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    Part A: Personal

    Uploaded by

    Vishwa Hegde

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Part A: Personal

    Uploaded by

    Vishwa Hegde
    5 views2 pages

    Original Title

    8

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    5 views2 pages

    Part A: Personal

    Uploaded by

    Vishwa Hegde

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 2

    ONLINE TRANSFER CLAIM FORM [FORM 13 (REVISED) ]

    ( Tracking ID: 10148384819905008 )


    Claim Date : 24/10/2024
    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,
    BANGALORE,
    Bhavishyanidhi Bhavan, No. 13, Raja Ram Mohan Roy Road, Bangalore

    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 : VISHWA HEGDE

    2. Mobile Number : 8904121495

    3. E-mail id : VISHWA.ICON9@GMAIL.COM

    4. Bank Account Number : 015201595797

    5. Bank IFSC : ICIC0000152

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

    1. PF Account No. (with EPFO : BGBNG00434980000011159

    2. Name of the Establishment : BRICKWORK RATINGS (I) PVT., LTD.

    3. Address of the Establishment : 3RD FLOOR, RAJ ALKAA PARK, KALENA AGRAHARA , BANNERGHATTA
    ROAD BANGALORE BENGALURU (BANGALORE) URBAN
    4. PF A/C No. held by : BANGALORE

    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 : VISHWA HEGDE

    10. Date of Birth : 19/02/1993

    11. Father's/Spouse Name : LAKSHMINARAYANA HEGDE

    12. Relationship : FATHER

    13. Date of joining : 24/05/2021

    14. Date of leaving : 10/02/2023


    PART C : DETAILS OF PRESENT PF

    1. PF Account No. (with EPFO : KNMYS00076400000332839

    2. Name of the Establishment : TRITON VALVES LIMITED

    3. Address of the Establishment : MERCARA ROAD BELAVADI MYSORE MYSORE

    4. PF A/C No. held by : SRO MYSORE

    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 : VISHWA HEGDE

    10. Date of Birth : 19/02/1993

    11. Father's/Spouse Name : LAKSHMINARAYANA HEGDE

    12. Relationship : FATHER

    13. Date of joining : 21/04/2023

    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 Previous
    Establishment i.e. BRICKWORK RATINGS (I) PVT., LTD.

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