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Nominee Form
NOMINEE FORM

NOMINEE FORM

For Provident Fund Nomination

Nominee Information
NOMINEE NAME
KRISHNABATI SARDAR
RELATION
WIFE
DATE OF BIRTH OF NOMINEE
13-04-1993
% OF SHARE OF P. F. BALANCE
100%
MARITAL STATUS
MARRIED
MARRIAGE DATE
18-11-2014
IDENTIFICATION MARK
A MOLE ON THE THUMB FINGER OF THE RIGHT HAND
Employee Information
NAME
BISHNU PADA MAHATO
DATE OF BIRTH
10-03-1985
MOBILE NUMBER
9088084504
EMAIL ID
bishnupadamahato@gmail.com
ADDRESS
VILL- SUBUDDHI PUR . POST- MAHADEV PUR .P.S- HARINGHATA. DIST- NADIA.PIN-741257. STATE- WESTBENGAL.
Bank Account Details
NOMINEE'S BANK A/C NO
123456789012
IFSC CODE
SBIN0001234
BRANCH NAME
HABRA BRANCH
BANK NAME
State Bank of India

SIGNATURE OF EMPLOYEE

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