Form-3a (Revised) - The Employee'S Provident Fund Scheme printable pdf download

Form-3a (Revised) - The Employee'S Provident Fund Scheme

FORM-3A ( Revised

)

THE EMPLOYEE’S PROVIDENT FUND SCHEME, 1952 AND THE EMPLOYEE’S PENSION SCHEME, 1995

( Paras 35 and 42 ) and ( Parea 19 )

1. Account no.

2. Name / Surname

3. Fathers / Husbands Name

4. Name & Address of the Factory /

Establishment

5. Statutory Rate of PF Contribution :

6. Voluntary Higher rate of employee’s contribution, if any :

Certified that the total amount of contributions ( both shares ) indicated in this Card, i.e. Rs __________ has already

been remitted in full in EPF A/c No.1 and Pension A/c no. 10 Rs ________.

Certified that the difference between the total of the contribution shown under Columns 3 and 4(a) and 4 (b) of the

table and that arrived at on the total wages shown in column 2 at the prescribed rate is solely due to rounding off of

contribution to the nearest rupee under the rules.

Employers Share

Workers

E.P.F.

PENSION

No. of days

Month

Amount of

Refund of

of non

Difference

FUND

Wages

Advance

contributing

Remarks

between

Contribution

E.P.F.

12% &

8.33%

service

8.33%

4(a)

4(b)

Dated: _____________

For __________________________

AUTHORISED SIGNATORY

Form-3a (Revised) - The Employee'S Provident Fund Scheme