. of Trust : NOT APPLICABLE


8. IFS Code of the Bank Branch of
Trust where account is maintained : NOT APPLICABLE

9. Member's Name : BASAM VENKATA RAMI REDDY

10. Date of Birth : 04/06/1992

11. Father's/Spouse Name : B RAMIREDDY

12. Relationship : FATHER

13. Date of joining : 27/07/2015

14. Date of leaving : 29/07/2016


PART C : DETAILS OF PRESENT PF ACCOUNT

1. PF Account No. (with EPFO office) : APHYD00565800000005374

2. Name of the Establishment : FRANKLIN TEMPLETON INTERNATIONAL SERVICES(INDIA)PVT LTD

3. Address of the Establishment : PNO:18-23,FINANCIAL DISTRICT NANAKRAMGUDA HYDERABAD 617

4. PF A/C No. held by : RO HYDERABAD

5. Name of the Trust : NOT APPLICABLE

6. PF A/C No. in Trust : NOT APPLICABLE

7. Bank A/C No. of Trust : NOT APPLICABLE


8. IFS Code of the Bank Branch of
Trust where account is maintained : NOT APPLICABLE

9. Member's Name : BASAM VENKATA RAMI REDDY

10. Date of Birth : 04/06/1992

11. Father's/Spouse Name : B RAMIREDDY

12. Relationship : FATHER

13. Date of joining : 08/08/2016

I, Certify that all the information given above are true to the best of my knowledge and I have ensured the correctness of
my present and previous account numbers.

Signature of the member

Note : Member should take a printout of this form and a signed copy of the same should be submitted to the Previous
Establishment i.e. BROADRIDGE FINANCIAL SOLUTIONS(INDIA)PVT LTD

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