Part A: Personal

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ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]

( Tracking ID: 10042826138405002 )


Claim Date : 20/07/2022
EMPLOYEES' PROVIDENT FUND SCHEME, 1952
(PARA 57)

(This form has been printed on the basis of Online Transfer Claim Form filled up by the member under Unified Portal for submission to the
employer.)

To,
The Regional P.F. Commissioner,
RAJKOT,
Bhavishyanidhi Bhawan, Panchayat Ngr Chwk,University Rd, Rajkot

Sir,
I request that my Provident Fund balance along with my Pension Service Details may please be transferred to my present
account under intimation to me. My details are as under :

PART A : PERSONAL

1. Name : VINAYKUMAR YADAV

2. Mobile Number : 7698810471

3. E-mail id : vy11609@gmail.com

4. Bank Account Number : 914010014197740

5. Bank IFSC : UTIB0000175

PART B : DETAILS OF PREVIOUS PF ACCOUNTS (WHICH IS TO BE TRANSFERRED)

1. PF Account No. (with EPFO : GJRAJ00448310000001139

2. Name of the Establishment : SRI SABARI ENGIMECH PVT. LTD.

3. Address of the Establishment : 102 COSY HILL BEDI BUNDER ROAD JAMNAGAR 557

4. PF A/C No. held by : RAJKOT

5. Name of the Trust : NOT APPLICABLE

6. PF A/C No. in Trust : NOT APPLICABLE

7. Bank A/C No. of Trust : NOT APPLICABLE


8. IFS Code of the Bank Branch of
Trust where account is : NOT APPLICABLE

9. Member's Name : VINAYKUMAR YADAV

10. Date of Birth : 08/09/1987

11. Father's/Spouse Name : DEVRAJ YADAV

12. Relationship : FATHER

13. Date of joining : 01/11/2014

14. Date of leaving : 25/11/2019


PART C : DETAILS OF PRESENT PF

1. PF Account No. (with EPFO : GJAHD00278800000010089

2. Name of the Establishment : METRO ELEVATOR COMPANY PRIVATE LIMITED

3. Address of the Establishment : 407, RAJKAMAL PLAZA. SATTAR TALUKA SOCIETY, HIGHCOURT
AHMEDABAD 554
4. PF A/C No. held by : RO AHMEDABAD

5. Name of the Trust : NOT APPLICABLE

6. PF A/C No. in Trust : NOT APPLICABLE

7. Bank A/C No. of Trust : NOT APPLICABLE


8. IFS Code of the Bank Branch of
Trust where account is : NOT APPLICABLE

9. Member's Name : VINAYKUMAR YADAV

10. Date of Birth : 08/09/1987

11. Father's/Spouse Name : DEVRAJ YADAV

12. Relationship : FATHER

13. Date of joining : 01/12/2019

I, Certify that all the information given above are true to the best of my knowledge and I have ensured the correctness of
my present and previous account numbers.

Signature of the member

Note : Member should take a printout of this form and a signed copy of the same should be submitted to the Present
Establishment i.e. METRO ELEVATOR COMPANY PRIVATE LIMITED

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