Return Reg. Sr. No_____________ Group No._______
Re-Credit Intimation No._______________
RE ISSUE PROFORMA
The Regional Provident Fund Commissioner,
Sub: Request for re-authorisation of returned cheques/Money Order in respect of Shri./Smt/Kum.____________________ bearing P.F.A/c No._______________
Sir/Madam,
Cheque/Money order towards settlement of my Provident Fund/Family Pension Fund amount has not been credited to my S.B.A/c/received by me and the same has been returned back to some reason. Now I have made the necessary correction/change and request you to kindly re-issue the amount. My Bank details are as under:-
- Saving Bank A/c No. :_______________________________________________
- Name of the Bank :_______________________________________________
- Name of the Branch :_______________________________________________
- Full Address of Bank :_______________________________________________
- Residential Address : ________________________________________________
________________________________________________
________________________________________________
________________________________________________
I hereby identify & certify that the applicant has signed/thumb impressed before me.
Signature of Employer/Authorized
