Employees' Pension Scheme 1995 Form 10-C Page 2

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(i)
On taking up employment in another establishment, his earlier service period will be
carried forward and clubbing both the spells together pension entitlement shall be regulated.
(ii)
If the member does not take up employment and dies before attaining the age of 58
years, his family will get family pension. On his survival, he will get withdrawal benefit with
weight age as may be prescribed.
(iii)
While availing a Scheme Certificate, there is no bar to withdraw the P.F. accumulations
by the member.
GENERAL INSTRUCTIONS
(Sl. No. given below refers to the one given in the application)
Sl. No. 1(a) Write members’s name in Capital letters as given in the service records of your
establishment
(b) To be furnished only when the application is preferred by a person other than the
member himself (i.e. Nominee/ family member).
Sl No 2: The exact date of birth of the member should be given.
Sl No 3 to 7. Particulars should be written clearly without any overwriting or cutting. Correction
if any, be attested.
Member’s Account Number: The account number should have the Region Code (two alphabets),
Office Code (three alphabets) code number (maximum 7 digits), extension (sub code, if any,
maximum three characters) and account number (maximum 7 digits).
The region codes have changed after creation of the multiple regions in some states, namely
Maharashtra, Tamil Nadu, Karnataka, West Bengal, Punjab, Gujarat, Andhra Pradesh, Uttar
Pradesh, Haryana and Delhi. For getting the correct Region and Office Codes, please visit
Establishment Search facility provided under link for Employees through the epfindia website
[epfindia.gov.in].
Sl No 8: The option is to be given by the member only if he has not rendered 10 years service
and eligible for withdrawal benefit. In case of more than 10 years service member has no
option and only Scheme Certificate can be issued.
IN CASE OF OPTION FOR SCHEME CERTIFICATE
Sl No 9: Should be filled in.
Sl No: 11: Is not required to be filled.
IN CASE OF OPTION FOR WITHDRAWAL BENEFIT
Sl No: 9: Is not required to be filled.
Sl No11: Should be filled in.
Payment is made by directly crediting the Bank Account mentioned by the claimant. In case the
bank account is in a computerized branch, payment may be made faster through electronic mode
(NEFT etc). The claimant should attach a copy of blank/cancelled cheque ensuring that the
IFS Code and Account numbers are clearly visible.
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