ZP PF NUMBER ALLOTMENT APPLICATION

 

APPENDIX ‘P’

FORM – 1/2/4

Application for admission to the Provident Fund

.(to be submitted induplicate)

01. Name of the Applicant ::

02. Official designation & Address ::

03. Date of Birth ::

04. Office to which attached if on deputation state

The parent department Government also ::

05. Father`s Name ::

06. Service to which the applicant belongs ::

07. Whether applicants service is pensionable of not ::

08. Whether applicants is permanent/temporary of

Re-employed. If temporary give the date of

Commencement of service ::

09. Date of entry into service ::

10. Rate of employments drawn per mensum ::

11. Rate of subscription per month ::

12. Whether individual is a compulsory or optional ::

13. If subscriber is subscri bing to any other fund the

Name of such fund ::

14. Whether the applicant has a family or not ::

15. A/C.No. tobe allotted by the Account Officer ::

16. Pay as on previous 31

st March ::

17. Remarks ::

 

A form of nomination in the prescribed form duly filed is enclosed.

Station:

Date:: SIGNATURE OF APPLICANT.

Signature of the Head Office Designation.

Office of the ___________________________dated___________________the _______________200

Returned with account number allotted. This number should be quoted in all correspondence

connected there with.

FORM – I

FORM OF NOMINATION

1. Whether the subscriber

has a family and wished to nominate one number there of

I hereby nominate the person mentioned below who is a member of my family as defined in Rule 2 of the

General Provident Fund (Andhra Pradesh) Rules to received the amount that may stand to my credit in the fund in

the even Of my death before that amount has becomes payable of having become payable has not been paid.

Name and Address of

Nominee

Relation ship with subscriber Age Contingencies on the happening of

which

The nomination shall become invalid

Name address and

relationship of the person if any

to whom the right of

thenominee shall pass on the

event of his predeceasing the

subscriber.

Date ____________________________________day of ______________________200________________

Two Witnessess to signature

1)

2) SIGNATURE OF SUBSCRIBER.

 

FORM – I I

FORM OF NOMINATION

I . WHEN THE SUBSCRIBER HAS A FAMILY AND WISHES TO NOMINATE MORE THAN ONE NUMBER OF

I here by nominate the persons mentioned below who are members of my family as defined Rule 2 of the General Provident Fund

(A.P) Rules to reserve the amount the may stand to my credit in the fund in the even of my death before that amount has become payable

Or having become payable has not been paid and direct that the said amount shall be distributed among the said persons in the manner

shown

against theirnames.

Name and address

of the Nominee

Relation ship

with subscriber

Age Amount of share

of accumulations

to be paid to each

Contingencies or

the happening of

which the

nomination

Name and address and relationship of

the person if whom the right of the

nominee shall pass on the event of his

predececessing the subscriber.

Date ____________________________________day of ______________________200________________

Two Witnessess to signature

1)

2) SIGNATURE OF SUBSCRIBER.

 

FORM OF NOMINATION

IV. WHEN THE SUBSCRIBER HAS NO FAMILY AND WISHES TO NOMINATE MORE THAN ONE PERSON

I

having no family as defined in Rules 2 of the General Provident Fund (AP) Rules, hereby nominate the persons mentioned below to receive the amount

that may stand to my credit in the fund in the event of my death before that amount has become payable, or having become payable,has not been paid

and direct that the said amount shall be distributing among said person in the manner shown against their names.

Name and address of the

Nominee

Relation ship with

subscriber

Age Amount of share of

accumulations to be

paid to each

Contingencies or the

happening of which the

nomination shall become

invalid

Name and address and relationship of the person if any

to whom the right of the nominee shall pass in the

predececessing the subscriber.

Dated this________________________________________day of_________________________________200 at

Two witnesssignatures:

1)

2)

SIGNATURE OF THE SUBSCRIBER.

NOTE: This column shall be filled inso as nto over the whole amount the may stand to the credit of the subscriber in the fund at any time.

NOTE; Here a subscribering has no family makes a nomination, he shall specify in this column that the nomination shall become invalid in the

Event of his subsequently acquiring a family.

 

FORM OF NOMINATION

III. WHEN THE SUBSCRIBER HAS NO FAMILY AND WISHED TONOMINATE ONE PERSON.

I having no familyas defined in Rules 2 of the General Provident Fund (AP) Rules, hereby nominate to the person

Mentioned below to receive the amount that may stand to my credit in the fund, in the event of my death before

That amount has become payable, or having become payable, has not been paid.

Name and address of the

Nominee

Relation ship with

subscriber

Age Amount of share of

accumulations to be

paid to each

Contingencies or the

happening of which the

nomination shall become

invalid

Name and address and relationship of the person if any

to where the right of the nominee shall pass in the

predececessing the subscriber.

Date this_______________________________________day of __________________200 at

Two witnesses to signature:-

1)

2) SIGNATURE OF SUBSCRIBER.

NOTE

: Where a subscriber who has no family makes nomination, he shall specifiy in this column that the nomination shall become invalid in the event of his subsequent acquiring a family.