Post on 11-Jul-2016
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FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :RAM SHANKAR SHUKLA R B SHUKLA
0
0
0
0
0
0
0
0
0
48562
0
0
0
0
0
0
0
0
0
0
5827
0
0
0
0
0
0
0
0
0
0
0
5827
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
48562 5827 5827 0 0 0
%
MP/JBP/00008617/000/0000002
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
11654
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 1 of 16
FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :SHIV KUMAR TIWARI A P TIWARI
0
0
0
0
0
0
0
0
0
38833
0
0
0
0
0
0
0
0
0
0
4660
0
0
0
0
0
0
0
0
0
0
0
4660
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
38833 4660 4660 0 0 0
%
MP/JBP/00008617/000/0000003
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
9320
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 2 of 16
FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :RAMNARAYAN VERMA N L VERMA
0
0
0
0
0
0
0
0
0
35708
0
0
0
0
0
0
0
0
0
0
4285
0
0
0
0
0
0
0
0
0
0
0
4285
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
35708 4285 4285 0 0 0
%
MP/JBP/00008617/000/0000004
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
8570
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 3 of 16
FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :VADAKKEDATH GOVINDAN KUTTY C G KUTTY
0
0
0
0
0
0
0
0
0
37301
0
0
0
0
0
0
0
0
0
0
4476
0
0
0
0
0
0
0
0
0
0
0
4476
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
37301 4476 4476 0 0 0
%
MP/JBP/00008617/000/0000006
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
8952
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 4 of 16
FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :GORAKHNATH SINGH R P SINGH
0
0
0
0
0
0
0
0
0
36784
0
0
0
0
0
0
0
0
0
0
4414
0
0
0
0
0
0
0
0
0
0
0
3164
0
0
0
0
0
0
0
0
0
0
0
1250
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
36784 4414 3164 0 1250 0
%
MP/JBP/00008617/000/0000007
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
8828
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 5 of 16
FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :RAJESH KUMAR SHARMA K R SHARMA
0
0
0
0
0
0
0
0
0
32727
0
0
0
0
0
0
0
0
0
0
3927
0
0
0
0
0
0
0
0
0
0
0
2677
0
0
0
0
0
0
0
0
0
0
0
1250
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
32727 3927 2677 0 1250 0
%
MP/JBP/00008617/000/0000009
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
7854
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 6 of 16
FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :ANNAMMA JOY N M JOY
0
0
0
0
0
0
0
0
0
32189
0
0
0
0
0
0
0
0
0
0
3863
0
0
0
0
0
0
0
0
0
0
0
2613
0
0
0
0
0
0
0
0
0
0
0
1250
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
32189 3863 2613 0 1250 0
%
MP/JBP/00008617/000/0000010
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
7726
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 7 of 16
FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :NARESH SHANKAR SHRIVASTVA J M LAL SHRIVASTVA
0
0
0
0
0
0
0
0
0
31712
0
0
0
0
0
0
0
0
0
0
3805
0
0
0
0
0
0
0
0
0
0
0
2555
0
0
0
0
0
0
0
0
0
0
0
1250
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
31712 3805 2555 0 1250 0
%
MP/JBP/00008617/000/0000011
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
7610
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 8 of 16
FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :VIRENDRA KUMAR MISHRA R K MISHRA
0
0
0
0
0
0
0
0
0
32189
0
0
0
0
0
0
0
0
0
0
3863
0
0
0
0
0
0
0
0
0
0
0
3863
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
32189 3863 3863 0 0 0
%
MP/JBP/00008617/000/0000013
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
7726
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 9 of 16
FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :UMESHCHANDRA TIWARI R A TIWARI
0
0
0
0
0
0
0
0
0
32189
0
0
0
0
0
0
0
0
0
0
3863
0
0
0
0
0
0
0
0
0
0
0
2613
0
0
0
0
0
0
0
0
0
0
0
1250
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
32189 3863 2613 0 1250 0
%
MP/JBP/00008617/000/0000014
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
7726
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 10 of 16
FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :DWARKA PRASAD GOSWAMI H D GOSWAMI
0
0
0
0
0
0
0
0
0
32189
0
0
0
0
0
0
0
0
0
0
3863
0
0
0
0
0
0
0
0
0
0
0
2613
0
0
0
0
0
0
0
0
0
0
0
1250
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
32189 3863 2613 0 1250 0
%
MP/JBP/00008617/000/0000015
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
7726
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 11 of 16
FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :ALOK KUMAR GOUR R D GOUR
0
0
0
0
0
0
0
0
0
32189
0
0
0
0
0
0
0
0
0
0
3863
0
0
0
0
0
0
0
0
0
0
0
2613
0
0
0
0
0
0
0
0
0
0
0
1250
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
32189 3863 2613 0 1250 0
%
MP/JBP/00008617/000/0000016
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
7726
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 12 of 16
FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :DINESH KUMAR SHARMA B P SHARMA
0
0
0
0
0
0
0
0
0
28235
0
0
0
0
0
0
0
0
0
0
3388
0
0
0
0
0
0
0
0
0
0
0
3388
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
28235 3388 3388 0 0 0
%
MP/JBP/00008617/000/0000017
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
6776
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 13 of 16
FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :SATISH KUMAR SHUKLA R R SHUKLA
0
0
0
0
0
0
0
0
0
25420
0
0
0
0
0
0
0
0
0
0
3050
0
0
0
0
0
0
0
0
0
0
0
1800
0
0
0
0
0
0
0
0
0
0
0
1250
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
25420 3050 1800 0 1250 0
%
MP/JBP/00008617/000/0000019
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
6100
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 14 of 16
FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :RAJKUMAR YADAV S L YADAV
0
0
0
0
0
0
0
0
0
20907
0
0
0
0
0
0
0
0
0
0
2509
0
0
0
0
0
0
0
0
0
0
0
1259
0
0
0
0
0
0
0
0
0
0
0
1250
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
20907 2509 1259 0 1250 0
%
MP/JBP/00008617/000/0000020
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
5018
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 15 of 16
FORM-3A (Revised) / FORM 7PS for PF Exempted Establishment
THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952 (Paras 35 & 42) and THE EMPLOYEES' PENSION SCHEME, 1995 [Para 19]
4. Name and Address of the
Estblishment: 5 Statutory rate of the contribution :
1. Account No.
Contribution Card for Currency Period 1ST April 2014 to 31ST March 2015
Month
(1)
Member's Share
Amount of
wages
(2)
EPF
(3)
Pension Fund
8.33%
(4b)
EPF difference between
10% 12% & 8.33%
(4a)
Employer's ShareRef. of Adv.
(5)
NCP
Days
(6)
Remarks
(7)
March Paid in April
May
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
Feb Paid in March
Total
2. Name 3. Father's/Husband Name :SAJJAN KUMAR BAHELIYA GORELAL
0
0
0
0
0
0
0
0
0
15028
0
0
0
0
0
0
0
0
0
0
1803
0
0
0
0
0
0
0
0
0
0
0
553
0
0
0
0
0
0
0
0
0
0
0
1250
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 (a) Date of leaving
Service, if any
(b) Reason for
leaving Service, if
15028 1803 553 0 1250 0
%
MP/JBP/00008617/000/0000021
12 V. F. J. EMP. CO-OP. SOCIETY LTD
CONTRIBUTION
Note1:(1) in respect of the form 3A sent to the Regional Office during the course of the currency period for the purpose of final settlement of the Account of the member who has
left service, details of date & reasons for leaving service should be furnished under col. 7(a) & (b)
Date :Signature of the employer with office Seal
(2) in respect of those who are not members of the Pension Fund the employers share of contribution to the EPF will be 12% 10% as the case may be & is to be shown under column 4(a)
Certified that total amount of contribution (both shares) indicated in this card ie. Rs. has already been remitted in full in EPF A/c No.1 and Pension Fund A/c No 10
(vide note below.)
Certified that the difference between the total of the contribution shown under cols 3 and 4a & 4b of the above table are arrived at on the total wages shown in cloumn 2 at the
prescribed rate is soley due to rounding off contributions to the nearest rupee under the rules.
ADHARTAL JABALPUR JABALPUR MADHYA PRADESH 482,001
3606
30-Jan-2015
0
MPJBP0008617000Form3A(20142015)30012015
Contribution rate for A/c 10/2/21/22 changed to - / - / - / - Wage ceiling is changed to staturatory/disabled 15000/-
Page 16 of 16