Assam Schedule III (Sec-I) Form No-III

Assam Schedule III (Sec-I) Form No-III

Application for admission of the General Provident Fund (to be submitted in duplicate)Account number to be allotted by theName of the applicantDate of birthFathers / Husband NameWhether IndianOfficial DesignationOffice to which attachedWhether the post is permanent /temporary

Whether the Applicant is on

Probation

If temporary whether it will last for at least three yearsRate of emoluments permensemRate of subscription permensemWhether Compulsory or optionalIf the subscriber has any other Fund, the name of such FundWhether the applicant has a Family or notWhether joining the Sterling or rupee branch of the fund Date of joining Head of AccountRemarks

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Station Signature of Applicant Signature of HOD.Dated the .. Designation

Office of the.. No..Date

Returned with account number allotted. This number should be quoted in all correspondence connected therewith. A form of nomination is sent herewith which should be returned duly filled in as soon as possible.

Signature .. Designation...