FORM 6A
THE EMPLOYEES' PROVIDENT FUND SCH (PARAGRAPH 43) and THE EMPLOYEE'S PENSION SCHEME ( PARAGRAPH 20 (4)) ANNUAL STATEMENT OF CONTRIBUTION for the currency period from 1st March' 2006 to 28th February' 2007 Name & Address of the establishment Code No: of the establishment
S.NO
Wages, retaining allowance (if any) and DA including cash Account Number NAME OF THE MEMBER value of food concessio n paid during the currency period.
EPF difference between 1 1
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
2
3
4
23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74
75 76 GRAND TOTAL
-
FORM 6A
S' PROVIDENT FUND SCHEME, 1952 (PARAGRAPH 43) and YEE'S PENSION SCHEME, 1995 PARAGRAPH 20 (4)) STATUTORY RATE OF CONTRIBUTION : 12% No. of members voluntarily contributing at a higher rate
Amount of Worker's contributio ns deducted from the wages on 10% / 12% EPF
Employer's contribution w.e.f. 16/11/1995
NIL NIL
Rate of higher Refund of voluntary Remarks advance contributio n (if any)
EPF difference between 10% / 12% & Pension 8.33% Fund contribution 8.33% 5
6
7
8
9
10
-
-
-
Only for un-exempted establishment
FORM 12-A (REVISED) (To be filled by the EPFO) EMPLOYEES' PROVIDENT FUND AND MISC PROVISIONS ACT 1952 Employees' Pension Scheme (Paragraph 20(4)}
Name and address of the Establishment CURRENCY PERIOD FROM IST APRIL 2007 TO 31ST MARCH-2008
Statement of contribution for the month of January 2008 Statutory rate of contribution for the month of January 2008
CODE NO Particulars
Wages on which
Amount of Contribtion
contributions are payable
Amount of Contribution remitted
3
4
Recovered from
Payable by
the workers
the employer
1 2 E.P.F. A/C NO. 01 PENSION FUND 0 A/C NO. 2&10 E.D.L.I. A/C NO.21&22 0 Total No of Employees (a)Contract (b)Rest (c) Total Details of Subscribers No.of Subscribers as perlast month No.of New Subscribers (Vide Form5) No.of Subscribers left service (Vide Form 10) (Nett) Total Number of Subscribers
Worker's share
Amount of adminitrative
Employer's Share charges due
0 NIL
0 0
0 NIL
0 0
5 0 NIL
NIL
0
NIL
0
0
0
Name & Address of the Bank in which the amount is remitted E.P.F. Pension Fund 0 0 0 0 0
STATE BANK OF INDIA,PONDI
EDLI 0 0 0 0
(To be filled by the EPFO) ONS ACT 1952
Establishment status Group Code
Amount of
Date of remittence
adminitrative (enclose triplicate copies of charges
challan)
remitted
6 0 NIL
7 18 | 02 | 2 0 0 8 | 18 | 02 | 2 0 0 8 |
0
18 | 02 | 2 0 0 8 |
STATE BANK OF INDIA,PONDICHERRY
0
Signature of employer with official(Seal)
COMBINED CHALLAN OF A/C No. 1,2,10,21 & 22 Original / Duplicate / Triplicate / Quadruplicate STATE BANK OF INDIA
EMPLOYEE'S PROVIDENT FUND ORGANISATION (USE SEPARATE CHALLAN FOR EACH MONTH)
ESTABLISHMENT CODE NO. DUES FOR THE MONTH OF:
ACCOUNT GROUP NO
………...……
Employees Share Employer Share
TOTAL NO. OF SUBSCRIBERS TOTAL WAGES DUE SL. PARTICULARS
PAID BY CHEQUE / CASH D
0
0
0
D
M
Y
Y
DATE OF PAYMENT
0
A/c 1
A/c 10 A/C No. 1
M
……………..………
A/c 21
A/C No 2. A/C No. 10 …………….……. AMOUNT
A/C No. 21 A/C No.22 ………...…………
TOTAL
(IN RUPEES)
1 EMPLOYER'S SHARE OF CONT.
0
2 EMPLOYEE'S SHARE OF CONT.
0
3 ADM. CHARGES
0
4 INSP. CHARGES 5 PENAL DAMAGES 6 MISC. PAYMENT (PAST ACCUMULATIONS ONLY) TOTAL
0 (AMOUNT IN WORDS) Rs.
0
0
0
0
0
Only [FOR BANK'S USE ONLY]
NAME OF ESTABLISHMENT: ADDRESS: NAME OF DEPOSITOR ……………………………..…………………………………. SIGNATURE OF THE DEPOSITOR ………………...…………………………………
AMOUNT RECEIVED Rs……...………..……….. FOR CHEQUES ONLY….……………………….. DATE OF PRESENTATION………....……….….. DATE OF REALISATION ……………..…………. BRANCH NAME …….……...…….…...………….. BRANCH CODE NO………….….………………..
(TO BE FILLED IN BY EMPLOYER) NAME OF THE BANK ------------- ###
-------- CHEQUE NO
--------------------------
DATE