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Form 9

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Applicant ID : 1982075

FORM 9
THE EMPLOYEES' PROVIDENT FUNDS SCHEME, 1952 (Paragraph 34)
AND
THE EMPLOYEES' PENSION SCHEME, 1995 (Paragraph 24)
Declaration by a person taking up employment in an establishment in which the Employees
'Provident Funds & Employees' Pension Scheme enforce

I, Gullipalli Tharunsai Teja son of Durgaprasad G Do hereby solemnly declare that :-

a) I was employed with Capgemini India Pvt Ltd with PF A/c Number MH/BAN/0018734000/050/4484 and left service on 13/02/2023 prior to that, I was employed with
MindTree Ltd with PF A/c Number BG/MRD/0024470000/011/4204 from 15/01/2021 to 29/06/2021

b) I am a member of the pension fund from 11/08/2016 to 13/02/2023

c) I have not withdrawn the amount of my Provident Fund

d) I have not withdrawn the amount of my Pension Fund

e) I have not drawn any benefits under the Employees Pension Scheme, 1995 in respect of my past service in any establishment.

f) I have contributed to the Social Security programme in NA from NA to NA.

Do you have UAN : Yes

Universal Account
Aadhaar Enrolment Number NPR PAN
Number(UAN)

100765290307 950789842380 NA NA BWMPG2822B

Bank Account Number Linked with UAN : Link UAN with TCS salary Account

Bank Account Number IFSC Code

NA NA

Date :

Signature of the Employee

_______________________________________________________________________________________________________________________________________________

(To be filled by the Employer)

1) Shri/Smt/Kumari Gullipalli Tharunsai Teja is appointed as in Tata Consultancy Services Limited with effect from bearing Provident
Fund Number: MH/BAN/48475/

2) Copy of Scheme Certificate enclose.

3) Declaration & Nomination in Form 2 is enclosed.

Tata Consultancy Services Limited


11th Floor, Air India Building,Nariman Point,
Mumbai-400 021

TCS Confidential

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