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Part A: Personal

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ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]

( Tracking ID: 10003673213905003 )


Claim Date : 27/04/2020
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,
BANDRA(MUMBAI-I),
341, Bhavishya Nidhi Bhawan Bandra (East), Mumbai

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

1. Name : CHETAN SEKHRI

2. Mobile Number : 7018055279

3. E-mail id : csekhri2@gmail.com

4. Bank Account Number : 50100070192066

5. Bank IFSC : HDFC0000387

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

1. PF Account No. (with EPFO : MHBAN00496110000036067

2. Name of the Establishment : HDB FINANCIAL SERVICES LIMITED

3. Address of the Establishment : PROCESS HOUSE, 2ND FLOOR KAMLA MILL S CPMPOUND SENAPATI
BAPAT MARG LOWER PAREL 599
4. PF A/C No. held by : BANDRA(MUMBAI-I)

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 : NOT APPLICABLE

9. Member's Name : CHETAN SEKHRI

10. Date of Birth : 18/04/1977

11. Father's/Spouse Name : NARINDER KUMAR

12. Relationship : FATHER

13. Date of joining : 21/05/2015

14. Date of leaving : 31/01/2017


PART C : DETAILS OF PRESENT PF

1. PF Account No. (with EPFO : DSNHP09405990000012682

2. Name of the Establishment : ANDROMEDA SALES & DISTRIBUTION PVT LTD

3. Address of the Establishment : B-52 3RD FLOOR, KALKAJI, NEW DELHI 190

4. PF A/C No. held by : RO DELHI (SOUTH)

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 : NOT APPLICABLE

9. Member's Name : CHETAN SEKHRI

10. Date of Birth : 18/04/1977

11. Father's/Spouse Name : NARINDER KUMAR

12. Relationship : FATHER

13. Date of joining : 01/09/2018

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. HDB FINANCIAL SERVICES LIMITED

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