PF Withdrawal Form 19 Filled Sample 2019

Introduction

This article provides a sample of a completed PF Withdrawal Form 19 for the year 2019. The form is used by employees to withdraw their Provident Fund (PF) savings when they leave their job. It is important to fill out the form correctly and submit it to the relevant authorities in order to receive the PF amount. The article also provides a brief overview of the form and the process of withdrawing PF savings.

PF Withdrawal Form 19 Filled Sample 2019

Name: John Smith

Address: 123 Main Street, Anytown, USA

Date: April 1, 2019

To:

The Board of Directors

Pension Fund of America

123 Any Street

Anytown, USA

Re: Request for Withdrawal from Pension Fund

Dear Board of Directors:

I am writing to request a withdrawal from my Pension Fund of America account. I understand that I am eligible to withdraw up to 25% of my total balance, and I am requesting to withdraw the full amount.

I understand that I will be subject to a 10% penalty for early withdrawal, and I am willing to accept this penalty. I also understand that I will be responsible for any applicable taxes on the withdrawal.

I have enclosed a copy of my driver’s license and a voided check for the account to which I would like the funds to be deposited.

Thank you for your prompt attention to this matter.

Sincerely,

John Smith
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EPF members need to submit EPF withdrawal form 19 to claim 12% of employer PF contribution and 3.67% of employer PF contribution. To withdraw pension amount employees need to submit PF form 10C. Employees are eligible to claim PF amount after 2 months from the date of exit. (But as per the recent amendment employees can claim 75% of PF amount even after 1 month also)

Download PF Form 19 PDF

Form 19 Filled Sample 2019

Sample Filled EPF Form 19 Page 1

Sample Filled PF Form 19 Page 1

Sample Filled EPF Form Page 2

Sample Filled PF Form 19 Page 2

How To Fill PF Form 19 For PF Final Settlement:

On right top corner write your mobile number, you will receive updates regarding your claim to this mobile number.

  • Field 1 name of the member, Write the name of the EPF member as it is present in the EPF portal.
  • Field 2 father’s name or husband’s name, Write father name or husband name of the EPF member.
  • Field 3 date of birth,  Write the date of birth of the EPF member as per the EPFO portal.
  • Field 4 name and address of the factory, Put address stamp of your employer.
  • Field5 PF number and UAN number, Write your PF account number and UAN number.
  • Field 6 date of joining in the establishment, Mention your date of joining in the establishment.
  • Field 7 date of leaving the service, Mention your date of leaving the service i.e date of exit.
  • Field 8 reason for leaving service, Write reason for leaving the service, whether it is retirement or resigned etc.
  • Field 9 PAN and form 15G details: If your service is less than 5 yrs and you are withdrawing more than 50000 Rs then mention your PAN number and submit Two copies of form 15G and One copy of PAN card. In other cases just leave this field blank.
  • Field 10 full postal address,  Here write full postal address of the EPF member. In case your claim forms are rejected then rejected PF withdrawal forms will be sent to this address.
  • Field 11 mode of payment, Write your bank name, bank a/c number, IFSC code and address of the bank. Be careful in writing this details, because if you write the wrong details then your PF claim will not settle.
  • Finally, sign the page 1 of PF form 19 and take your employer attestation also.

On page 2 of PF form 19 sign across the revenue stamp box, and there is no need to attest 1 Rupee revenue stamp on PF form 19.

Number of Signatures Required on EPF Form 19

  • PF form 19 needs two signatures of EPF member on page 1 and page 2. Employer needs to sign on the first page of PF form 19. So total 2 signatures of EPF member and 1 signature of employer are required on PF form 19.
  • There is no need to attest One Rupee revenue stamp on PF form 19.

Note: Recently Employee Provident Fund Organization has introduced PF composite claim forms aadhaar and non aadhaar, EPF members can use either those new forms or old PF claim forms like Form 19 and 10C to withdraw their PF and pension amounts.

How To Fill PF Form 19 In Online

  • Login to UAN member portal with UAN number and password.
  • Now go to online services in the primary menu and click on claim form 31, 19 & 10C.
  • Now in the new page, you will find your details like name, dob, father name or husband name and mobile number along with your KYC details like Aadhar, bank account details and also your service details.
  • If you find everything is correct then click on proceed for the online claim.
  • Now you have to choose the type of the claim i.e whether it is PF advance withdrawal (Form 31) or PF withdrawal(Form 19) or pension withdrawal(Form 10C).
  • After selecting the claim an OTP will be sent to your registered mobile number, now enter that OTP and submit your claim.
  • After successful submission of the claim, you will receive an SMS confirmation to your mobile number.
  • Remember you need to submit both form 19 and form 10C separately in the online PF withdrawal process.

Still, if you have any question on filling PF form 19 then ask those questions in below comments section.

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PF Withdrawal Form 19 Filled Sample 2019

Employees’ Provident Fund Organisation (EPFO) has introduced a new form, Form 19, for the purpose of withdrawing the Provident Fund (PF) amount. This form is applicable for all the members of the EPFO. The form is available online and can be filled and submitted online. In this article, we will discuss the details of the form and provide a sample of a filled Form 19.

What is Form 19?

Form 19 is a form that is used by the members of the EPFO to withdraw their Provident Fund (PF) amount. The form is available online and can be filled and submitted online. The form is used to withdraw the PF amount when the member has left the job or has retired. The form is also used to withdraw the PF amount when the member has reached the age of 58 years.

Details Required in Form 19

The form requires the following details to be filled:

  • Name of the member
  • EPF Account Number
  • Date of Leaving the Job
  • Name of the Employer
  • Address of the Employer
  • Name of the Bank
  • Account Number of the Bank
  • IFSC Code of the Bank
  • Signature of the Member

PF Withdrawal Form 19 Filled Sample 2019

Below is a sample of a filled Form 19:

Name of the Member: John Doe

EPF Account Number: 1234567890

Date of Leaving the Job: 01/01/2019

Name of the Employer: ABC Company

Address of the Employer: 123 Main Street, Anytown, USA

Name of the Bank: XYZ Bank

Account Number of the Bank: 9876543210

IFSC Code of the Bank: XYZ12345

Signature of the Member: ___________________

Conclusion

Form 19 is an important form that is used by the members of the EPFO to withdraw their Provident Fund (PF) amount. The form is available online and can be filled and submitted online. The form requires the details of the member, the employer, and the bank account details. The form should be filled carefully and accurately to ensure that the PF amount is withdrawn without any issues. The sample of a filled Form 19 provided in this article can be used as a reference for filling the form.

Jaspreet Singh Ghuman

Jaspreet Singh Ghuman

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