Form 14 - Application For Financing A Life Insurance Policy Out Of The Provident Fund Account Page 4

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of recent 12
mention the date
months Form No.
of the withdrawal
12
The above case has been examined vide Paras 62 to 64 of the Employees’
Provident Funds Scheme, 1952. A sum of Rs. ……………(Rupees……….) may
be paid.
Clerk
Head Clerk
Accounts Officer
R.P.F.C.
Insurance Section
D.P. Sheet prepared and put up for signature
Clerk (ins.)
Head Clerk (ins.)
Accounts Officer
R.P.F.C.

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