Proforma Statement To Be Obtained From The Contractor

PROFORMA STATEMENT TO BE OBTAINED FROM THE CONTRACTOR

NAME & ADDRESS OF THE PRINCIPAL EMPLOYER:

TN/

NAME & ADDRESS OF THE CONTRACTOR :

TN/

MONTH:

Date

of

Joining

No. of days

Total Wages paid

Wages for PF

Contribution

Sl. No.

Name of the Employee

Father's Name

PF A/c No.

[DD/MM/YYYY]

worked

[in Rupees]

I/We hereby certify that all the above employees who were actually deployed in your establishment during ___________ 2011, have all been covered under EPF & MP Act, 1952 and the contributions in respect of them

for the month of _____________ 2011 have been remitted by me/us under Code No. TN/_______________ maintained at _____________ RO/SRO on ___________________________.

DATE:

SIGNATURE OF THE CONTRACTOR