TATA CONSULTANCY S E R V I C E S EMPLOYEE’S PROVIDENT FUND
APPLICATION FOR SETTLEMENT O F PROVIDENT FUND ACCOUNT
(TO BE FILLED BY APPLICANT)
To,
The Trustees,
TATA Consultancy Services Employees Provident Fund,
Dear Sir,
As I have ceased to be an employee of TCS Limited with effect from Last working date,, I request you to settle my
Provident Fund account and pay the said amount at an early date.
1. Name: XXXXXXXX
2. Father’s / Husband’s Name: XXXXXXXX Address for Correspondence:
3. Employee Number: 1111111 AAAA DDDD CCCCCCCCC XXXXXXX
4. Date of Joining Service: 00-00-0000 XXXXXXXXXX, XXXXXXXXXXX
5. Date of Cessation of Service: Last Working date Mumba- 4000000, Maharashtra
6. Period of Service: 4 years 5 Months Mobile No: 9999999999
7. PAN Card No: APPPPPC0000 Personal Email id: abc@[Link]
8. Aadhaar Number: 1234 4567 7890
(*Self-attested Aadhaar Card copy is Mandatory)
9. Bank Account details:
Name of Bank Branch Saving Bank Account No. Account Type IFSC Code MICR
XXXXX Address XXXXX Saving XXXX XXXX
10. Reason for leaving service / withdrawal of Provident Fund Accumulations: (Tick any one appropriate option)
a) Retirement b) Permanent migration from India
c) Permanent & total Disablement ✓d) Unemployment (More than 2 months)
e) Getting Married (Only in case of Female members)
Note:
• The PF withdraw alamount is subject to tax, if contributory service (inclusive of service rendered in previous
employment is transferred to TCS PF a/c) is less than five years.
• Additional Tax will be applicable if Aadhaar & Pan is not linked in income tax e-filling portal.
DECLARATION OF NON-EMPLOYMENT
(This declaration is applicable if you have selected option (d) from the above reason for withdrawal)
I declare that I have not been employed in any Factory/Establishment to which the Act applies for a continuous period of not less
than 2 months immediately preceding the date of my application for withdrawal of my Provident Fund money
Digital Signature.
Date: Last working Date TCS
Signature of Employee
I certify that the particulars given above are true.
Digital Signature
Signature of Employee
Seal & Signature of Employer
