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APPLICATION FOR WITHDRAWAL / ADVANCE FROM GENERAL PROVIDENT FUND
Department of Education (S) - Government of Manipur
All the (
*
) marked feilds are mandatory.
Apply Application For
*
:
--select--
Advance
Part Final
Final
Name of the Subscriber
*
(As recorded in the initial appointment order)
Select Employees Zone
*
--select--
ZONE-II
ZONE-I
ZONE-III
ZONE-IV
ZEO WANGOI
ZEO KAKCHING
DI MOIRANG
DI LILONG
ZEO JIRIBAM
ZEO UKHRUL
ZEO CHURACHANDPUR
ZEO SENAPATI
ZEO CHANDEL
ZEO KANGPOKPI
ZEO TAMENGLONG
DI SAIKUL
DI HENGLEP
DI SAITU
DI TAMEI
ZEO TENGNOUPAL
ZEO KAMGJONG
ZEO NONEY
ZEO PHERZAWL
DI MOREH
ADDL. HILL
ADDL. VALLEY
NCC
HILLS DISTRICT COUNCIL
TRIAL pls do not select
Select Office / School Name
*
(Office or School Name to be entered on next input)
Office Name
School Name
Office Name
*
Date of birth (dd-mm-yyyy)
*
GPF Account Number
*
(with Departmental Suffix)
MGel/EIN No.
*
Designation
*
(In case of change in designation, please visit directorate)
Select Grade
*
--select--
Grade-I
Grade-II
Grade-III
Grade-IV
Mobile Number
*
+91-
Email
Basic Pay
*
Date of Joining Service
Date of Superannuation
Check if not above Superannuation Date
New Superannuation Date
Balance at credit of the subscriber on the date of application as below:
(i) Closing Balance as per statement for the year ending 31st March
*
(ii) Credit
( Enter start date and end date )
On account of monthly subscription @
/- p.m. (in Rs.)
(in Rs.)
(iii) Refunds made to the Fund after the closing balance, viz (i) above
From
To
Amount
( /- p.m. in Rs.)
Total Refund Amt.
(Rs.)
(iv) Withdrawal during the period/Year
/- p.m. (in Rs.)
(in Rs.)
(v) Net balance at credit on the date of application
*
(in Rs.)
Amount of advance/advances outstanding
*
:
Amount of advance taken on date of sanction
Balance outstanding as on date
(
Add More
)
1.
Amount of
withdrawal
required (in rs.)
*
(in Rs.)
(a) Purpose for which
withdrawal
is required
*
--select--
For education outside India for academic, technical, professional or vocational course beyond the High School stage
For any medical, engineering or other technical or specialized course in India beyond the High School stage
Meeting the expenditure in connection with the betrothal/marriage of the subscriber or his sons or his daughters and any other female relation actually dependent on him
Meeting the expenses in connection with the illness, including where necessary, the travelling expenses of the subscriber and members of his family or any person actually dependent on him
Meeting the cost of consumer durables such as TV,VCR/VCP,washing machines,cooking range,geysers and computers
Building or acquiring a suitable house or ready-built flat for his residence including the cost of the site (or any payment towards allotment of a plot or flat by the Delhi Development Authority,State Housing Board or a House Building Society)
Repaying an outstanding amount on account of loan expressly taken for building or acquiring a suitable house or ready-built flat for his residence
Purchasing a house-site for building a house thereon for his residence or repaying any outstanding amount on account of loan expressly taken for this purpose
Reconstruction or making additions or alterations to a house or a flat already owned or acquired by a subscriber
Renovating,additions or alterations or upkeep of the ancestral house or a house built with the assistance or loan from Government
Constructing a house on a site purchased within twelve months before the date of subscriber's retirement on superannuation from the amount standing to the credit in the Fund, without linking to any purpose
Other Purposes
(b) Rule under which the request is covered
*
(c)
Check If Advance is sought for house building, etc., the following information may be given-
(i) Location and measurement of the plot
(ii) Whether the plot is free hold or on lease
(iii) Plan for construction
(iv) If the flat or plot being purchase is from a H.B. society, the name of the society, the location and measurement, etc.
(v) Cost of construction
(vi) If the purchase of flat is from D.D.A. or any Housing Board, etc. the location, dimention, etc. may be given
(d)
Check If Advance is required for education of children, following details may be given-
(i) Name of the son/daughter
(ii) Class and Institute/College where studying
(iii) Whether a day's scholar or hosteller
(e)
Check If Advance is required for treatment of ailing family members, following details may be given-
(i) Name of patient and relationship
(ii) Name of Hospital/Dispensary/Doctor where the patient is undergoing treatment
(iii) Whether outdoor/indoor patient
(iv) Whether reimbursement available or not
NOTE: In case of advance under above points (c) to (e), no certificate or documentary evidence should be required.
Amount of the consolidated advance and number of the monthly instalments:
Consilidated advance amount
*
( proposed to be repaid in Rs. )
No. of instalments to be repaid
*
Whether any Withdrawal was taken for the same purpose earlier, if so, indicate the amount and the year
Name of the Account officer maintaining the Provident Fund
*
Submit Form
(After submission, Copy of this form certified by DDO should be submitted online)
