This declaration establishes whether the employee has been a member of the fund before. It determines whether an existing account is continued or a new one opened, whether the wage ceiling exemption applies, and whether past service counts towards pension. Collect it before the first salary is processed, not afterwards.
Provident Fund Declaration
Declaration by a person taking up employment
This declaration establishes whether the employee has been a member of the fund before. It determines whether an existing account is continued or a new one opened, whether the wage ceiling exemption applies, and whether past service counts towards pension. Collect it before the first salary is processed, not afterwards.
[COMPANY NAME] Establishment code: [CODE] [ADDRESS]
1. Particulars of the Employee
| Item | Detail |
|---|---|
| Full name | [NAME] |
| [Father’s / Spouse’s] name | [NAME] |
| Relationship | [Father / Spouse] |
| Date of birth | [DATE] |
| Sex | [MALE / FEMALE / OTHER] |
| Marital status | [Married / Unmarried / Widow / Widower / Divorced] |
| Mobile number | [NUMBER] |
| Email address | [EMAIL] |
| Date of joining this establishment | [DATE] |
| Designation and department | [DESIGNATION], [DEPARTMENT] |
| Monthly wages as statutorily defined at joining | ₹ [AMOUNT] |
| Employee identification number | [ID] |
2. Previous Membership
| # | Question | Answer |
|---|---|---|
| 1 | Have you been a member of the Employees’ Provident Fund at any time before? | [YES / NO] |
| 2 | Have you been a member of the Employees’ Pension Scheme at any time before? | [YES / NO] |
| 3 | Has a Universal Account Number already been allotted to you? | [YES / NO] |
| 4 | Have you withdrawn the full amount from your previous provident fund account? | [YES / NO] |
| 5 | Have you withdrawn the full amount from your previous pension account? | [YES / NO] |
| 6 | Were your monthly wages at the time of leaving your previous employment above the statutory wage ceiling? | [YES / NO] |
| 7 | Have you been issued a scheme certificate in respect of past pensionable service? | [YES / NO] |
| 8 | Are you an international worker? | [YES / NO] |
Complete section 3 only where the answer to question 1 or question 2 above is "Yes".
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Preview of the first page. Highlighted fields are the ones you fill in — they appear the same way in Word. Scroll the preview to read on; the full document runs to 6 pages.
These notes accompany the template and explain the drafting choices, the compliance points and the mistakes most often made with this document. They appear as a final page in the Word file, intended to be deleted before the document is executed.
The declaration determines whether an existing account is continued or a new one opened, and whether the employee falls within an exemption. Processing the first salary without it is how duplicate accounts are created, and a duplicate is far harder to merge later than it is to avoid at the outset.
An employee who does not recall previous membership, or who answers question 1 carelessly, causes a second number to be generated. The consequences surface years later as a fragmented service record, a broken pension entitlement and a delayed settlement. Verify against the documents rather than accepting the answer, and run the duplicate check at step 4.
Service under successive employers counts towards the pension entitlement only where accounts are transferred and records linked. An employee who withdraws in full at each job change breaks that continuity permanently. Where an employee has withdrawn, or is contemplating withdrawing, make sure they understand the effect before it happens — question 4 and question 5 are there to surface it.
A person joining for the first time whose wages exceed the statutory ceiling may fall outside mandatory coverage, but a person who has been a member before generally continues to be covered regardless of current wages. Question 6 combined with question 1 establishes which applies. Applying the exemption to someone with prior membership is a compliance failure that accrues quietly.
The obligation arises from the date the employee becomes eligible, not from the date the paperwork is completed. Where a declaration is collected late, contributions must still be deposited from the date of joining, and interest and damages accrue on delay. Do not let a missing form delay the contribution.
Contributions are computed on wages as the consolidated legislation defines them, with components excluded from wages capped at half of total remuneration. A structure with a small basic and a large special allowance understates the contribution base and creates an accruing liability. Step 7 requires the wage base to be confirmed against that definition, not taken from the offer letter.
An international worker is generally covered without regard to the wage ceiling, and different rules apply to withdrawal and to the period of contribution. Where a social security agreement is in force with the person’s home country and a certificate of coverage is held, contributions may be exempt for the period of the certificate. Section 5 collects what is needed; take advice before applying the exemption.
The declaration and the nomination are different forms and both are needed. Collecting one and not the other is common. Issue them as a single joining pack, along with the gratuity nomination, so the employee completes them once.
Claims and transfers are processed against seeded identification and bank details. An account with unseeded or mismatched details produces a rejection at exactly the point the employee needs the money. Verify at joining rather than at exit.
The counterpart obligation at the other end of employment is to update the exit date promptly. An employee whose exit date is never marked cannot transfer or withdraw, and will contact the former employer months later. Make it part of the exit checklist.
This template captures the substance required. Where the scheme prescribes a form, or where enrolment is done through the online portal, use those and keep this as the internal record and verification checklist.
Retain the declaration for the whole period of employment and for the retention period afterwards. It is the document that answers a later question about why an employee was or was not enrolled from a particular date.
Reflects Indian law current as of {{DATE OF USE}}. Wage ceilings, contribution rates, exemption conditions, international worker treatment and the mechanics of universal account numbers all change — confirm the current position with a payroll specialist before adopting this form.
This is a ready-to-use template provided for convenience. Laws and requirements change, and every situation is different — please have it reviewed by a qualified professional (a lawyer, company secretary, or chartered accountant as relevant) before you rely on it.