Form 3A "The Employee's Provident Fund Scheme, 1952 and the Employee's Pension Scheme, 1995" - India

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FORM-3A ( Revised
)
THE EMPLOYEE’S PROVIDENT FUND SCHEME, 1952 AND THE EMPLOYEE’S PENSION SCHEME, 1995
( Paras 35 and 42 ) and ( Parea 19 )
1. Account no.
:
2. Name / Surname
:
3. Fathers / Husbands Name
:
4. Name & Address of the Factory /
Establishment
:
5. Statutory Rate of PF Contribution :
6. Voluntary Higher rate of employee’s contribution, if any :
Certified that the total amount of contributions ( both shares ) indicated in this Card, i.e. Rs __________ has already
been remitted in full in EPF A/c No.1 and Pension A/c no. 10 Rs ________.
Certified that the difference between the total of the contribution shown under Columns 3 and 4(a) and 4 (b) of the
table and that arrived at on the total wages shown in column 2 at the prescribed rate is solely due to rounding off of
contribution to the nearest rupee under the rules.
Employers Share
Workers
E.P.F.
PENSION
No. of days
Month
Amount of
Share
Refund of
of non
Difference
FUND
Wages
Advance
contributing
Remarks
between
Contribution
E.P.F.
12% &
8.33%
service
8.33%
1
2
3
4(a)
4(b)
5
6
7
Dated: _____________
For __________________________
AUTHORISED SIGNATORY
FORM-3A ( Revised
)
THE EMPLOYEE’S PROVIDENT FUND SCHEME, 1952 AND THE EMPLOYEE’S PENSION SCHEME, 1995
( Paras 35 and 42 ) and ( Parea 19 )
1. Account no.
:
2. Name / Surname
:
3. Fathers / Husbands Name
:
4. Name & Address of the Factory /
Establishment
:
5. Statutory Rate of PF Contribution :
6. Voluntary Higher rate of employee’s contribution, if any :
Certified that the total amount of contributions ( both shares ) indicated in this Card, i.e. Rs __________ has already
been remitted in full in EPF A/c No.1 and Pension A/c no. 10 Rs ________.
Certified that the difference between the total of the contribution shown under Columns 3 and 4(a) and 4 (b) of the
table and that arrived at on the total wages shown in column 2 at the prescribed rate is solely due to rounding off of
contribution to the nearest rupee under the rules.
Employers Share
Workers
E.P.F.
PENSION
No. of days
Month
Amount of
Share
Refund of
of non
Difference
FUND
Wages
Advance
contributing
Remarks
between
Contribution
E.P.F.
12% &
8.33%
service
8.33%
1
2
3
4(a)
4(b)
5
6
7
Dated: _____________
For __________________________
AUTHORISED SIGNATORY