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  • UAN Based Form19

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    Chandrasekhar Babu
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    This document is an Employees' Provident Fund (EPF) Form 19 used to close an EPF account when an employee leaves employment. It requests information such as the employee's Universal Account Number (UAN), name, date of leaving, reason for leaving such as retirement or termination, permanent account number, address, and signature. The employee confirms the accuracy of their personal details linked to their UAN and that EPF settlement payment should be made to the bank account linked in their UAN portal account.

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    This document is an Employees' Provident Fund (EPF) Form 19 used to close an EPF account when an employee leaves employment. It requests information such as the employee's Universal Account Number (UAN), name, date of leaving, reason for leaving such as retirement or termination, permanent account number, address, and signature. The employee confirms the accuracy of their personal details linked to their UAN and that EPF settlement payment should be made to the bank account linked in their UAN portal account.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    79 views1 page

    UAN Based Form19

    Uploaded by

    Chandrasekhar Babu
    This document is an Employees' Provident Fund (EPF) Form 19 used to close an EPF account when an employee leaves employment. It requests information such as the employee's Universal Account Number (UAN), name, date of leaving, reason for leaving such as retirement or termination, permanent account number, address, and signature. The employee confirms the accuracy of their personal details linked to their UAN and that EPF settlement payment should be made to the bank account linked in their UAN portal account.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    www.epfindia.gov.

    in

    Employees Provident Fund Scheme, 1952


    Form - 19 (UAN)
    (Applicable in cases where employees complete details in Form 11 (New), Aadhaar Number and Bank
    Accounts details are available on UAN Portal and UAN has been activated)
    Mobile Number
    1

    Universal Account Number (UAN)

    Name (In capital letters)

    Date of Leaving

    Reason of Leaving Service


    (Tick the appropriate for TDS
    purposes)

    *Permanent Account Number


    (PAN)

    (a)
    (b)
    (c)
    (d)
    (e)

    Superannuation
    Cessation
    Resignation
    Disablement
    Termination
    a. Ill health
    b. Contraction/Discontinuation of employers business
    c. Causes beyond the control of employees
    d. Personal reasons
    (f) Marriage
    (g) Permanent settlement abroad

    Whether submitting Form


    15G/15H, if applicable (YES/NO)
    Please enclosed two copies of
    Form No. 15G/15H, if applicable
    *Only in case of service less than 5
    years

    Full postal address


    Pincode:
    *I certify that I have gone through the data seeded in UAN Portal and found all data including
    Form No.11 (New), bank account details and Aadhar number.
    * Please make payment in the bank account mentioned in the UAN portal. A cancelled cheque
    (containing members name, bank account number and IFS Code) is attached herewith.

    Signature of the Member

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