PF closure Forms filling Guidelines

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PF Closure process
Associates willing to close the Provident Fund from Cognizant have to fill PF settlement Form 19 & 10C.

GUIDELINES TO FILL PF CLOSURE FORM 19 & 10C

PLEASE READ THE INSTRUCTIONS BEFORE FILLING THE FORM

Do not overwrite or use white ink or eraser for corrections

Please Do not fill those which are marked FOR OFFICE USE ONLY
Points mentioned below are Mandatory to fill
Make sure you print the Form in back to back format

FORM 19 Page - 1
POINT NO. 1

Name

POINT NO. 2

Fathers Name (OR) Husbands Name in case of Married Woman

POINT NO. 3

Name & Address of the Establishment

Cognizant Technology Solutions India Private Limited
New No 165, Old No 110,
Menon Eternity building, St. Marys Road, Alwarpet,
Chennai 600 018.

POINT NO. 4

TN/MS/31309/XXXXX (XXXXX Please refer your Pay slip for PF no.)

POINT NO. 5

Date of Release (Last Date in CTS)

POINT NO. 6

Reasons for Leaving Services PERSONAL / RESIGNED

POINT NO. 7

Your permanent address (Any further communication will be sent to

this address)

POINT NO. 8

Mode of Remittance
You need to select (B) By Account Payee cheque sent for direct credit to
my account in the Scheduled Bank
S.B. Account No.
Name of the Bank
Branch
Full Address of the Bank

MANDATORY
MANDATORY
MANDATORY
MANDATORY

Banks Accepted
(SBI / IOB / IB / HDFC / CITI BANK / AXIS / ICICI / ANDHRA BANK)
You need to mention your DATE OF JOINING & DATE OF BIRTH under CERTIFIED THAT THE PARTICULARS
ARE TRUE TO THE BEST OF MY KNOWLEDGE.

FORM 19 Page - 2
You need sign under Signature of Left / Right hand thumb impression of the member.
You need sign under Signature of Left / Right hand thumb impression of the member. (Given in the
section Declaration of the non-employment) as well.
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You need to affix a 1 Re. revenue stamp alone & sign across it in ADVANCE STAMPED RECEIPT.

FORM 10 C Page - 1
POINT NO. 1 (a)
POINT NO. 1 (b)

Name of the Member Your Name

Name of the claimant(s) - Your Name

POINT NO. 2

Date of Birth

POINT NO. 3 (a)

POINT NO. 3 (b)

Fathers Name
Husbands Name (If applicable)

POINT NO. 4

Name & Address of the Establishment

Cognizant Technology Solutions India Private Limited
New No 165, Old No 110,
Menon Eternity building, St. Marys Road, Alwarpet,
Chennai 600 018.

POINT NO. 5

Region
SRO Code
Esst. Code
Account No.

TN
MS
31309
XXXXX (XXXXX Please refer your Pay slip for PF no.)

POINT NO. 6

Reasons for Leaving Services PERSONAL / RESIGNED

Date of Leaving Service - (Last Date in CTS)

POINT NO. 7

Your permanent address (Any further communication will be sent to

this address)

Are you will to accept Scheme Certificate in lieu of Withdrawal

Benefit

FORM 10 C Page - 2
POINT NO. 8

If you select YES, you will be getting a Scheme Certificate

If you select NO, you will be getting the Pension amount
POINT NO. 9

If you select YES in POINT No. 8, you have to furnish Nominee Details
If you select NO in POINT No. 8, you need not fill any details

POINT NO. 10

Need not fill any details

POINT NO. 11

Mode of Remittance
You need to select (B) By Account Payee cheque sent for direct credit to
my account in the Scheduled Bank
S.B. Account No.
Name of the Bank
Branch
Full Address of the Bank

POINT NO. 12

MANDATORY
MANDATORY
MANDATORY
MANDATORY

Need not fill any details

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You need to sign under Certified THAT THE PARTICULARS ARE TRUE TO THE BEST OF MY KNOWLEDGE

FORM 10 C Page - 3
You need to affix a 1 Re. revenue stamp alone & sign across it in ADVANCE STAMPED RECEIPT.

Documents to be enclosed along with the PF Closure Forms:

Proof for your Bank A/c. (Copy of Bank Pass Book / Bank statement / Cancelled Cheque)
(Mandatory)

A letter addressing to Regional Provident Fund Commissioner, Chennai justifying the reason for
closing your PF A/c. (Mandatory)

TIME DURATION FOR SETTLEMENT:

PF Closure forms will be processed only after 60 days from your Date of Release.
After submission in PF office it takes around 45 TO 60 days for crediting the amount in your Bank
A/c.

After three months from your Date of Release you can check the status by logging on to
http://www.epfochennai.tn.nic.in (or) you can directly call to PF office at 044 28132700 & check the
status in Group 23 by referring your PF A/c. with CTS which is in your pay slip (TN/MS/31309/..).
FOR ANY FURTHER QUERIES YOU CAN REACH:
Contact Person
Phone
e-mail

HR SS (Provident Fund Team)

044 45659176
hrss@cognizant.com

Address

Payroll Shared Services Benefits Team

Cognizant Technology Solutions India Pvt. Ltd,
Phase 2, 3rd Floor,
No. 1, Veeranam Road,
Perungudi Bye Pass,
Perungudi,
Chennai 600 096

PS: Please furnish your email ID & contact no (refer page 1 of both forms right side top)

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