Joint declaration form filled sample - pdf

Joint declaration form sample

Download this example of Joint Declaration By the Member and The Employer in pdf format. 

Copy of Any one document needs to be enclosed in a support to make the necessary corrections.

1) Birth Certificate Copy
2) School Leaving Certificate Copy
3) Passport Copy
4) PAN Card
5) Voters Identity Card
6) Driving License
7) Aadhaar Card
8) Bank Passbook copy/Post Office Passbook.
9) Ration Card

The below said letter and any one of the above documents is required for Name correction only. The said needs to be fill in duplicate, one copy for the PF office and another one is for the company record for any future communication and follow up actions.

For any correction in date of birth, only 3 documents are valid 

1) Birth Certificate copy
2) School Leaving Certificate Copy
3) Passport Copy

Any enclosed document from the above needs to be authorized by the employee as well as by the employer.

For correction you all are requested to follow the following format which is prepared by us for the simple and fast processing. Format of the same is as under, and that needs to be filled by the employee in his own handwriting and self attested in duplicate and forward the same to employer.

Example of Joint declaration form filled sample :

I,Son of / Daughter of / Wife of Bearing Provident Fund Account No. am willing  to  become  member of the  Employees’ Provident  Funds Scheme, 1952  with effect  from ______________  and  to  contribute  to  the Employees’ Provident  Fund at the Statutory Rate as prescribed under Para 29 of the Employees’ Provident  Funds  Scheme, 1952  on my  Emoluments consisting  of Basic  Pay, Dearness Allowance (including  cash value of food concession) and Retaining Allowance (if any), which altogether  not  exceeding  Rs.6,500/­ per  month with effect  from  _________________. I agree to  abide  by the  conditions contained  in  the  Employees’ Provident  Funds  Scheme, 1952  Therefore, kindly permit  me  to  enroll myself as Member of the Employees’ Provident Fund and to  contribute on my  Emoluments not exceeding Rs.6,500/­ per  month  with same  benefits  as available  to  other  Provident  Fund  members whose  monthly salary does not exceed Rs.6,500/­ with effect from ___________________. Signature of the Employee

Joint declaration form sample