Application

EPF Withdrawal Application

Request your employer to process the withdrawal of your EPF balance.

EPF Withdrawal Application

Date: [DD/MM/YYYY]

To,
The HR/PF Manager
[Company Name], [City]

Subject: Application for EPF Withdrawal

Respected Sir/Madam,

I would like to apply for withdrawal of my Employees' Provident Fund accumulated during my service. My UAN is [UAN number] and PF account number is [PF number]. I am submitting this request for [reason, e.g., post-resignation settlement / permitted advance for medical/housing needs].

The duly filled Form 19/10C along with my bank details and KYC documents are enclosed. I request you to kindly attest and forward the claim to the EPFO for processing.

Yours faithfully,

___
[Name]
[Emp ID/Dept]

Before you use it — fill in / check

  • Applicant
  • To/Recipient
  • Reason/detail
  • Date

How to use this template

  1. Read through and replace every [bracketed] or blank placeholder with your actual details.
  2. Delete any clause that doesn't apply and add anything specific to your situation.
  3. Click Print / Save as PDF to download, or Copy text to paste into your letterhead.
  4. Get it signed / stamped / notarised as required, and keep a copy for your records.

This is a general, editable template for convenience only — not legal advice. For anything material, have a professional review it. TaxClue isn't liable for how it's used.