Form 3A (Revised)

(For Unexempted Establishments Only)

The Employees' Provident Fund Scheme, 1952 (Para 35 & 42)
and
The Employees Pension Scheme, 1995 (Para 19)
Contribution Card for Currency Period 1st April,2016 To 31st March, 2017
1. Account Number : 5. Name and Address of the Establishment
PU/PUN/123905/7249
2. Name/Surname : BARCLAYS TECHNOLOGY CENTRE INDIA PRIVATE LIMI
SEEMA YADAV
801+808, 3RD FLOOR, BLOCK-C,
3. Father/Husband Name : KRISHNA YADAV
PANSHEEL TECK PARK, AIRPORT ROAD,
4. Statutory Rate of Contribution : 12.00%
YERWADA, PUNE
6. Voluntary Rate of Contribution (if any) : No
PUNE 411006

Month Amount of Worker's Share Employer's Share Refund of No.of Days/

Wages E.P.F.Difference Pension
Fund Advance Period of non
-contribution
Remarks
E.P.F. between 12% & Contribution Service
8.1/3% (if any) (if any)
8.1/3 %
(1) (2) (3) 4(a) 4(b) (5) (6) (7)
Apr ,2016 65,667 7,880 6,630 1,250
May ,2016 0 0 0 0
Jun ,2016 0 0 0 0
Jul ,2016 0 0 0 0
Aug ,2016 0 0 0 0
Sep ,2016 0 0 0 0
Oct ,2016 0 0 0 0
Nov ,2016 0 0 0 0
Dec ,2016 0 0 0 0
Jan ,2017 0 0 0 0
Feb ,2017 0 0 0 0
Mar ,2017 0 0 0 0
Total 65,667 7,880 6,630 1,250
Certified that the difference between the total of the contribution shown under columns 3, 4(a) & 4 (b) of the above table and that arrived at on the total wages shown in column
2 at solely due to rounding off of contributions to the nearest rupee under the rules.
For BARCLAYS TECHNOLOGY CENTRE INDIA PRIVATE LIMI
a) Date of Leaving Service : / / b) Reason of Leaving Service :
c) Certified that the total amount of contribution (both shares) indicated in this card i.e.Rs.
has already been remitted in full in EPF A/c.No.114510.00 and Pension Fund A/c.10 1250.00
Date : / /
Place : AUTHORISED SIGNATORY