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Part A: Personal

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ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]

( Tracking ID: 10053573162405002 )


Claim Date : 27/12/2022
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,
MALAD (KANDIVALI),
Bhavishya Nidhi Bhavan,Plot No.222, Sector No.3,Charkop Market, Kandivali (West)

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 : KRANTI KUMAR

2. Mobile Number : 8459035767

3. E-mail id : kranti.kumar15aug@gmail.com

4. Bank Account Number : 4172000100194713

5. Bank IFSC : PUNB0417200

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

1. PF Account No. (with EPFO : KDMAL00931180000062658

2. Name of the Establishment : INTEGRATED PERSONNEL SERVICES LTD

3. Address of the Establishment : SHOP NO 14, WHISPERING PALMS SHOPPING CENTRE, LOKHANDWALA
TOWNSH IP AKURLI ROAD KANDIVALI EAST 598
4. PF A/C No. held by : MALAD (KANDIVALI)

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 : KRANTI KUMAR

10. Date of Birth : 21/11/1986

11. Father's/Spouse Name : RAMESH KUMAR SINGH

12. Relationship : FATHER

13. Date of joining : 01/04/2019

14. Date of leaving : 24/01/2022


PART C : DETAILS OF PRESENT PF

1. PF Account No. (with EPFO : BGBNG00446690000012770

2. Name of the Establishment : VEN CONSULTING INDIA PVT LTD

3. Address of the Establishment : #100/1-1, SURAJ MANOR, I FLOOR BULL TEMPLE ROAD BASAVANAGUDI
656
4. PF A/C No. held by : RO BANGALORE

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 : KRANTI KUMAR

10. Date of Birth : 21/11/1986

11. Father's/Spouse Name : RAMESH KUMAR SINGH

12. Relationship : FATHER

13. Date of joining : 03/10/2022

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 Present
Establishment i.e. VEN CONSULTING INDIA PVT LTD

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