PF New challan format

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LOGO EMPLOYEES’ PROVIDENT FUND ORGANISATION
COMMON MONTHLY RETURN FORM
ESTABLISHMENT ID CURRENCY PERIOD RETURN FOR THE MONTH CONTRIBUTION RATE ESTABLISHMENT EXEMPTION STATUS (Please tick)
1st APRIL 20 To 31st March 20 % EPF Un-Exempted Exempted
NAME AND ADDRESS OF THE ESTABLISHMENT M M Y Y Y Y EPF Un-Exempted Exempted
EDLI Un-Exempted Exempted
SL NO MEMBER ID NAME INTL. WORKER WAGES VPF RATE EPF EPF Difference between 12% and 8.33% EPS Refund of Advance Number of days/period of non contributing service, if any Date of leaving, if left in preceeding month Reason for leaving service (PL USE CODES) SUMMARY
DETAILS DUE AS PER THIS RETURN PAID AS PER CHALLAN
WAGE
EPF CONTRIBUTION EE
EPF CONTRIBUTION ER
EPS CONTRIBUTION
A B C E F G H I J K L M N EDLI CONTRIBUTION
1 Y/N EPF ADM/INSP CH
2 Y/N EDLI ADM/INSP CH
3 Y/N PENAL DAMAGES DUE
4 Y/N 7Q INTEREST
5 Y/N ANY OTHER PAYMENT
6 Y/N TOTAL
7 Y/N
8 Y/N DETAILS OF EMPLOYEES
9 Y/N TOTAL
10 Y/N DIRECT EMPLOYEES – MEMBERS
11 Y/N DIRECT-EXCLUDED
12 Y/N THROUGH CONTRACTOR
13 Y/N
14 Y/N DETAILS OF SUBSCRIBERS
15 Y/N EPF EPS EDLI
16 Y/N EXISTING UP TO LAST MONTH
17 Y/N NEW SUBSCRIBERS ADDED
18 Y/N NUMBER WHO LEFT SERVICE
19 Y/N TOTAL AT THE END OF MONTH
20 Y/N
DETAILS OF NEW MEMBERS WHO JOINED IN THE PRECEEDING MONTHJ FATHER’S/HUSBAND’S NAME DT OF BIRTH GENDER DT OF JOINING TOTAL PERIOD OF PAST SERVICE Disabled
A B C E F G H I J K L M N O P Q R S T
1 Y/N Y/N
2 Y/N Y/N
3 Y/N Y/N
4 Y/N Y/N
5 Y/N Y/N
6 Y/N Y/N
7 Y/N Y/N
PAYMENT DETAILS INSTRUCTIONS DETAILS OF COLUMNS IN THE FORM
CHALLAN REFERENCE NO TOTAL REMITTANCE DATE 1 PLEASE USE ADDITIONAL SHEETS PART 1 FOR EXISTING MEMBERS B PLEASE ENTER ONLY THE ACCOUNT NO OF MEMBER
2 PLEASE USE ADDITIONAL SHEETS PARTR 2 FOR NEW MEMBERS C NAME OF THE MEMBER IN CAPITAL LETTERS
3 PLESAR ENTER THE CODES FOR REASON FOR LEAVING E WHETHER INTERNATIONAL WORKER, IF YES ENTER ‘Y’ OTHERWISE ‘N’
4 PLESAR SUBMIT SEPARATE FORM FOR EACH SUB CODE G VOLUNTARY RATE OF CONTRIBUTION BY THE MEMBER
S PREVIOUS SERVICE AS ON JOINING, ENCLOSE SCHEME CERTIFICATE, IF ANY
T WHETHER A DISABLED MEMBER, IF YES ENTER ‘Y’, OTHERWISE ‘N’
REASON FOR LEAVING CODES CERTIFICATES
RETIREMENT–R Certified that the member mentioned at serial number              Sri                                                               was paid/not paid retrenchment compensation of Rs                         under the ID Act, 1947. (Attach list if more members).
SUPERANNUATION–S
DEATH IN SERVICE –D Certified that the total amount of contributions (both shares) indicated in this return has already been remitted in full in EPF A/c No. 1 and Pension A/c No 10. SIGNATURE OF EMPLOYER/AUTHORISED SIGNATORY
PERMANENT DIASBLEMENT–P
CESSATION–C
SEAL OF ESTABLISHMENT

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