Sample filled Form 19 & Form 10 C
I know this is irrelevant on this blog, but it can be so helpful for many.
PF Closure process
Employees willing to close the Provident Fund from Employer have to fill PF settlement Form – 19 & 10C.
GUIDELINES TO FILL PF CLOSURE FORM 19 & 10C
FORM – 19 – Page - 1
POINT NO. 1 - Name
POINT NO. 2 - Father’s Name (OR) Husband’s Name in case of Married Woman
POINT NO. 3 - Name & Address of the Establishment/Company
POINT NO. 4 - PF no.
POINT NO. 5 - Date of Release
POINT NO. 6 - Reasons for Leaving Services – PERSONAL / RESIGNED
POINT NO. 7 - Your permanent address (Any further communication will be sent to
this address)
POINT NO. 8 - Mode of Remittance
You need to select (B) By Account Payee cheque sent for direct credit to
my account in the Scheduled Bank
S.B. Account No. - MANDATORY
Name of the Bank - MANDATORY
Branch - MANDATORY
Full Address of the Bank - MANDATORY
Bank’s Accepted
(SBI / IOB / IB / HDFC / CITI BANK / AXIS / ICICI / ANDHRA BANK)
You need to mention your DATE OF JOINING & DATE OF BIRTH under CERTIFIED THAT THE PARTICULARS ARE TRUE TO THE BEST OF MY KNOWLEDGE.
FORM – 19 – Page - 2
You need sign under Signature of Left / Right hand thumb impression of the member.
You need sign under Signature of Left / Right hand thumb impression of the member. (Given in the section “Declaration of the non-employment”) as well.
You need to affix a 1 Re. revenue stamp alone & sign across it in ADVANCE STAMPED RECEIPT.
FORM – 10 C – Page - 1
POINT NO. 1 (a) - Name of the Member – Your Name
POINT NO. 1 (b) - Name of the claimant(s) - Your Name
POINT NO. 2 - Date of Birth
POINT NO. 3 (a) - Father’s Name
POINT NO. 3 (b) - Husband’s Name (If applicable)
POINT NO. 4 - Name & Address of the Establishment/Company
POINT NO. 5 - PF no details.
Region -
SRO Code -
Esst. Code -
Account No. - XXXXX (XXXXX Please refer your Pay slip for PF no.)
POINT NO. 6 - Reasons for Leaving Services – PERSONAL / RESIGNED
Date of Leaving Service
POINT NO. 7 - Your permanent address (Any further communication will be sent to
this address)
FORM – 10 C – Page - 2
POINT NO. 8 - Are you will to accept Scheme Certificate in lieu of Withdrawal
Benefit
If you select YES, you will be getting a Scheme Certificate
If you select NO, you will be getting the Pension amount
POINT NO. 9 - If you select YES in POINT No. 8, you have to furnish Nominee Details If you select NO in POINT No. 8, you need not fill any details
POINT NO. 10 - Need not fill any details
POINT NO. 11 - Mode of Remittance
You need to select (B) By Account Payee cheque sent for direct credit to
my account in the Scheduled Bank
S.B. Account No. - MANDATORY
Name of the Bank - MANDATORY
Branch - MANDATORY
Full Address of the Bank - MANDATORY
POINT NO. 12 - Need not fill any details
You need to sign under Certified THAT THE PARTICULARS ARE TRUE TO THE BEST OF MY KNOWLEDGE
FORM – 10 C – Page - 3
You need to affix a 1 Re. revenue stamp alone & sign across it in ADVANCE STAMPED RECEIPT.
Documents to be enclosed along with the PF Closure Forms:
Proof for your Bank A/c. (Copy of Bank Pass Book / Bank statement / Cancelled Cheque) – (Mandatory)
A letter addressing to Regional Provident Fund Commissioner, justifying the reason for closing your PF A/c. – (Mandatory)
TIME DURATION FOR SETTLEMENT:
PF Closure forms will be processed only after 60 days from your Date of Release.
After submission in PF office it takes around 45 TO 60 days for crediting the amount in your Bank A/c.
PS: Please furnish your email ID & contact no (refer page 1 of both forms – right side top)
I know this is irrelevant on this blog, but it can be so helpful for many.
PF Closure process
Employees willing to close the Provident Fund from Employer have to fill PF settlement Form – 19 & 10C.
GUIDELINES TO FILL PF CLOSURE FORM 19 & 10C
FORM – 19 – Page - 1
POINT NO. 1 - Name
POINT NO. 2 - Father’s Name (OR) Husband’s Name in case of Married Woman
POINT NO. 3 - Name & Address of the Establishment/Company
POINT NO. 4 - PF no.
POINT NO. 5 - Date of Release
POINT NO. 6 - Reasons for Leaving Services – PERSONAL / RESIGNED
POINT NO. 7 - Your permanent address (Any further communication will be sent to
this address)
POINT NO. 8 - Mode of Remittance
You need to select (B) By Account Payee cheque sent for direct credit to
my account in the Scheduled Bank
S.B. Account No. - MANDATORY
Name of the Bank - MANDATORY
Branch - MANDATORY
Full Address of the Bank - MANDATORY
Bank’s Accepted
(SBI / IOB / IB / HDFC / CITI BANK / AXIS / ICICI / ANDHRA BANK)
You need to mention your DATE OF JOINING & DATE OF BIRTH under CERTIFIED THAT THE PARTICULARS ARE TRUE TO THE BEST OF MY KNOWLEDGE.
FORM – 19 – Page - 2
You need sign under Signature of Left / Right hand thumb impression of the member.
You need sign under Signature of Left / Right hand thumb impression of the member. (Given in the section “Declaration of the non-employment”) as well.
You need to affix a 1 Re. revenue stamp alone & sign across it in ADVANCE STAMPED RECEIPT.
FORM – 10 C – Page - 1
POINT NO. 1 (a) - Name of the Member – Your Name
POINT NO. 1 (b) - Name of the claimant(s) - Your Name
POINT NO. 2 - Date of Birth
POINT NO. 3 (a) - Father’s Name
POINT NO. 3 (b) - Husband’s Name (If applicable)
POINT NO. 4 - Name & Address of the Establishment/Company
POINT NO. 5 - PF no details.
Region -
SRO Code -
Esst. Code -
Account No. - XXXXX (XXXXX Please refer your Pay slip for PF no.)
POINT NO. 6 - Reasons for Leaving Services – PERSONAL / RESIGNED
Date of Leaving Service
POINT NO. 7 - Your permanent address (Any further communication will be sent to
this address)
FORM – 10 C – Page - 2
POINT NO. 8 - Are you will to accept Scheme Certificate in lieu of Withdrawal
Benefit
If you select YES, you will be getting a Scheme Certificate
If you select NO, you will be getting the Pension amount
POINT NO. 9 - If you select YES in POINT No. 8, you have to furnish Nominee Details If you select NO in POINT No. 8, you need not fill any details
POINT NO. 10 - Need not fill any details
POINT NO. 11 - Mode of Remittance
You need to select (B) By Account Payee cheque sent for direct credit to
my account in the Scheduled Bank
S.B. Account No. - MANDATORY
Name of the Bank - MANDATORY
Branch - MANDATORY
Full Address of the Bank - MANDATORY
POINT NO. 12 - Need not fill any details
You need to sign under Certified THAT THE PARTICULARS ARE TRUE TO THE BEST OF MY KNOWLEDGE
FORM – 10 C – Page - 3
You need to affix a 1 Re. revenue stamp alone & sign across it in ADVANCE STAMPED RECEIPT.
Documents to be enclosed along with the PF Closure Forms:
Proof for your Bank A/c. (Copy of Bank Pass Book / Bank statement / Cancelled Cheque) – (Mandatory)
A letter addressing to Regional Provident Fund Commissioner, justifying the reason for closing your PF A/c. – (Mandatory)
TIME DURATION FOR SETTLEMENT:
PF Closure forms will be processed only after 60 days from your Date of Release.
After submission in PF office it takes around 45 TO 60 days for crediting the amount in your Bank A/c.
PS: Please furnish your email ID & contact no (refer page 1 of both forms – right side top)
