INSTRUCTIONS
(These Instructions sheets are not required to
be printed for submission of the claim form and are not required to be attached
with the claim.
These are only for
information of the member/claimant) THE
EMPLOYEES’ PENSION SCHEME, 1995 APPLICATION FOR MONTHLY PENSION
Note: Claim Form 10D should be
submitted in two copies in case pension is to be drawn in other Region/Sub
Region.
EXPLANATORY NOTE FOR THE
APPLICATION:
Serial
No given below relates to the corresponding number given in the application
form.
1. By whom the pension is claimed?
Indicate
anyone of the following under Sl. No. 1.
|
MEMBER |
WIDOW |
WIDOWER |
MAJOR/ORPHAN |
|
GUARDIAN |
NOMINEE |
DEPENDENT PARENT |
|
2. Type of Pension claimed-
Indicate
any one of the following
a) SUPERANNUATION
PENSION :By member on attaining 58 years age, whether in service or not
b) REDUCED
PENSION: By member after the age of 50 years but below 58 years and having left service
c) DISABLEMENT
PENSION: By member on leaving service on account of total and permanent disablement.
d) WIDOW &
CHILDREN PENSION: By family (spouse and children) on death of the Member.
e) ORPHAN
PENSION: By surviving son/daughter (of age up to 25 years as on date of death
of member/spouse whichever is later) on the
death or remarriage of the deceased member.
f) NOMINEE
PENSION: By nominee declared by the Member through his/her Form 2(R) in case
the member had no family (Spouse and children).
g) DEPENDENT
PARENT: By the dependent father and mother of the deceased member who died
without a family (spouse and children) and failed to nominate a person for pension.
Note: A
member who has completed 58 years of / claimant on behalf of a deceased member
who died after the age of 58 years without completing the eligible service of
10 years should apply for Withdrawal Benefit through Form 10C.
3: Please furnish the
particulars relating to the member correctly.
(a) The name must be mentioned
in BLOCK LETTERS.
(b) Marital Status: Whether married/unmarried/widow/widower/Divorcee.
(c) Date of Birth: In dd/mm/yyyy format.
(d) Father’s
Name and in case of a married female member, Husband’s name in BLOCK LETTERS.
4. EPF Account
Number: The account number should have the Region Code (two alphabets), Office
Code (three alphabets) code number (maximum 7 digits), extension (sub code, if
any, maximum three characters) and account number (maximum 7 digits).
The region codes
have changed after creation of the multiple regions in some states, namely
Maharashtra, Tamil Nadu, Karnataka, West Bengal, Punjab, Gujarat, Andhra
Pradesh, Uttar Pradesh, Haryana and Delhi. For getting the correct Region and
Office Codes, please visit Establishment
Search facility provided under link for Employees through the epfindia
website [epfindia.gov.in].
5. Name and
Address of the Establishment where the member was last employed.
6. Indicate
the actual date of leaving service. This need not be filled by a member who has
attained 58 years and continues to be in service. In such case indicate,” still
in service”.
If the reason for leaving service was on account of total and permanent
disablement, as indicated by the establishment to the P.F. Office through Form
10/Form 5 (PS)/ECR (Electronic Challan cum Return) then only the member is
entitled for Disablement Pension. In all other cases the actual reason for
leaving service may be given.
However, a member who continues in service beyond the age of 58 years may
indicate “still in service.”
8. If the
present address is temporary one, also indicate permanent address.
8 A. If the
member has left service before 58 years of age, has not completed 58 years age
as on date of application and is ready for drawing reduced pension, he/she
should mention the date from which
/she wishes to get pension.
The opted date cannot be prior to date of attaining 50 years age and date
of leaving service.
NOTE: Sl. No.9, 10 and 11 are
applicable only to a member of the Pension Scheme and not for his/her family or
any other claimant. Claimants applying for pension due to death of member need
not fill in the details under serial number 9, 10 and 11.
For the members also, the serial
number 9, 10 and 11 are applicable only if the date of start of member pension
is before 26/09/2008 (cases where the application is being filed belatedly but
the member is due for pension from such date). From 26/09/2008, the provisions
for Commutation and Return of Capital have been abolished vide Notification Number GSR 688 (E) dated 26- 09-2008 and any member who is due for pension from 26/09/2008 is not eligible for them.
9. Sl. No.9 is
applicable only to a member of the Pension Scheme and not for his family or any
other claimant. Claimants after death of member need not fill in the details
under serial number 9, 10 and 11.
In case of a
member who is entitled to draw pension from a date prior to 26-09-2008, he/she
is eligible to commute upto a maximum of 1/3 of his pension so as to receive
100 times of the pension commuted. If a pensioner who is getting an original
pension of Rs.600/-commutes 1/3 of it, he will get Rs.20, 000/- as commuted
value. The commutation will be effective only from 16.11.1998. The applicant
may give his option for commutation in the application and this will be
effective and paid only if the member-pensioner continues to draw his pension
as on 16.11.1998. On opting for commuted value of pension, the origin pension
mentioned for Return of Capital will be the balance of pension after
commutation.
Option for the commutation of
Pension cannot be given if the Pension Start Date is on or after 26-09-2008 as
this facility has been abolished vide Notification Number GSR 688 (E) dated
26-09-2008.
10. Sl. No.10
is applicable only to a member of the Pension Scheme and not for his family or any other claimant.
In case of a
member who is entitled to draw pension from a date prior to 26-09-2008, he/she
can give his option for return of Capital. Option once exercised is final. He
may choose any one of the following and indicate the No. shown under
alternative against Sl. No. 10 of the application.
Option for the Return of Capital cannot be given
if the Pension Start Date is on or after 26-09-2008 as this facility has been
abolished vide Notification Number GSR 688 (E) dated 26-09-2008.
|
Alternative |
Quantum of Pension |
Return of Capital |
|
1. |
90% of original |
On member’s death |
|
|
pension |
100 times the original
monthly pension to nominee |
|
2. |
90%
of original pension to member. On his death 80% of pension to widow/widower. |
On death or remarriage of widow/widower whichever is earlier. 90 times of
original pension to nominee. |
|
3. |
87.5% of original pension
for a fixed period of 20 years to member. On his death before 20 years,
nominee will get pension for balance period. |
At the end of 20 years,
100 times of original pension to member, if he is alive, otherwise to
nominee. |
11. The member
is required to furnish the details of his/her nominee for receiving the Return
of Capital. A member can nominate his/her spouse or sons or daughters. A
married member who is not survived by any member of his family
(spouse/sons/daughters) and a bachelor spinster may nominate a person of
his/her choice to receive the return of Capital/Pension due if any, under
Alternative 3 as per Sl. No. 10 above.
In case of
option 2, spouse cannot be nominated as he/she will get 80% of pension along
with widow pension. Nominee will get the amount only after death/remarriage of
the widow/widower (spouse).
This field is
applicable only if the Field 10 has been opted/member is eligible for opting
ROC.
12. This should be completed by
the member.
While the member pension is approved, the pension amount payable to the
family (spouse/children) are also decided and in case of the death of the
member as pensioner, the spouse/children/orphan will start getting the pension on submission of the death certificate and there will
not be any
requirement of processing of the widow/children/orphan pension again.
In case of a deceased member, it has to be filled by the spouse/children.
The list of surviving family members of the Member, covering his spouse, all
children should be furnished. The particulars of Guardian should be given in
respect of each minor child, as of the date of application. In support of the
age of children, age proof certificate obtained from the school or Registrar of
Birth-death or E.S.I. Record, or Municipal authorities should be enclosed. In
the case of Guardian other than natural guardian, a Guardianship Certificate
should be enclosed.
13. Applicable
only in case the member is not alive. In support of the date of death, death
Certificate should be enclosed.
14. The details
of Bank S.B.A/c No for receiving the pension should be given.
In case the claim is preferred by spouse, he/ she should give his/her
S.B.A/c No. and also separate S.B.A/c No.s in respect of each child.
S.B. A/c
No.s of children who are below the age of 25 years (as on date of death of the
member) should be given. On behalf of minor child, S.B. A/c opened in the name
of minor and operated by the guardian of the minor and A/c No. should be given.
Pension is
payable through any branch of certain Bank depending on state where the
pensioner want to receive pension by credit to the S.B. A/c No.s of eligible
pensioners. Hence S.B. A/c should be opened only in the said Bank(s). Necessary
guidelines have been given to all the branches of the said Banks to open a S.B.
A/c for the pensioners. The applicant may approach any branch of the said
Bank(s) to open the account. Click here
to see the List of Banks where Pension Account can be opened.
The member, the spouse and children (minor or major) should necessarily
open S.B. A/cs in the same branch of the Bank.
Whenever pension is opted from a place beyond the jurisdiction of the
region in which the member was last employed, he should ascertain the name of the designated bank applicable in that Region and open a
S.B. A/C therein.
On sanction of Pension, intimation will be sent to the pensioner to
contact the bank.
14- A. In case
of death of the member before attaining 58 years without leaving any eligible
family members to receive the pension, the nominee as appointed by the member
through the From 2 (Revised) already sent to the P.F. Office may apply, giving
his particulars against this column.
In case the
member had no family and had died before appoint a nominee for pension, his/her
dependent parent (father & mother) may apply for pension, pension will be
paid to father and on his death to mother.
15. In case the
member was working in different establishments and obtained Scheme Certificate,
the details should be furnished against this column. In case, no Scheme
Certificate was received or not applied for the same, the details of past
employment may be indicated in this column.
16. If the
applicant is already receiving pension under Employees’ Pension Scheme, 1995
claim pension, the details should be furnished against this column.
17. List of documents to be enclosed and specified under
Column No.17:
a) Descriptive
role of pensioner and his/her specimen signature/Thumb impression (in
duplicate); (Form is enclosed with the Claim
Form)
b)
3 pass-port size photographs
If claimed by
the member Joint photo with spouse, there is no need to send photograph of the
children.
If claimed by
widow/widower the photograph should be sent for widow/widower and his/her two
children (below 25 years) separately.
The photographs
should be attested by the employer or his authorized official, indicating the
person, whom the photograph relates to and also the P.F. Account No. of the
member, written on the verse and placed in a separate envelope.
c) In the case
of a member, who is permanently and totally disabled during the employment,
he/she should undergo a Medical Examination before the Medical Board advised by
the E.P.F. Office. However, the disablement should occur while in employment.
d) The application
should be forwarded through the establishment in which the member last
served/died. The establishment should furnish the certificate and wage
particulars duly attested by the authorized officer.
e) Only if the
establishment is closed, the application should be forwarded through
Magistrate/Gazetted Officer/Bank Manager/any other authorized officer as may be
approved by the Commissioner.

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