PARTICULARS FOR THE GRANT OF RELAXATION/EXEMPTION UNDER SECTION 17(1)(a)/PARA 27A/PARA 79

NAME AND ADDRESS OF THE ESTABLISHMENT:                                                                                   CODE NO.:

1. Details of Branches with address & employment strength (if there are more branches a separate sheet may be added)

(i)

(ii)

(iii)

(iv)

(v)

(vi)

2. Total Employment Strength

3(i). Date of Coverage (w.e.f.)

    

4(i). Relaxation Order No. & date

  

(ii) Reference No. and date

    

(ii) w.e.f.

  

5. If participating in a Trust already exempted, Name of the Trust

  

6. Place where the Trust is functioning

  

7. Code No. alloted to the Trust

  

8. Income Tax recognition order No. & date

 

9. Rate of Contribution

  

10. Whether consent of majority of employees for the exemption obtained

YES

NO

11. Whether any objections have been received for grant of Exemption

YES

NO

12. The number of Trustees representing

Employer

Employees

13. Date of  constitution / reconstitution of the Board of Trustees

  
   

14. Whether contributions at the statutory rate has been transferred to the BOT regularly during the last one year

YES

NO

(if no, details be furnished separately)

15. Compliance under

EPF Scheme, 1952

Paid upto

EPS, 1995

Paid upto
EDLI Scheme,76

Paid upto

16. Whether contributions of members are recorded properly and up-to-date (Specify whether on computer or manually)

YES

NO

19. Whether amount available for investment after meeting obligatory outgoings are invested according to the pattern of investment during the last two financial years

YES

NO

(If no, extent of deviation and reasons to be furnished separately)

17. Whether proper records of withdrawals, settlements, transfer etc. are maintained

YES

NO

18. Whether audited balance sheet of the trust is submitted to Regional P. F. Commissioner (If yes, please specify the last financial year for which balance sheet submitted)

YES (please specify the last financial year for which balance sheet submitted)

NO

(if no, reasons for non submission to be furnished)

20. Whether monthly returns are submitted regularly and the period upto which submitted

  

21. Rate of interest declared for the last two financial years.

    

22. Whether inspection charges/ administrative charges are paid regularly and period upto which remittances made.

  

23. Mode of calculation of interest

On Opening / Closing Balance

On monthly running balance

24. The latest financial year for which annual statement of accounts were issued to the members.

  

25. Whether the employer is agreeable to bear the cost of administration of the Provident Fund Scheme

YES

NO

26. Whether the employer is agreeable to accept the past accumulations partly in securities.

YES

NO

27. Whether the employer is agreeable to make good the loss caused to the P.F. due to theft, burglary, defalcation, misappropriation or any other reason.

YES

NO

28. Whether the employer is agreeable to meet the difference if any, in income to the Trust to declare the statutory rate of interest.

YES

NO

29. Whether the employer is agreeable to remit inspection / administrative charges as fixed from time to time.

YES

NO

30. Whether the employer is agreeable to abide by all the conditions governing grant of exemption that may be laid down from time to time.

YES

NO

Details of supporting documents enclosed:

i)                    Application for exemption duly signed by the employer addressed to the appropriate government.

ii)                  Undertaking to abide by the revised conditions governing grant of exemption duly signed by the employer.

iii)                 Consent of majority of employees/or that of the representative union in favour of securing exemption.

iv)                Names and addresses of the members of the Board of Trustees.

v)                  Two copies of the PF Trust rules incorporating all the amendments approved by the RPFC duly signed by the trustees.

vi)                Copy of the Income Tax Recognition Order.

vii)               Copies of objections, if any, received from employees for grant of exemption.

viii)             Certificate regarding enrollment of contractors employees including names of the contractors, Code Nos. already allotted to them, if any.

ix)                Copy of the audited balance sheet of the Trust for the last two years.

x)                  Copy of the relaxation order.

xi)                Comparison of benefits under the rules of the Trust in the proforma.

xii)               Other documents, if any.

(Signature of the Employer with seal)

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(FOR OFFICE USE ONLY)

The particulars mentioned above, have been verified and found correct. (In case there is any variation, the details may be furnished in a separate covering letter.)  The establishment may be Exempted under Section 17(1)(a)/Para 27A or relaxed under Para 79.

(Regional Provident Fund Commissioner)


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