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OPTION UNDER PARA 11(3) (DELETED) OF THE EPS, 1995

The Regional P.F. Commissioner,


Regional Office, S.D.A. Complex,
Kasumpti, Shimla-171009
Himachal Pradesh

Subject: Joint option under Para 11(3) (Now deleted) & Para 11 (4) of Employees’
Pension Scheme, 1995 based upon the Hon’ble Supreme Court’s Order in
SLP No. 33033 of 2015 and Head Office letter dated 23.03.2017.

I, _______________________S/o Sh. _______________________having PF


Account No. HP ________________ employee of M/s ____________________________
and drawing pay more than Rs. 5000/- P.M. w.e.f (16.11.1995) _________________ and Rs.
6500/- P.M. w.e.f. (01.06.2001) ___________________ and Rs. 15000/- P.M. w.e.f.
(01.09.2014) _________________ and pay 1.16% of salary exceeding Rs. 15000/- P.M. as an
additional contribution towards EPS, 1995 w.e.f. 01/09/2014.

I, therefore request my employer to contribute to the EPS, 1995 on my wages


exceeding Rs. 5000/- P.M. w.e.f. (16.11.1995) _________________ and Rs. 6500/- P.M.
w.e.f. (01.06.2001) ____________________ and Rs. 15000/- P.M. w.e.f. (01.09.2014)
_________________ along with interest as payable.

Signature of the Applicant

UNDERTAKING ON BEHALF OF THE EMPLOYER

I, ___________________________ as authorized signatory of M/s


_________________________________________ undertake to pay matching contribution
and divert 8.33% of the actual salary to the Employees Pension Scheme, 1995 from the date
the salary exceeds the statutory limit or commencement of the Scheme whichever is later
along with interest as declared under EPS Scheme, 1952 from time to time.

Signature with seal

Note:- The facility of exercising the option under Para 11(4) of EPS, 1995 w.e.f. 01.09.2014
to new entrants on wages more than Rs. 15000/- P.M. is not available.

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