Form 31 - Employees' Provident Fund Organisation
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4eks c kby la - @ Mobile Number
ds o y dk;kZ y ; es a iz ; ks x ds fy;s @ For Office use only
nkok la [ ;k@Clam I.D ……………………………
deZ p kjh Hkfo’; fuf/k ;ks t uk] 1952
EMPLOYEES’ PROVIDENT FUND SCHEME, 1952
QkeZ la [ ;k&31/FORM NO-31
fuf/k ls vfxz e gs r q iz k FkZ u k i= /Application for Advance From the Fund
(d` i ;k vuq n s ” k ns [ ks a ) (Refer: INSTRUCTIONS)
vfxz e ys u s dk iz ; ks t u+ + + + + Purpose for which
vis f {kr vfxz e /ku jkf”k Amount of Advance
required ₹………....................................
advance is required
………………………………………
“kCnks a es a In words …………………………
………………………...…………………
1-
lnL; dk uke ¼Li’V v{kjks a es a ½
Name of the member (in block letters)
2-
firk@ifr dk uke ¼fookfgr efgykvks a ds ekeys
es a ½
Father’s/ husband’s Name in the case
of married women
3-
QS D Vª h @LFkkiuk dk uke o irk ftles a lnL;
कार्य र त है
@Name and Address of the
Factory /Establishment in which the
member is employed.
4-
Hkfo’; fuf/k [kkrk la - @Provident Fund
Account No.
5-
ekfld ew y os r u rFkk ea g xkbZ HkÙkk
ew y
+ea g xkbZ HkÙkk
= ;ks x
Monthly Basic Wages & D.A
Basic
+ D.A.
= Total
6-
i= O;ogkj dk iw j k irk
Jh@Jhefr@dq e kjh@Shri/Smt./Kumari.......................
Full postal address (in block letters)
................................................................................
lq i q = @iRuh@lq i q = h@S/o/W/o/D/o...............................
................................................................................
................................................................................
.............................. fiu dks M /Pin No. …………….
lnL; ds gLrk{kj@Signature of applicant
fu;ks D rk ds gLrk{kj@Signature of Employer
Form 31 ( )
Page 1 of 4
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