AP GPF Application Form for Final payment of GPF Balance-GO.214New TS GPF Application Form, GO.214 Revised AP GPF Application Form for Final payment of GPF, How to fill AP GPF Details for final payment of GPF Balance. GOVERNMENT OF ANDHRA PRADESH-GPF-Revision of ‘’Form of Application for the Final Payment of General Provident Fund (GPF) Balance”- Orders -issued. Finance(HR.5-Pensions& GPF)Department. G.O.MS.No. 214 Dated: 04-11-2016.
Read the following
1. G.O.Ms.No.261, Finance & Planning (FW.Pen.II)Department, Dated 28.08.1999.
2. Letter.No.FM/GL.II/9-3/2016-17/797 dated 28.07.2016 of the Accountant
General (A&E), Andhra Pradesh and Telangana, Hyderabad.
In the G.O. 1st read above Government issued orders revising Form of Application for Final Payment of General Provident Fund balances.
2. In the reference 2nd read above the Accountant General proposed certain changes in the form of application for final payment of General Provident Fund Balances.
3. Government after careful examination of the proposal have decided to revise the form of application for final payment of General Provident Fund as suggested by the Accountant General (A&E), Andhra Pradesh and Telangana. The revised form is annexed to this G.O.
4. All Drawing and Disbursing Officers/Head of the Departments shall hereafter send to the Accountant General (A&E) two sets of applications in the revised format instead of 3 sets of form of application for processing of final payment from the General Provident Fund.
Read | How to fill TS GPF Details in application form for final payment of GPF Balance
Read | How to fill AP GPF Details in application form for final payment of GPF Balance
Form of Application for Final Payment of General Provident Fund Balance
[Retirement/Resignation/Removal/Transfer of Balance or Death Case]
TO BE FILLED IN BY THE APPLICANT
The Principal Accountant General (A&E) Andhra Pradesh & Telangana HYDERABAD. (Through the Head of office in case of Non-Gazetted and Through Head of the department in case of Gazetted officers)
- 1. (i)Name of the Subscriber(in capital letters) : Emp I(7 digit) :
- 2. Date of Birth :
- 3. Designation and office to which attached :
- 4. G.P.F. Account No. With Departmental Suffix :
- 5. Details of Nomination filed : ( As per Rule 7 ) :
- 6. Residential address of the claimant :
- Present Address:
- Permanent Address:
- 7. Copy of the latest Account slip is enclosed: YES/NO
- 8. i) Date of Retirement : or ii) Date of resignation :or
- iii) Date of voluntary Retirement :or
- iv) Date of dismissal/removal/Compulsory retirement/invalidation
- 9. Particulars of offices worked during the Last 3 years
- Name of Office & Address Working during the period Designation From To
- 10. Office/Treasury at which payment is desired:
- a) Personal marks of identification :
- b) Two specimen signatures :
- c) Left/Right hand thumb impression (in case of illiterate claimants)
- i) I have not resigned from Government Service to take up appointment in another
- iv) I hereby undertake to refund any excess payment arising out of clerical error in the settlement of G.P.F. Clai
- 12. In case of death the following particulars may be furnishe a) Date of death : (Copy of death certificate to be enclosed)
- b) Religion of Deceased Government :
- c) Details of the surviving members of :
FOR THE USE OF HEAD OF THE OFFICE/HEAD OF THE DEPARTMENT
The final withdrawal application is forwarded to the Accountant General, Andhra Pradesh, Hyderabad, for authorizing the balance.
- 13. Certified that all the particulars furnished above have been verified with reference to office records and are found correct.
- 14. The last fund deduction was made from his/her pay for the month of …………….Vide this Office Bill No……………………….Dt………………………………for Rs…………………………..(Rupees……………………………………………………………….)cash voucher No……………………………………………..of Treasury, the amount of deduction towards G.P.F
- 15. Details of G.P.F. Deduction made from the subscriber’s salary during the last 12 months immediately preceding the date of retirement (in the proforma appended to G.O. No. 216. Dated 4-6-1986.
- 16. Certified that he/she was neither sanctioned any temporary advances nor any part – final withdrawal from his/her provident fund account during the 12 months immediately preceding the date of his/her quitting service/proceeding on leave preparatory to retirement or thereaft
- 17. Certified that the following temporary advance part-final withdrawals were sanctioned to him / her and drawn from his / her provident fund account during the 12 months immediately preceding the date of his / her quitting service/proceeding on leave preparatory to retirement or thereaft
TRANSFER OF BALANCE:
In case of absorption in other Departments other state Government/Public/sector under takings Furnish the following information.
- Date of absorption :
- II. Is absorption on permanent basis? :
- III. Is absorption without breaks in service? :
- IV. In case of break in service whether it is limited to joining time allowed on transfer? :
- V. Is the absorption with the approval of State : Government? If yes, Copy of the order may be enclosed
- VI. Accounts Officer to whom the balance has to be transferred and the new G.P.F. Account No. allotted by him