Demo Form 3a

(For Unexempted Establishment only)
FORM - 3A (Revised)
The Employee's Provident Funds scheme, 1952 (Para 35 and 42) And The Employee's Family Pension Scheme, 1995 (Para 19) Contribution Card for the currency period from
1. Account Number 2. Name / Surname 3. Father's / Husband Name
MH/105299/1 SAMRATH RAJKUMAR NARSHINA
4. Name and address of the Establishment 5. Statutory Rate of Contribution
SANGHVI QUALITY PRODUCTS PVT. LTD. 85/87 Industrial Estate No. 2 ,BARSHI DIST. SOLAPUR 12.00%
6. Voluntary Higher NIL Rate of Employee Contribution, if any
Contributions
Worker's Share
Employer's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
No. of Days/ Pension Refund Period of Fund of NonContribution Advance E.P.F. contributing (4)-B (5) Difference (4)-A service (6) 165.00 162.00 187.00 180.00 176.00 191.00 158.00 182.00 179.00 179.00 165.00 171.00
2095.00
MARCH/APR 2007 APR MAY JUNE JULY AUG SEPT OCT NOV DEC Jan-08 FEB
Total
Remarks
4494.00 4423.00 5082.00 4894.00 4800.00 5215.00 4292.00 4959.00 4864.00 4864.00 4483.00 4660.00
57030.00
539.00 531.00 610.00 587.00 576.00 626.00 515.00 595.00 584.00 584.00 538.00 559.00
6844.00
374.00 369.00 423.00 407.00 400.00 435.00 357.00 413.00 405.00 405.00 373.00 388.00
4749.00
NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL
0 0 0 0 0 0 0 0 0 0 0 0
0
A) Date of Leaving Service Nill B) Reason for Leaving Service Nill C) Certified that the Total amount of contribution indicated in this card isRs. has already been remitted in full in EPF A/c No. 1 and Pension A/c No. 10 Rs.
8939/4749/-
1. Certified that the Difference between the Total of the Contribution shown under Cols. 3 & 4(a)
& 4(b) of the above table and that arrived at on the total wages shown in Col (2) at the
prescribed rate is solely due to the rounding off of contribution to the nearest rupees one under the rules. Signature of Employer
Dated Place - BARSHI
Director Sanghvi Quality Products Pvt. Ltd. Barshi
FORM - 3A (Revised)
MH/105299/2 VANVE RAMLING NARSU
Contributions
Worker's Share
Employer's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
No. of Days/ Pension Refund Period of Fund of NonContribution Advance E.P.F. contributing (4)-B (5) Difference (4)-A service (6) 168.00 173.00 187.00 170.00 166.00 191.00 175.00 175.00 179.00 179.00 189.00 179.00 2131.00 382.00 392.00 423.00 384.00 376.00 435.00 397.00 397.00 405.00 405.00 429.00 405.00 4830.00 NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL 0 0 0 0 0 0 0 0 0 0 0 0
0
Total
Remarks
4580.00 4706.00 5082.00 4611.00 4518.00 5211.00 4769.00 4769.00 4864.00 4864.00 5150.00 4868.00 57992.00
550.00 565.00 610.00 554.00 542.00 626.00 572.00 572.00 584.00 584.00 618.00 584.00 6961.00
9092/4830/-
FORM - 3A (Revised)
MH/105299/3 WAGHMARE SANJAY NIVRUTI
4. Name and address of the Establishment 5. Statutory Rate of Contribution 6. Voluntary Higher Rate of Employee Contribution, if any
SANGHVI QUALITY PRODUCTS PVT. LTD. 85/87 Industrial Estate No. 2 ,BARSHI 12.00%
NIL
Contributions Month and Year (1) MARCH/APR 2007 APR MAY JUNE JULY AUG SEPT OCT NOV DEC Jan-08 FEB
Total
Remarks
Amount of Wages (2) 4580.00 4423.00 4706.00 4611.00 4894.00 5216.00 4769.00 4959.00 4769.00 4673.00 5150.00 4771.00
57521.00
Worker's Share E.P.F. (3)
Employer's Share E.P.F. Difference (4)-A
550.00 531.00 565.00 554.00 587.00 626.00 572.00 595.00 572.00 561.00 618.00 573.00
6904.00
168.00 162.00 173.00 170.00 180.00 191.00 175.00 182.00 175.00 172.00 189.00 175.00
2112.00
Pension Refund No. of Fund of Days/ Contrib Advanc Period ution e (5) of Non382.00 NIL 0 369.00 NIL 0 392.00 NIL 0 384.00 NIL 0 407.00 NIL 0 435.00 NIL 0 397.00 NIL 0 413.00 NIL 0 397.00 NIL 0 389.00 NIL 0 429.00 NIL 0 398.00 NIL 0
4792.00 0
A) Date of Leaving Service // Nill B) Reason for Leaving Service Nill C) Certified that the Total amount of contribution indicated in this card isRs. has already been remitted in full in EPF A/c No. 1 and Pension A/c No. 10 Rs.
9016/4792/-
FORM - 3A (Revised)
MH/105299/5 ZINJURADE ATUL VYANKATESH
Contributions
Worker's Share
Employer's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
0
Total
Remarks
5186.00 5186.00 5601.00 5394.00 4875.00 5624.00 2940.00 5670.00 5145.00 5459.00 5670.00 5233.00 61983.00
622.00 622.00 672.00 647.00 585.00 675.00 353.00 680.00 617.00 655.00 680.00 628.00 7436.00
9710/5162/-
FORM - 3A (Revised)
MH/105299/7 DESHMUKH SUNIL MADHUKAR
Contributions
Worker's Share
Employer's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
0
Total
Remarks
4667.00 4706.00 5082.00 4894.00 4894.00 5216.00 4769.00 5150.00 4960.00 4959.00 5150.00 4966.00 59413.00
560.00 565.00 610.00 587.00 587.00 626.00 572.00 618.00 595.00 595.00 618.00 596.00 7129.00
9310/4948/-
FORM - 3A (Revised)
MH/105299/9 SHAKHRE PRAFULLA LAXMAN
Contributions
Worker's Share
Employer's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
0
Total
Remarks
4667.00 4706.00 5082.00 4894.00 4518.00 5211.00 4864.00 4959.00 4960.00 4959.00 5150.00 4966.00 58936.00
560.00 565.00 610.00 587.00 542.00 626.00 584.00 595.00 595.00 595.00 618.00 596.00 7073.00
9237/4909/-
FORM - 3A (Revised)
MH/105299/12 SHIRSHAWKAR SHAMRAJ MURLIDHAR
Contributions
Worker's Share
Employer's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
0
Total
Remarks
4994.00 5083.00 5601.00 5394.00 5290.00 5524.00 4200.00 5354.00 4935.00 5459.00 5670.00 5233.00 62737.00
599.00 610.00 672.00 647.00 635.00 663.00 504.00 643.00 592.00 655.00 680.00 628.00 7528.00
9831/5225/-
FORM - 3A (Revised)
MH/105299/13 JAMDAR DIGAMBAR SHIVAJI
Contributions
Worker's Share
Employer's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
0
Total
Remarks
4062.00 4517.00 4800.00 4517.00 4706.00 5213.00 4769.00 5150.00 4673.00 4483.00 4960.00 4962.00 56812.00
488.00 542.00 576.00 542.00 565.00 626.00 572.00 618.00 561.00 538.00 595.00 596.00 6819.00
8905/4733/-
FORM - 3A (Revised)
MH/105299/14 MALI VITTHAL NAMDEO
Contributions
Worker's Share
Employer's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
0
Total
Remarks
4580.00 4517.00 4988.00 4894.00 4329.00 5208.00 4578.00 4864.00 4769.00 4864.00 4960.00 4378.00 56929.00
550.00 542.00 599.00 587.00 520.00 625.00 549.00 584.00 572.00 584.00 595.00 525.00 6832.00
8923/4741/-
FORM - 3A (Revised)
MH/105299/15 ATTAR SARTAJ RASHID
Contributions
Worker's Share
Employer's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
0
Total
Remarks
6224.00 6148.00 6394.00 6394.00 6394.00 6774.00 5963.00 6460.00 6460.00 6459.00 6708.00 6408.00 76786.00
747.00 738.00 767.00 767.00 767.00 813.00 716.00 775.00 775.00 775.00 805.00 769.00 9214.00
12033/6395/-
FORM - 3A (Revised)
MH/105299/16 KULKARNI GANESH BHASKAR
Contributions
Worker's Share
Employer's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
0
Total
Remarks
4667.00 4706.00 4894.00 4706.00 4894.00 5025.00 4673.00 4960.00 4960.00 4959.00 4960.00 4962.00 58366.00
560.00 565.00 587.00 565.00 587.00 603.00 561.00 595.00 595.00 595.00 595.00 595.00 7003.00
9146/4860/-
FORM - 3A (Revised)
MH/105299/17 JADHWAR RAMESH PRABHU
Contributions
Worker's Share
Employer's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
0
Total
Remarks
4667.00 4706.00 4894.00 4706.00 4706.00 5213.00 4769.00 5150.00 4960.00 4959.00 5150.00 4966.00 58846.00
560.00 565.00 587.00 565.00 565.00 626.00 572.00 618.00 595.00 595.00 618.00 596.00 7062.00
9222/4902/-
FORM - 3A (Revised)
MH/105299/27 SANGHVI NAYANESH MANOHARLAL
Contributions
Worker's Share
Employer's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
0
Total
Remarks
6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 78000.00
780.00 780.00 780.00 780.00 780.00 780.00 780.00 780.00 780.00 780.00 780.00 780.00 9360.00
12228/6492/-
FORM - 3A (Revised)
MH/105299/29 SANGHVI VINAYKUMAR MANOHARLAL
Contributions
Worker's Share
Employer's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
0
Total
Remarks
6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 78000.00
780.00 780.00 780.00 780.00 780.00 780.00 780.00 780.00 780.00 780.00 780.00 780.00 9360.00
12228/6492/-
FORM - 3A (Revised)
MH/105299/31 KHODWAY ANIL AMBRUSHI
Contributions
Worker's Share
Employer's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
0
Total
Remarks
4667.00 4706.00 5082.00 4894.00 4894.00 5216.00 4769.00 5150.00 4769.00 3815.00 6295.00 4966.00 59223.00
560.00 565.00 610.00 587.00 587.00 626.00 572.00 618.00 572.00 458.00 756.00 596.00 7107.00
9281/4933/-
FORM - 3A (Revised)
MH/105299/32 MULEY SUBHAS PRABHAKAR
Contributions
Worker's Share
Employer's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Pension Refund No. of Days/ Fund of Period of NonContribution Advance contributing E.P.F. (4)-B (5) service (6) Difference (4)-A 239.00 239.00 239.00 239.00 239.00 239.00 239.00 239.00 239.00 239.00 239.00 239.00 2868.00 541.00 541.00 541.00 541.00 541.00 541.00 541.00 541.00 541.00 541.00 541.00 541.00 6492.00 NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL 0 0 0 0 0 0 0 0 0 0 0 0
0
Total
Remarks
6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 6500.00 78000.00
780.00 780.00 780.00 780.00 780.00 780.00 780.00 780.00 780.00 780.00 780.00 780.00 9360.00
12228/6492/-
FORM - 3A (Revised)
MH/105299/34 KULKARNI ARUN ANANTRAO
Contributions Month and Year (1) Amount of Wages (2) 4580.00 4706.00 4612.00 4894.00 4141.00 5015.00 4578.00 4864.00 4960.00 4864.00 4960.00 4962.00 57136.00
Worker's Share Employer's Share
E.P.F. (3)
Total
Remarks
550.00 565.00 554.00 587.00 497.00 602.00 550.00 584.00 595.00 584.00 595.00 595.00 6858.00
Pension Refund No. of Days/ Period of Fund of NonE.P.F. Contribution Advance contributing Difference (4)-A (4)-B (5) service (6) 168.00 382.00 NIL 0 173.00 392.00 NIL 0 170.00 384.00 NIL 0 180.00 407.00 NIL 0 152.00 345.00 NIL 0 184.00 418.00 NIL 0 168.00 382.00 NIL 0 179.00 405.00 NIL 0 182.00 413.00 NIL 0 179.00 405.00 NIL 0 182.00 413.00 NIL 0 182.00 413.00 NIL 0 0 2099.00 4759.00
A) Date of Leaving Service / / ill N B) Reason for Leaving Service Nill C) Certified that the Total amount of contribution indicated in this card isRs. has already been remitted in full in EPF A/c No. 1 and Pension A/c No. 10 Rs.
8957/4759/-
FORM - 3A (Revised)
MH/105299/36 SHIKH KABIR ISAK
Total
Remarks
Amount of Wages (2) 5186.00 5186.00 5601.00 5394.00 5394.00 5735.00 5459.00 5460.00 5459.00 5459.00 1890.00 5057.00 61280.00
Worker's Share Employer's Share Pension Fund Refund of E.P.F. (3) E.P.F. Difference (4)-A
Contribution (4)-B 432.00 432.00 466.00 449.00 449.00 478.00 455.00 455.00 455.00 455.00 158.00 421.00 5105.00
Advance (5) NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL
622.00 622.00 672.00 647.00 647.00 688.00 655.00 655.00 655.00 655.00 227.00 607.00 7352.00
190.00 190.00 206.00 198.00 198.00 210.00 200.00 200.00 200.00 200.00 69.00 186.00 2247.00
No. of Days/ Period of Noncontributing service (6) 0 0 0 0 0 0 0 0 0 0 0 0

0
A) Date of Leaving Service / / Nill B) Reason for Leaving Service Nill C) Certified that the Total amount of contribution indicated in this card isRs. has already been remitted in full in EPF A/c No. 1 and Pension A/c No. 10 Rs. 1. Certified that the Difference between the Total of the Contribution shown under Cols. 3 & 4(a)
9599/5105/-
FORM - 3A (Revised)
1. Account Number 2. Name / Surname
MH/105299/37 BHALERAO MILLIND
4. Name and address of the Establishment
SANGHVI QUALITY PRODUCTS PVT. LTD. 85/87 Industrial Estate No. 2 ,BARSHI DIST. SOLAPUR
3. Father's / Husband KESHAV Name
5. Statutory Rate 12.00% of Contribution 6. Voluntary Highe IL N Rate of Employee Contribution, if any
Total
Remarks
Amount of Wages (2) 4147.00 4140.00 4563.00 4394.00 4394.00 4697.00 4288.00 4631.00 4459.00 4459.00 4631.00 4485.00 53288.00
E.P.F. (3)
No. of Days/ Pension Fund Refund of Period of NonContribution E.P.F. Advance (5) contributing Difference (4)(4)-B service (6) A 152.00 152.00 168.00 161.00 161.00 172.00 158.00 170.00 164.00 164.00 170.00 164.00 1956.00 346.00 345.00 380.00 366.00 366.00 392.00 357.00 386.00 371.00 371.00 386.00 374.00 4440.00 NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL 0 0 0 0 0 0 0 0 0 0 0 0
0
498.00 497.00 548.00 527.00 527.00 564.00 515.00 556.00 535.00 535.00 556.00 538.00 6396.00
A) Date of Leaving Service /Nill / B) Reason for Leaving Service Nill C) Certified that the Total amount of contribution indicated in this card is Rs. has already been remitted in full in EPF A/c No. 1 and Pension A/c No. 10 Rs. 1. Certified that the Difference between the Total of the Contribution shown under Cols. 3 & 4(a)
8352/4440/-
FORM - 3A (Revised)
MH/105299/38 MURGUDE DATTATRY LIMBRAJ
12.00%
Contributions Month and Year (1) Amount of Wages (2) 3459.00 3575.00 3940.00 3794.00 3648.00 3774.00 3711.00 3859.00 3711.00 3711.00 3563.00 3668.00 44413.00
E.P.F. (3)
No. of Days/ Pension Fund Refund of Period of NonContribution Advance E.P.F. contributing (4)-B (5) Difference (4)-A service (6) 127.00 131.00 145.00 139.00 134.00 139.00 136.00 142.00 136.00 136.00 131.00 135.00 1631.00 288.00 298.00 328.00 316.00 304.00 314.00 309.00 321.00 309.00 309.00 297.00 305.00 3698.00 NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL 0 0 0 0 0 0 0 0 0 0 0 0
0
Total
Remarks
415.00 429.00 473.00 455.00 438.00 453.00 445.00 463.00 445.00 445.00 428.00 440.00 5329.00
A) Date of Leaving Service / / Nill B) Reason for Leaving Service Nill C) Certified that the Total amount of contribution indicated in this card is Rs. has already been remitted in full in EPF A/c No. 1 and Pension A/c No. 10 Rs. 1. Certified that the Difference between the Total of the Contribution shown under Cols. 3 & 4(a)
6960/3698/-
prescribed rate is solely due to the rounding off of contribution to the nearest rupees one under the rules. Dated Place - BARSHI Signature of Employer
FORM - 3A (Revised)
MH/105299/39 DESHPANDE GIRISH VINAYAK
12.00%
Total
Remarks
Amount of Wages (2) 3840.00 4225.00 4225.00 4394.00 4394.00 4697.00 4288.00 4631.00 4288.00 4459.00 4460.00 4481.00 52382.00
Worker's Share Employer's Share Pension Fund
E.P.F. (3)
E.P.F. Difference (4)-A
Refund of Contribution Advance (5) (4)-B 320.00 352.00 352.00 366.00 366.00 392.00 357.00 386.00 357.00 371.00 371.00 374.00 4364.00 NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL
No. of Days/ Period of Non-contributing service (6) 0 0 0 0 0 0 0 0 0 0 0 0

0
461.00 507.00 507.00 527.00 527.00 564.00 515.00 556.00 515.00 535.00 535.00 538.00 6287.00
141.00 155.00 155.00 161.00 161.00 172.00 158.00 170.00 158.00 164.00 164.00 164.00 1923.00
A) Date of Leaving Service // Nill B) Reason for Leaving Service Nill C) Certified that the Total amount of contribution indicated in this card is Rs. has already been remitted in full in EPF A/c No. 1 and Pension A/c No. 10 Rs. 1. Certified that the Difference between the Total of the Contribution shown under Cols. 3 & 4(a)
8210/4364/-
FORM - 3A (Revised)
1. Account Number MH/105299/41 2. Name / Surname
PETADE PADURANG
3. Father's / Husband DNYANDEO Name
12.00%
6. Voluntary HigherNIL Rate of Employee Contribution, if any
Total
Remarks
Amount of Wages (2) 3394.00 3064.00 3867.00 3502.00 3648.00 3997.00 3563.00 3488.00 3563.00 3637.00 4008.00 3603.00 43334.00
Pension Fund
E.P.F. (3)
Contribution (4)E.P.F. Difference (4)B A 125.00 113.00 142.00 129.00 134.00 147.00 131.00 128.00 131.00 134.00 147.00 132.00 1593.00 282.00 255.00 322.00 291.00 304.00 333.00 297.00 291.00 297.00 303.00 334.00 300.00 3609.00
Refund of Advance (5) NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL

0
407.00 368.00 464.00 420.00 438.00 480.00 428.00 419.00 428.00 437.00 481.00 432.00 5202.00
6795/3609/-
FORM - 3A (Revised)
1. Account Number MH/105299/42 2. Name / Surname MANE NETAJI 3. Father's / HusbandBHARAT Name 4. Name and address of the Establishment 5. Statutory Rate of Contribution 6. Voluntary Higher Rate of Employee Contribution, if any
12.00%
NIL
Total
Remarks
Amount of Wages (2) 3394.00 3502.00 3648.00 3502.00 3283.00 3694.00 3711.00 3711.00 3488.00 3563.00 3711.00 3672.00 42879.00
Worker's Share Employer's Share E.P.F. Difference E.P.F. (3) (4)-A
Pension Fund Contribution (4)-B 282.00 292.00 304.00 291.00 274.00 308.00 309.00 309.00 291.00 297.00 309.00 306.00 3572.00

0
407.00 420.00 438.00 420.00 394.00 444.00 446.00 445.00 419.00 428.00 445.00 441.00 5147.00
125.00 128.00 134.00 129.00 120.00 136.00 137.00 136.00 128.00 131.00 136.00 135.00 1575.00
A) Date of Leaving Service // Nill B) Reason for Leaving Service Nill C) Certified that the Total amount of contribution indicated in this card is Rs. has already been remitted in full in EPF A/c No. 1 and Pension A/c No. 10 Rs. 1. Certified that the Difference between the Total of the Contribution shown under Cols. 3 & 4(a)
6722/3572/-
FORM - 3A (Revised)
M 1. Account Number H/105299/43
2. Name / SurnameKSHIRSAGAR NAGESHWAR

APPARAO 3. Father's / Husban
12.00%
Name
6. Voluntary HigherNIL Rate of Employee Contribution, if any
Total
Remarks
Amount of Wages (2) 3394.00 3648.00 3721.00 3502.00 3794.00 3925.00 3637.00 3859.00 3785.00 3859.00 3934.00 3525.00 44583.00
Worker's Share Employer's Share Pension Fund Contribution E.P.F. E.P.F. (3) Difference (4)(4)-B A

0
407.00 438.00 447.00 420.00 455.00 471.00 437.00 463.00 454.00 463.00 472.00 423.00 5350.00
125.00 134.00 137.00 129.00 139.00 144.00 134.00 142.00 139.00 142.00 144.00 129.00 1638.00
282.00 304.00 310.00 291.00 316.00 327.00 303.00 321.00 315.00 321.00 328.00 294.00 3712.00
A) Date of Leaving Service / Nill B) Reason for Leaving Service Nill C) Certified that the Total amount of contribution indicated in this card is Rs. has already been remitted in full in EPF A/c No. 1 and Pension A/c No. 10 Rs. 1. Certified that the Difference between the Total of the Contribution shown under Cols. 3 & 4(a)
6988/3712/-
Director
FORM - 3A (Revised)
MH/105299/45 JAMDAR BALASAHEB MADHUKAR
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
No. of Days/ Pension Refund Period of Fund of NonContribution Advance E.P.F. contributing (4)-B (5) Difference (4)-A service (6)
Employer's Share
Total
Remarks
3263.00 3648.00 3502.00 3502.00 3502.00 3920.00 3711.00 3711.00 3414.00 3637.00 3860.00 3600.00 43270.00
392.00 438.00 420.00 420.00 420.00 471.00 446.00 445.00 410.00 437.00 463.00 432.00 5194.00
120.00 134.00 129.00 129.00 129.00 144.00 137.00 136.00 125.00 134.00 142.00 132.00 1591.00
272.00 304.00 291.00 291.00 291.00 327.00 309.00 309.00 285.00 303.00 321.00 300.00 3603.00
0 0 0 0 0 0 0 0 0 0 0 0
0
A) Date of Leaving Service Nill B) Reason for Leaving Service Nill C) Certified that the Total amount of contribution indicated in this card is Rs. has already been remitted in full in EPF A/c No. 1 and Pension A/c No. 10 Rs.
6785/3603/-
FORM - 3A (Revised)
MH/105299/46 DESHAMUKH SAMPAT HANUMANT
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3524.00 3502.00 3940.00 3794.00 3794.00 4073.00 3414.00 4008.00 3711.00 2523.00 3860.00 3828.00 43971.00
423.00 420.00 473.00 455.00 456.00 489.00 410.00 481.00 445.00 303.00 463.00 459.00 5277.00
129.00 128.00 145.00 139.00 139.00 150.00 125.00 147.00 136.00 93.00 142.00 140.00 1613.00
294.00 292.00 328.00 316.00 317.00 339.00 285.00 334.00 309.00 210.00 321.00 319.00 3664.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6890/3664/-
FORM - 3A (Revised)
MH/105299/47 KAMBLE RUPCHAND LAXMAN
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3524.00 3210.00 3721.00 3794.00 3283.00 3619.00 3860.00 3859.00 3859.00 3711.00 3563.00 3897.00 43900.00
423.00 385.00 447.00 455.00 394.00 435.00 463.00 463.00 463.00 445.00 428.00 468.00 5269.00
129.00 118.00 137.00 139.00 120.00 133.00 142.00 142.00 142.00 136.00 131.00 143.00 1612.00
294.00 267.00 310.00 316.00 274.00 302.00 321.00 321.00 321.00 309.00 297.00 325.00 3657.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6881/3657/-
FORM - 3A (Revised)
MH/105299/48 1. Account Num SADAVARTE ABHAYKUMAR 2. Name / Surnam KASHINATH 3. Father's / Husb
Name
No. of Days/ Worker's Share Employer's Share Pension Refund of Period of Month and Amount of Fund Advance NonE.P.F. Year (1) Wages (2) Contributi (5) contributin Difference (4)- on (4)-B E.P.F. (3) g service A (6) MARCH/AP R 2007 APR MAY JUNE JULY AUG SEPT OCT NOV DEC Jan-08 FEB
Total
Remarks
Contributions
3524.00 3648.00 3502.00 3502.00 3721.00 3924.00 3860.00 3859.00 3859.00 3859.00 3563.00 3897.00 44718.00
423.00 438.00 420.00 420.00 447.00 471.00 463.00 463.00 463.00 463.00 428.00 468.00 5367.00
129.00 134.00 129.00 129.00 137.00 144.00 142.00 142.00 142.00 142.00 131.00 143.00 1644.00
294.00 304.00 291.00 291.00 310.00 327.00 321.00 321.00 321.00 321.00 297.00 325.00 3723.00
0 0 0 0 0 0 0 0 0 0 0 0
0
7011/3723/-
FORM - 3A (Revised)
MH/105299/49 BHOSALE RAJARAM SHIVMURTI
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3524.00 3648.00 3794.00 3429.00 3502.00 4068.00 3711.00 3711.00 3414.00 3711.00 3860.00 3676.00 44048.00
423.00 438.00 455.00 412.00 420.00 489.00 446.00 445.00 410.00 445.00 463.00 441.00 5287.00
129.00 134.00 139.00 126.00 129.00 150.00 137.00 136.00 125.00 136.00 142.00 135.00 1618.00
294.00 304.00 316.00 286.00 291.00 339.00 309.00 309.00 285.00 309.00 321.00 306.00 3669.00
0 0 0 0 0 0 0 0 0 0 0 0
0
7011/3669/-
FORM - 3A (Revised)
MH/105299/50 JAGADALE MAHESH SUNIL
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
2089.00 3064.00 3940.00 3210.00 3794.00 3925.00 3711.00 4008.00 3860.00 3414.00 2969.00 3120.00 41104.00
251.00 368.00 473.00 385.00 455.00 471.00 445.00 481.00 463.00 410.00 356.00 375.00 4933.00
77.00 113.00 145.00 118.00 139.00 144.00 136.00 147.00 142.00 125.00 109.00 115.00 1510.00
174.00 255.00 328.00 267.00 316.00 327.00 309.00 334.00 321.00 285.00 247.00 260.00 3423.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6443/3423/-
FORM - 3A (Revised)
MH/105299/51 PANDHARE VAIBHAV SURESH
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
2480.00 3064.00 3648.00 3502.00 3502.00 3920.00 3563.00 4008.00 3711.00 3859.00 3711.00 3139.00 42107.00
298.00 368.00 438.00 420.00 420.00 470.00 428.00 481.00 445.00 463.00 445.00 377.00 5053.00
91.00 113.00 134.00 128.00 129.00 144.00 131.00 147.00 136.00 142.00 136.00 115.00 1546.00
207.00 255.00 304.00 292.00 291.00 326.00 297.00 334.00 309.00 321.00 309.00 262.00 3507.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6599/3507/-
FORM - 3A (Revised)
MH/105299/52 DHUS VIJAY EKANATH
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3002.00 2772.00 3940.00 3210.00 3356.00 3621.00 3266.00 3859.00 3860.00 3563.00 3711.00 3900.00 42060.00
360.00 333.00 473.00 385.00 403.00 435.00 392.00 463.00 463.00 428.00 445.00 468.00 5048.00
110.00 102.00 145.00 118.00 123.00 133.00 120.00 142.00 142.00 131.00 136.00 143.00 1545.00
250.00 231.00 328.00 267.00 280.00 302.00 272.00 321.00 321.00 297.00 309.00 325.00 3503.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6593/3503/-
FORM - 3A (Revised)
MH/105299/53 KADAM SANDEEP DATTATRYA
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3494.00 3145.00 3669.00 3894.00 3370.00 4169.00 3731.00 3807.00 3807.00 3807.00 4035.00 2675.00 43603.00
419.00 377.00 440.00 467.00 404.00 501.00 448.00 457.00 457.00 457.00 484.00 321.00 5232.00
128.00 115.00 135.00 143.00 124.00 153.00 137.00 140.00 140.00 140.00 148.00 98.00 1601.00
291.00 262.00 305.00 324.00 280.00 348.00 311.00 317.00 317.00 317.00 336.00 223.00 3631.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6833/3631/-
FORM - 3A (Revised)
MH/105299/56 PATIL KIRAN KUBIR
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3524.00 3648.00 3429.00 3794.00 3502.00 3994.00 3117.00 2895.00 3711.00 3340.00 4008.00 3908.00 42870.00
423.00 438.00 412.00 455.00 420.00 480.00 374.00 348.00 445.00 401.00 481.00 469.00 5146.00
129.00 134.00 126.00 139.00 129.00 147.00 114.00 106.00 136.00 123.00 147.00 143.00 1573.00
294.00 304.00 286.00 316.00 291.00 333.00 260.00 242.00 309.00 278.00 334.00 326.00 3573.00
0 0 0 0 0 0 0 0 0 0 0 0
0
8719/3573/-
FORM - 3A (Revised)
MH/105299/57 PATIL SANTOSH SHAHAJIRAO
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3628.00 3744.00 4044.00 3894.00 3894.00 5216.00 4483.00 5150.00 4959.00 4959.00 5150.00 4771.00 53892.00
435.00 449.00 485.00 467.00 467.00 626.00 538.00 618.00 595.00 595.00 618.00 573.00 6466.00
133.00 137.00 148.00 143.00 143.00 191.00 165.00 189.00 182.00 182.00 189.00 175.00 1977.00
302.00 312.00 337.00 324.00 324.00 435.00 373.00 429.00 413.00 413.00 429.00 398.00 4489.00
0 0 0 0 0 0 0 0 0 0 0 0
0
8443/4489/-
FORM - 3A (Revised)
MH/105299/58 BEDHMUTHA ANAND RIKHABCHAND
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3628.00 3744.00 4044.00 3894.00 3894.00 5216.00 4769.00 5150.00 4959.00 4959.00 5150.00 4966.00 54373.00
435.00 449.00 485.00 467.00 467.00 626.00 572.00 618.00 595.00 595.00 618.00 596.00 6523.00
133.00 137.00 148.00 143.00 143.00 191.00 175.00 189.00 182.00 182.00 189.00 182.00 1994.00
302.00 312.00 337.00 324.00 324.00 435.00 397.00 429.00 413.00 413.00 429.00 414.00 4529.00
0 0 0 0 0 0 0 0 0 0 0 0
0
8517/4529/-
FORM - 3A (Revised)
MH/105299/59 CHIKANE HANUMANT PARMESHWAR
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3421.00 2699.00 3836.00 3410.00 3552.00 3967.00 2603.00 3904.00 3760.00 3615.00 3181.00 3496.00 41444.00
411.00 324.00 460.00 409.00 426.00 476.00 312.00 468.00 451.00 434.00 382.00 420.00 4973.00
126.00 99.00 141.00 125.00 130.00 146.00 96.00 143.00 138.00 133.00 117.00 129.00 1523.00
285.00 225.00 319.00 284.00 296.00 330.00 216.00 325.00 313.00 301.00 265.00 291.00 3450.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6496/3450/-
FORM - 3A (Revised)
MH/105299/60 TAKALE SHAHUBA BHIVA
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3421.00 3552.00 3836.00 3410.00 3694.00 3680.00 3615.00 3615.00 3760.00 3470.00 3904.00 3812.00 43769.00
411.00 426.00 460.00 409.00 443.00 442.00 434.00 434.00 451.00 417.00 468.00 458.00 5253.00
126.00 130.00 141.00 125.00 136.00 135.00 133.00 133.00 138.00 128.00 143.00 140.00 1608.00
285.00 296.00 319.00 284.00 307.00 307.00 301.00 301.00 313.00 289.00 325.00 318.00 3645.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6861/3645/-
FORM - 3A (Revised)
MH/105299/61 GARANDE SANJAY VITTHAL
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
1647.00 3268.00 2699.00 3410.00 3694.00 3970.00 3615.00 3326.00 3615.00 3470.00 3904.00 3812.00 40430.00
198.00 392.00 324.00 409.00 443.00 476.00 434.00 399.00 434.00 417.00 468.00 458.00 4852.00
61.00 120.00 99.00 125.00 136.00 146.00 133.00 122.00 133.00 128.00 143.00 140.00 1486.00
137.00 272.00 225.00 284.00 307.00 330.00 301.00 277.00 301.00 289.00 325.00 318.00 3366.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6338/3366/-
FORM - 3A (Revised)
MH/105299/62 MULIK SADASHIV JOTIRAM
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
5705.00 5763.00 6224.00 5533.00 5994.00 6358.00 5826.00 6292.00 6059.00 6059.00 6293.00 6023.00 72129.00
685.00 692.00 747.00 664.00 719.00 763.00 699.00 755.00 727.00 727.00 755.00 723.00 8656.00
210.00 212.00 228.00 203.00 220.00 233.00 214.00 231.00 222.00 222.00 231.00 221.00 2647.00
475.00 480.00 519.00 461.00 499.00 530.00 485.00 524.00 505.00 505.00 524.00 502.00 6009.00
0 0 0 0 0 0 0 0 0 0 0 0
0
11303/6009/-
FORM - 3A (Revised)
MH/105299/63 KSHIRSAGAR DHANANJAY LIMBRAJ
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
2914.00 3126.00 3410.00 3268.00 3694.00 3825.00 3615.00 3904.00 3760.00 3326.00 3326.00 3574.00 41742.00
350.00 375.00 409.00 392.00 443.00 459.00 434.00 468.00 451.00 399.00 399.00 429.00 5008.00
107.00 115.00 125.00 120.00 136.00 140.00 133.00 143.00 138.00 122.00 122.00 131.00 1532.00
243.00 260.00 284.00 272.00 307.00 319.00 301.00 325.00 313.00 277.00 277.00 298.00 3476.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6540/3476/-
FORM - 3A (Revised)
MH/105299/64 SHINDE SACHIN APPASHAHEB
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3421.00 2699.00 3694.00 2273.00 1989.00 3072.00 3037.00 3326.00 3615.00 3759.00 3904.00 3812.00 38601.00
411.00 324.00 443.00 273.00 239.00 369.00 365.00 399.00 434.00 451.00 468.00 457.00 4633.00
126.00 99.00 135.00 84.00 73.00 113.00 112.00 122.00 133.00 138.00 143.00 140.00 1418.00
285.00 225.00 308.00 189.00 166.00 256.00 253.00 277.00 301.00 313.00 325.00 317.00 3215.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6051/3215/-
FORM - 3A (Revised)
MH/105299/65 KATMORE ATUL BHARAT
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3294.00 3552.00 3836.00 3410.00 3694.00 3970.00 3470.00 3470.00 3470.00 3036.00 3615.00 3656.00 42473.00
395.00 426.00 460.00 409.00 443.00 476.00 416.00 416.00 417.00 365.00 434.00 439.00 5096.00
121.00 130.00 141.00 125.00 136.00 145.00 127.00 127.00 128.00 112.00 133.00 134.00 1559.00
274.00 296.00 319.00 284.00 307.00 331.00 289.00 289.00 289.00 253.00 301.00 305.00 3537.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6655/3537/-
FORM - 3A (Revised)
MH/105299/66 GHAVANE SACHIN NAMDEO
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3421.00 3552.00 2842.00 3410.00 3552.00 3678.00 3326.00 3904.00 3760.00 3615.00 3760.00 3808.00 42628.00
411.00 426.00 341.00 409.00 426.00 441.00 399.00 468.00 451.00 434.00 451.00 457.00 5114.00
126.00 130.00 104.00 125.00 130.00 135.00 122.00 143.00 138.00 133.00 138.00 140.00 1564.00
285.00 296.00 237.00 284.00 296.00 306.00 277.00 325.00 313.00 301.00 313.00 317.00 3550.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6678/3550/-
FORM - 3A (Revised)
MH/105299/67 KALE MOHAN RAMCHANDRA
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3294.00 2415.00 3836.00 3410.00 3694.00 3970.00 3615.00 3904.00 3760.00 3759.00 3543.00 3802.00 43002.00
395.00 290.00 460.00 409.00 443.00 476.00 434.00 468.00 451.00 451.00 425.00 456.00 5158.00
121.00 89.00 141.00 125.00 136.00 145.00 133.00 143.00 138.00 138.00 130.00 140.00 1579.00
274.00 201.00 319.00 284.00 307.00 331.00 301.00 325.00 313.00 313.00 295.00 316.00 3579.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6737/3579/-
FORM - 3A (Revised)
MH/105299/68 VAIRAT RAVINDRA BALKRISHANA
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3421.00 2415.00 3836.00 3410.00 3694.00 3247.00 3470.00 3904.00 3760.00 3470.00 3904.00 3218.00 41749.00
411.00 290.00 460.00 409.00 443.00 390.00 416.00 468.00 451.00 417.00 468.00 386.00 5009.00
126.00 89.00 141.00 125.00 136.00 119.00 127.00 143.00 138.00 128.00 143.00 118.00 1533.00
285.00 201.00 319.00 284.00 307.00 271.00 289.00 325.00 313.00 289.00 325.00 268.00 3476.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6542/3476/-
FORM - 3A (Revised)
MH/105299/69 KHALSE VINAYAK IRRAPPA
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
2154.00 2984.00 3836.00 3410.00 3552.00 3678.00 3326.00 3470.00 3760.00 3470.00 2747.00 2891.00 39278.00
259.00 358.00 460.00 409.00 426.00 441.00 399.00 416.00 451.00 417.00 330.00 347.00 4713.00
79.00 110.00 141.00 125.00 130.00 135.00 122.00 127.00 138.00 128.00 101.00 106.00 1442.00
180.00 248.00 319.00 284.00 296.00 306.00 277.00 289.00 313.00 289.00 229.00 241.00 3271.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6155/3271/-
FORM - 3A (Revised)
MH/105299/71 KHOBAN CHIDANAND VITTHAL
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
2154.00 2984.00 3694.00 3126.00 3126.00 3670.00 3181.00 3759.00 3615.00 3470.00 3615.00 3062.00 39456.00
259.00 358.00 443.00 375.00 375.00 440.00 382.00 451.00 434.00 417.00 434.00 368.00 4736.00
79.00 110.00 135.00 115.00 115.00 135.00 117.00 138.00 133.00 128.00 133.00 113.00 1451.00
180.00 248.00 308.00 260.00 260.00 305.00 265.00 313.00 301.00 289.00 301.00 255.00 3285.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6187/3285/-
FORM - 3A (Revised)
MH/105299/72 MEHTRI BHIMASHANKAR TUKARAM
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
2027.00 2984.00 3410.00 3126.00 2984.00 3234.00 3326.00 3615.00 3615.00 3181.00 3326.00 2906.00 37734.00
243.00 358.00 409.00 375.00 358.00 388.00 399.00 434.00 434.00 382.00 399.00 349.00 4528.00
74.00 110.00 125.00 115.00 110.00 119.00 122.00 133.00 133.00 117.00 122.00 107.00 1387.00
169.00 248.00 284.00 260.00 248.00 269.00 277.00 301.00 301.00 265.00 277.00 242.00 3141.00
0 0 0 0 0 0 0 0 0 0 0 0
0
5915/3141/-
FORM - 3A (Revised)
MH/105299/73 KENDE JITENDRA SADASHIV
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3421.00 3268.00 3410.00 3552.00 3552.00 3967.00 3470.00 3615.00 3615.00 3615.00 3760.00 3808.00 43053.00
411.00 392.00 409.00 426.00 426.00 476.00 417.00 434.00 434.00 434.00 451.00 457.00 5167.00
126.00 120.00 125.00 130.00 130.00 146.00 128.00 133.00 133.00 133.00 138.00 140.00 1582.00
285.00 272.00 284.00 296.00 296.00 330.00 289.00 301.00 301.00 301.00 313.00 317.00 3585.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6749/3585/-
FORM - 3A (Revised)
MH/105299/74 GAWALI MAHESH PARSURAM
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
392.00 3064.00 3356.00 3721.00 3794.00 4074.00 3711.00 4008.00 3637.00 3860.00 4008.00 3908.00 41533.00
47.00 368.00 403.00 447.00 455.00 489.00 446.00 481.00 436.00 463.00 481.00 469.00 4985.00
14.00 113.00 123.00 137.00 139.00 150.00 136.00 147.00 133.00 142.00 147.00 143.00 1524.00
33.00 255.00 280.00 310.00 316.00 339.00 310.00 334.00 303.00 321.00 334.00 326.00 3461.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6509/3461/-
FORM - 3A (Revised)
MH/105299/75 LAD SHITALNATH HIRALAL
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3294.00 3126.00 1563.00 3268.00 3410.00 3965.00 3181.00 3615.00 3326.00 3759.00 3904.00 3367.00 39778.00
395.00 375.00 188.00 392.00 409.00 476.00 382.00 434.00 399.00 451.00 468.00 404.00 4773.00
121.00 115.00 58.00 120.00 125.00 146.00 117.00 133.00 122.00 138.00 143.00 124.00 1462.00
274.00 260.00 130.00 272.00 284.00 330.00 265.00 301.00 277.00 313.00 325.00 280.00 3311.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6235/3311/-
FORM - 3A (Revised)
MH/105299/77 BANSODE NITIN BHAGAWAT
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3294.00 3268.00 2415.00 3552.00 3268.00 3818.00 3615.00 3759.00 2603.00 3759.00 3615.00 3656.00 40622.00
395.00 392.00 290.00 426.00 392.00 458.00 434.00 451.00 312.00 451.00 434.00 439.00 4874.00
121.00 120.00 89.00 130.00 120.00 140.00 133.00 138.00 95.00 138.00 133.00 134.00 1491.00
274.00 272.00 201.00 296.00 272.00 318.00 301.00 313.00 217.00 313.00 301.00 305.00 3383.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6365/3383/-
FORM - 3A (Revised)
MH/105299/78 JAGADALE PRAVIN SHESRAO
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3421.00 3552.00 2273.00 2841.00 852.00 1606.00 3181.00 3904.00 3615.00 3759.00 3181.00 3793.00 35978.00
411.00 426.00 273.00 341.00 102.00 193.00 382.00 468.00 434.00 451.00 382.00 455.00 4318.00
126.00 130.00 83.00 104.00 31.00 59.00 117.00 143.00 133.00 138.00 117.00 139.00 1320.00
285.00 296.00 190.00 237.00 71.00 134.00 265.00 325.00 301.00 313.00 265.00 316.00 2998.00
0 0 0 0 0 0 0 0 0 0 0 0
0
5638/2998/-
FORM - 3A (Revised)
MH/105299/79 PATIL RAJESH KISHOR
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3041.00 3552.00 2415.00 3410.00 3552.00 3967.00 3326.00 3904.00 3759.00 3759.00 3615.00 3804.00 42104.00
365.00 426.00 290.00 409.00 426.00 476.00 399.00 468.00 451.00 451.00 434.00 457.00 5052.00
112.00 130.00 89.00 125.00 130.00 146.00 122.00 143.00 138.00 138.00 133.00 140.00 1546.00
253.00 296.00 201.00 284.00 296.00 330.00 277.00 325.00 313.00 313.00 301.00 317.00 3506.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6598/3506/-
FORM - 3A (Revised)
MH/105299/80 BAGAL SHIRISH MADHUKAR
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
2154.00 2557.00 2699.00 3410.00 3694.00 3825.00 3037.00 3904.00 3759.00 3615.00 3904.00 3515.00 40073.00
259.00 307.00 324.00 409.00 443.00 459.00 365.00 468.00 451.00 434.00 468.00 422.00 4809.00
79.00 94.00 99.00 125.00 136.00 140.00 112.00 143.00 138.00 133.00 143.00 129.00 1471.00
180.00 213.00 225.00 284.00 307.00 319.00 253.00 325.00 313.00 301.00 325.00 293.00 3338.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6280/3338/-
FORM - 3A (Revised)
MH/105299/81 KAPSE SADANAND SHAHAJI
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
2154.00 2984.00 2415.00 3410.00 3694.00 3970.00 3470.00 3904.00 3759.00 3615.00 3832.00 3810.00 41017.00
259.00 358.00 290.00 409.00 443.00 476.00 416.00 468.00 451.00 434.00 460.00 457.00 4921.00
79.00 110.00 89.00 125.00 136.00 146.00 127.00 143.00 138.00 133.00 141.00 140.00 1507.00
180.00 248.00 201.00 284.00 307.00 330.00 289.00 325.00 313.00 301.00 319.00 317.00 3414.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6428/3414/-
FORM - 3A (Revised)
MH/105299/82 BANG MUKUND RAMNARAYAN
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3524.00 2626.00 3356.00 3356.00 3283.00 4065.00 2301.00 3711.00 3785.00 3489.00 3414.00 3893.00 40803.00
423.00 315.00 403.00 403.00 394.00 488.00 276.00 445.00 454.00 419.00 410.00 467.00 4897.00
129.00 96.00 123.00 123.00 121.00 149.00 85.00 136.00 139.00 128.00 125.00 143.00 1497.00
294.00 219.00 280.00 280.00 273.00 339.00 191.00 309.00 315.00 291.00 285.00 324.00 3400.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6394/3400/-
FORM - 3A (Revised)
MH/105299/83 CHIKNE DATTATRY SHAHAJI
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3294.00 3410.00 2912.00 3694.00 3694.00 3680.00 3615.00 3904.00 3759.00 3687.00 3904.00 3663.00 43216.00
395.00 409.00 350.00 443.00 443.00 442.00 434.00 469.00 451.00 443.00 469.00 440.00 5188.00
121.00 125.00 107.00 135.00 135.00 135.00 133.00 143.00 138.00 136.00 143.00 135.00 1586.00
274.00 284.00 243.00 308.00 308.00 307.00 301.00 326.00 313.00 307.00 326.00 305.00 3602.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6774/3602/-
FORM - 3A (Revised)
The Employee's Provident Funds scheme, 1952 (Para 35 and 42) And The Employee's Family Pension Scheme, 1995 (Para 19) Contribution Card for the currency period from 01/04/2007- 31/03/2008
MH/105299/84 JAGDALE BABAN BALASAHEB
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3421.00 3552.00 2415.00 3410.00 3410.00 3386.00
411.00 426.00 290.00 409.00 409.00 406.00
126.00 130.00 89.00 125.00 125.00 124.00
285.00 296.00 201.00 284.00 284.00 282.00
0 0 0 0 0 0 0 0 0 0 0 0
0
19594.00
2351.00
719.00
1632.00
A) Date of Leaving Service 9/25/2007 B) Reason for Leaving Service RESIGNED C) Certified that the Total amount of contribution indicated in this card is Rs. has already been remitted in full in EPF A/c No. 1 and Pension A/c No. 10 Rs.
3070/1632/-
FORM - 3A (Revised)
MH/105299/85 BANDGAR LAXMAN BABAN
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
2154.00 3552.00 1847.00 3268.00 3694.00 3970.00 3615.00 3904.00 3470.00 2747.00 3615.00 2172.00 38008.00
259.00 426.00 222.00 392.00 443.00 476.00 434.00 468.00 417.00 330.00 434.00 261.00 4562.00
79.00 130.00 68.00 120.00 136.00 146.00 133.00 143.00 128.00 101.00 133.00 80.00 1397.00
180.00 296.00 154.00 272.00 307.00 330.00 301.00 325.00 289.00 229.00 301.00 181.00 3165.00
0 0 0 0 0 0 0 0 0 0 0 0
0
A) Date of Leaving Service NIL B) Reason for Leaving Service NIL C) Certified that the Total amount of contribution indicated in this card is Rs. has already been remitted in full in EPF A/c No. 1 and Pension A/c No. 10 Rs.
5959/3165/-
FORM - 3A (Revised)
MH/105299/86 SHAIKH K. NASIRUDDIN AHAMAD
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3421.00 3552.00 3836.00 3410.00 3694.00 3970.00 3615.00 3904.00 2747.00 3759.00 3904.00 3812.00 43624.00
411.00 426.00 460.00 409.00 443.00 476.00 434.00 468.00 330.00 451.00 468.00 458.00 5234.00
126.00 130.00 141.00 125.00 136.00 146.00 133.00 143.00 101.00 138.00 143.00 140.00 1602.00
285.00 296.00 319.00 284.00 307.00 330.00 301.00 325.00 229.00 313.00 325.00 318.00 3632.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6836/3632/-
FORM - 3A (Revised)
MH/105299/87 SHAIKH AZARUDDIN MAINUDDIN
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3041.00 2557.00 2699.00 3268.00 3552.00 3678.00 2747.00 3759.00 3470.00 2458.00 3615.00 3804.00 38648.00
365.00 307.00 324.00 392.00 426.00 441.00 330.00 451.00 417.00 295.00 434.00 457.00 4639.00
112.00 94.00 99.00 120.00 130.00 135.00 101.00 138.00 128.00 90.00 133.00 140.00 1420.00
253.00 213.00 225.00 272.00 296.00 306.00 229.00 313.00 289.00 205.00 301.00 317.00 3219.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6059/3219/-
FORM - 3A (Revised)
The Employee's Provident Funds scheme, 1952 (Para 35 and 42) And The Employee's Family Pension Scheme, 1995 (Para 19) Contribution Card for the currency period from01/04/2007- 31/03/2008
MH/105299/88 SURYAWANSI NILESH RAJENDRA
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3167.00 2557.00 2415.00 3410.00 3410.00 3965.00 3326.00 3904.00 3470.00 3759.00 3326.00 3797.00 40506.00
380.00 307.00 290.00 409.00 409.00 476.00 399.00 468.00 417.00 451.00 399.00 456.00 4861.00
116.00 94.00 89.00 125.00 125.00 146.00 122.00 143.00 128.00 138.00 122.00 139.00 1487.00
264.00 213.00 201.00 284.00 284.00 330.00 277.00 325.00 289.00 313.00 277.00 317.00 3374.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6348/3374/-
FORM - 3A (Revised)
MH/105299/89 DOMBLE JAGANNATH BALASAHEB
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3421.00 3552.00 1989.00 3268.00 3552.00 3967.00 2892.00 3615.00 3760.00 3759.00 3904.00 1586.00 39265.00
411.00 426.00 239.00 392.00 426.00 476.00 347.00 434.00 451.00 451.00 468.00 190.00 4711.00
126.00 130.00 73.00 120.00 130.00 146.00 106.00 133.00 138.00 138.00 143.00 58.00 1441.00
285.00 296.00 166.00 272.00 296.00 330.00 241.00 301.00 313.00 313.00 325.00 132.00 3270.00
0 0 0 0 0 0 0 0 0 0 0 0
0
6152/3270/-
FORM - 3A (Revised)
MH/105299/90 KUMBHAR ARUN UTTAM
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3421.00 3268.00 1705.00 3410.00 2557.00 3516.00 3181.00 3615.00 3326.00 3470.00 2024.00 3317.00 36810.00
411.00 392.00 205.00 409.00 307.00 422.00 382.00 434.00 399.00 417.00 243.00 398.00 4419.00
126.00 120.00 63.00 125.00 94.00 129.00 117.00 133.00 122.00 128.00 74.00 122.00 1353.00
285.00 272.00 142.00 284.00 213.00 293.00 265.00 301.00 277.00 289.00 169.00 276.00 3066.00
0 0 0 0 0 0 0 0 0 0 0 0
0
5772/3066/-
FORM - 3A (Revised)
MH/105299/91 KAPSE SHARAD VINAYAK
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
3294.00 852.00 2273.00 2273.00 2557.00 3660.00 3181.00 3904.00 3760.00 3759.00 2024.00 1982.00 33519.00
395.00 102.00 273.00 273.00 307.00 439.00 382.00 468.00 451.00 451.00 243.00 238.00 4022.00
121.00 31.00 83.00 84.00 94.00 134.00 117.00 143.00 138.00 138.00 74.00 73.00 1230.00
274.00 71.00 190.00 189.00 213.00 305.00 265.00 325.00 313.00 313.00 169.00 165.00 2792.00
0 0 0 0 0 0 0 0 0 0 0 0
0
5252/2792/-
FORM - 3A (Revised)
MH/105299/92 MISAL SANGRAM VISHWANATH
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 3694.00 3970.00 3615.00 3904.00 3760.00 2603.00 3904.00 3812.00 29262.00
0.00 0.00 0.00 0.00 443.00 476.00 434.00 468.00 451.00 312.00 468.00 458.00 3510.00
0.00 0.00 0.00 0.00 136.00 146.00 133.00 143.00 138.00 96.00 143.00 140.00 1075.00
0.00 0.00 0.00 0.00 307.00 330.00 301.00 325.00 313.00 216.00 325.00 318.00 2435.00
0 0 0 0 0 0 0 0 0 0 0 0
0
4585/2435/-
FORM - 3A (Revised)
MH/105299/93 GAIKWAD RAMKRUSHNA NAVNATH
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 3694.00 2524.00 289.00 3904.00 3760.00 3615.00 3904.00 3218.00 24908.00
0.00 0.00 0.00 0.00 443.00 303.00 35.00 468.00 451.00 434.00 468.00 386.00 2988.00
0.00 0.00 0.00 0.00 136.00 93.00 11.00 143.00 138.00 133.00 143.00 118.00 915.00
0.00 0.00 0.00 0.00 307.00 210.00 24.00 325.00 313.00 301.00 325.00 268.00 2073.00
0 0 0 0 0 0 0 0 0 0 0 0
0
3903/2073/-
FORM - 3A (Revised)
MH/105299/94 MOTE MAHESH MAHADEO
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 3694.00 3536.00 3181.00 3904.00 3760.00 3036.00 3326.00 2758.00 27195.00
0.00 0.00 0.00 0.00 443.00 424.00 382.00 468.00 451.00 365.00 399.00 331.00 3263.00
0.00 0.00 0.00 0.00 136.00 130.00 117.00 143.00 138.00 112.00 122.00 101.00 999.00
0.00 0.00 0.00 0.00 307.00 294.00 265.00 325.00 313.00 253.00 277.00 230.00 2264.00
0 0 0 0 0 0 0 0 0 0 0 0
0
4262/2264/-
FORM - 3A (Revised)
MH/105299/95 KARALE BABURAO PRAKASH
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 2984.00 3957.00 3181.00 3904.00 3759.00 3759.00 3181.00 3644.00 28369.00
0.00 0.00 0.00 0.00 358.00 475.00 382.00 468.00 451.00 451.00 382.00 437.00 3404.00
0.00 0.00 0.00 0.00 110.00 145.00 117.00 143.00 138.00 138.00 117.00 134.00 1042.00
0.00 0.00 0.00 0.00 248.00 330.00 265.00 325.00 313.00 313.00 265.00 303.00 2362.00
0 0 0 0 0 0 0 0 0 0 0 0
0
4446/2362/-
FORM - 3A (Revised)
MH/105299/96 KHORATE ABHIJIT ESHWAR
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 3410.00 2952.00 3615.00 3904.00 3326.00 3759.00 3760.00 3660.00 28386.00
0.00 0.00 0.00 0.00 409.00 354.00 434.00 468.00 399.00 451.00 451.00 439.00 3405.00
0.00 0.00 0.00 0.00 125.00 108.00 133.00 143.00 122.00 138.00 138.00 134.00 1041.00
0.00 0.00 0.00 0.00 284.00 246.00 301.00 325.00 277.00 313.00 313.00 305.00 2364.00
0 0 0 0 0 0 0 0 0 0 0 0
0
4446/2364/-
FORM - 3A (Revised)
MH/105299/97 DHANWADE SANTOSH PASNDHARINATH
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 3552.00 3967.00 3615.00 3037.00 3326.00 3759.00 3470.00 3800.00 28526.00
0.00 0.00 0.00 0.00 426.00 476.00 434.00 364.00 399.00 451.00 416.00 456.00 3422.00
0.00 0.00 0.00 0.00 130.00 146.00 133.00 111.00 122.00 138.00 127.00 139.00 1046.00
0.00 0.00 0.00 0.00 296.00 330.00 301.00 253.00 277.00 313.00 289.00 317.00 2376.00
0 0 0 0 0 0 0 0 0 0 0 0
0
4468/2376/-
FORM - 3A (Revised)
MH/105299/98 BIRAJDAR JAGDISH PANDITRAO
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 3694.00 3970.00 3326.00 3759.00 3470.00 3470.00 2892.00 818.00 25399.00
0.00 0.00 0.00 0.00 443.00 476.00 399.00 451.00 417.00 417.00 347.00 98.00 3048.00
0.00 0.00 0.00 0.00 136.00 146.00 122.00 138.00 128.00 128.00 106.00 30.00 934.00
0.00 0.00 0.00 0.00 307.00 330.00 277.00 313.00 289.00 289.00 241.00 68.00 2114.00
0 0 0 0 0 0 0 0 0 0 0 0
0
A) Date of Leaving Servic 5/2/2008 B) Reason for Leaving Service RESIGNED C) Certified that the Total amount of contribution indicated in this card is Rs. has already been remitted in full in EPF A/c No. 1 and Pension A/c No. 10 Rs. 1. Certified that the Difference between the Total of the Contribution shown under Cols. 3 & 4(a)
3982/2114/-
FORM - 3A (Revised)
MH/105299/99 DOKE DATTATRYA LAXMAN
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 3694.00 3970.00 3326.00 3904.00 3759.00 3759.00 3470.00 3058.00 28940.00
0.00 0.00 0.00 0.00 443.00 476.00 399.00 468.00 451.00 451.00 416.00 367.00 3471.00
0.00 0.00 0.00 0.00 136.00 146.00 122.00 143.00 138.00 138.00 127.00 112.00 1062.00
0.00 0.00 0.00 0.00 307.00 330.00 277.00 325.00 313.00 313.00 289.00 255.00 2409.00
0 0 0 0 0 0 0 0 0 0 0 0
0
4533/2409/-
FORM - 3A (Revised)
MH/105299/100 ATTAR IMRAN MAHAMADSALI M
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 3694.00 3608.00 3470.00 3859.00 3759.00 3615.00 3904.00 3812.00 29721.00
0.00 0.00 0.00 0.00 443.00 433.00 417.00 463.00 451.00 434.00 469.00 458.00 3568.00
0.00 0.00 0.00 0.00 136.00 132.00 128.00 143.00 138.00 133.00 143.00 140.00 1093.00
0.00 0.00 0.00 0.00 307.00 301.00 289.00 320.00 313.00 301.00 326.00 318.00 2475.00
0 0 0 0 0 0 0 0 0 0 0 0
0
4661/2475/-
FORM - 3A (Revised)
MH/105299/101 DESHPANDE AMEET PANDURANG
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 3694.00 3897.00 3398.00 3470.00 2892.00 3470.00 3904.00 2921.00 27646.00
0.00 0.00 0.00 0.00 443.00 468.00 408.00 417.00 347.00 416.00 469.00 351.00 3319.00
0.00 0.00 0.00 0.00 136.00 143.00 125.00 128.00 106.00 127.00 143.00 107.00 1015.00
0.00 0.00 0.00 0.00 307.00 325.00 283.00 289.00 241.00 289.00 326.00 244.00 2304.00
0 0 0 0 0 0 0 0 0 0 0 0
0
4334/2304/-
FORM - 3A (Revised)
MH/105299/102 PATIL SUREKHA SUNIL
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 3694.00 3970.00 3398.00 2747.00 2241.00 3760.00 3470.00 3800.00 27080.00
0.00 0.00 0.00 0.00 443.00 477.00 408.00 330.00 269.00 451.00 416.00 456.00 3250.00
0.00 0.00 0.00 0.00 136.00 146.00 125.00 101.00 82.00 138.00 127.00 139.00 994.00
0.00 0.00 0.00 0.00 307.00 331.00 283.00 229.00 187.00 313.00 289.00 317.00 2256.00
0 0 0 0 0 0 0 0 0 0 0 0
0
4244/2256/-
FORM - 3A (Revised)
MH/105299/103 BHATAMBREKAR RUPALI SATISHRAO
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 3339.00 3963.00 3326.00 3904.00 3615.00 3760.00 3832.00 2474.00 28213.00
0.00 0.00 0.00 0.00 401.00 476.00 399.00 469.00 434.00 451.00 460.00 297.00 3387.00
0.00 0.00 0.00 0.00 123.00 146.00 122.00 143.00 133.00 138.00 141.00 91.00 1037.00
0.00 0.00 0.00 0.00 278.00 330.00 277.00 326.00 301.00 313.00 319.00 206.00 2350.00
0 0 0 0 0 0 0 0 0 0 0 0
0
4424/2350/-
FORM - 3A (Revised)
MH/105299/104 KHADTARE TRUPTI NANDAKUMAR
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 3694.00 3608.00 2458.00 3398.00 3615.00 3615.00 2675.00 293.00 23356.00
0.00 0.00 0.00 0.00 443.00 433.00 295.00 408.00 434.00 434.00 321.00 35.00 2803.00
0.00 0.00 0.00 0.00 136.00 132.00 90.00 125.00 133.00 133.00 98.00 11.00 858.00
0.00 0.00 0.00 0.00 307.00 301.00 205.00 283.00 301.00 301.00 223.00 24.00 1945.00
0 0 0 0 0 0 0 0 0 0 0 0
0
3661/1945/-
FORM - 3A (Revised)
MH/105299/105 KSHRISAGAR PRASHANT BHASHKAR
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 3623.00 3968.00 3398.00 3470.00 3759.00 3759.00 3760.00 3808.00 29545.00
0.00 0.00 0.00 0.00 435.00 476.00 408.00 416.00 451.00 451.00 451.00 457.00 3545.00
0.00 0.00 0.00 0.00 133.00 146.00 125.00 127.00 138.00 138.00 138.00 140.00 1085.00
0.00 0.00 0.00 0.00 302.00 330.00 283.00 289.00 313.00 313.00 313.00 317.00 2460.00
0 0 0 0 0 0 0 0 0 0 0 0
0
4630/2460/-
FORM - 3A (Revised)
MH/105299/106 SAIYYAD FIROJ JALAL
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 3694.00 3825.00 3615.00 3832.00 3759.00 3615.00 3904.00 3812.00 30056.00
0.00 0.00 0.00 0.00 443.00 459.00 434.00 460.00 451.00 434.00 469.00 458.00 3608.00
0.00 0.00 0.00 0.00 135.00 140.00 133.00 141.00 138.00 133.00 143.00 140.00 1103.00
0.00 0.00 0.00 0.00 308.00 319.00 301.00 319.00 313.00 301.00 326.00 318.00 2505.00
0 0 0 0 0 0 0 0 0 0 0 0
0
4711/2505/-
FORM - 3A (Revised)
MH/105299/107 JADHAV VINAY SHIVAJI
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3326.00 3036.00 3398.00 3057.00 12817.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 399.00 365.00 408.00 367.00 1539.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 122.00 112.00 125.00 112.00 471.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 277.00 253.00 283.00 255.00 1068.00
0 0 0 0 0 0 0 0 0 0 0 0
0
2010/1068/-
FORM - 3A (Revised)
MH/105299/108 LUNDHE PRASHANT SUBHASH
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3760.00 3181.00 3687.00 0.00 10628.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 451.00 382.00 443.00 0.00 1276.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 138.00 117.00 136.00 0.00 391.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 313.00 265.00 307.00 0.00 885.00
0 0 0 0 0 0 0 0 0 0 0 0
0
A) Date of Leaving Service // 2/4/2008 B) Reason for Leaving Service RESIGNED C) Certified that the Total amount of contribution indicated in this card is Rs. has already been remitted in full in EPF A/c No. 1 and Pension A/c No. 10 Rs. 1. Certified that the Difference between the Total of the Contribution shown under Cols. 3 & 4(a)
1667/885/-
FORM - 3A (Revised)
MH/105299/109 SURYAWANSI NITIN PANDURANG
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3470.00 3759.00 2169.00 0.00 9398.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 417.00 451.00 260.00 0.00 1128.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 128.00 138.00 80.00 0.00 346.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 289.00 313.00 180.00 0.00 782.00
0 0 0 0 0 0 0 0 0 0 0 0
0
1474/782/-
FORM - 3A (Revised)
MH/105299/110 PAWAR SANTOSH LALSING
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3470.00 3759.00 2169.00 3173.00 12571.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 417.00 451.00 260.00 381.00 1509.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 128.00 138.00 80.00 117.00 463.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 289.00 313.00 180.00 264.00 1046.00
0 0 0 0 0 0 0 0 0 0 0 0
0
1972/1046/-
FORM - 3A (Revised)
MH/105299/111 ARAGADE BALAJI LAXMAN
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1880.00 1591.00 3470.00 2613.00 9554.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 226.00 191.00 416.00 314.00 1147.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 69.00 58.00 127.00 96.00 350.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 157.00 133.00 289.00 218.00 797.00
0 0 0 0 0 0 0 0 0 0 0 0
0
1497/797/-
FORM - 3A (Revised)
MH/105299/112 JALGOUD BILENSHIDH ANEAPPA
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3470.00 3036.00 3181.00 3793.00 13480.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 417.00 364.00 382.00 455.00 1618.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 128.00 111.00 117.00 139.00 495.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 289.00 253.00 265.00 316.00 1123.00
0 0 0 0 0 0 0 0 0 0 0 0
0
2113/1123/-
FORM - 3A (Revised)
MH/105299/113 INAMADAR GANESH SHANKAR
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3615.00 3470.00 3181.00 3199.00 13465.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 434.00 417.00 382.00 384.00 1617.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 133.00 128.00 117.00 117.00 495.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 301.00 289.00 265.00 267.00 1122.00
0 0 0 0 0 0 0 0 0 0 0 0
0
2112/1122/-
FORM - 3A (Revised)
MH/105299/114 JAMBHALE ROHIDHAS HARICHANDRA
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3759.00 3326.00 2024.00 1537.00 10646.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 451.00 399.00 243.00 184.00 1277.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 138.00 122.00 74.00 56.00 390.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 313.00 277.00 169.00 128.00 887.00
0 0 0 0 0 0 0 0 0 0 0 0
0
1667/887/-
FORM - 3A (Revised)
MH/105299/115 THAPA PREMLAL GAYANI
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3904.00 3812.00 7716.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 469.00 458.00 927.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 143.00 140.00 283.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 326.00 318.00 644.00
0 0 0 0 0 0 0 0 0 0 0 0
0
1210/644/-
FORM - 3A (Revised)
MH/105299/116 SATIJA TEJASVI RAMESH
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3635.00 3635.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 436.00 436.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 133.00 133.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 303.00 303.00
0 0 0 0 0 0 0 0 0 0 0 0
0
569/303/-
FORM - 3A (Revised)
MH/105299/117 CHOBE SHASHIKANT SHAHU
Contributions
Worker's Share
Month and Year (1)
Amount of Wages (2)

E.P.F. (3)
Employer's Share
Total
Remarks
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3415.00 3415.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 410.00 410.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 125.00 125.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 285.00 285.00
0 0 0 0 0 0 0 0 0 0 0 0
0
535/285/-

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Copyright:

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Demo Form 3a

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Copyright:

Formatos disponibles

(For Unexempted Establishment only)

4. Name and address of the Establishment 5. Statutory Rate of Contribution

6. Voluntary Higher NIL Rate of Employee Contribution, if any

Month and Year (1)

Amount of Wages (2)

Dated Place - BARSHI

Director Sanghvi Quality Products Pvt. Ltd. Barshi

(For Unexempted Establishment only)

4. Name and address of the Establishment 5. Statutory Rate of Contribution

6. Voluntary Higher NIL Rate of Employee Contribution, if any

Month and Year (1)

Amount of Wages (2)

Dated Place - BARSHI

Director Sanghvi Quality Products Pvt. Ltd. Barshi

(For Unexempted Establishment only)

Worker's Share E.P.F. (3)

Employer's Share E.P.F. Difference (4)-A

Dated Place - BARSHI

Director Sanghvi Quality Products Pvt. Ltd. Barshi

(For Unexempted Establishment only)

4. Name and address of the Establishment 5. Statutory Rate of Contribution

6. Voluntary Higher NIL Rate of Employee Contribution, if any

Month and Year (1)

Amount of Wages (2)

Dated Place - BARSHI

Director Sanghvi Quality Products Pvt. Ltd. Barshi

(For Unexempted Establishment only)

4. Name and address of the Establishment 5. Statutory Rate of Contribution

6. Voluntary Higher NIL Rate of Employee Contribution, if any

Month and Year (1)

Amount of Wages (2)

Dated Place - BARSHI

Director Sanghvi Quality Products Pvt. Ltd. Barshi

(For Unexempted Establishment only)

4. Name and address of the Establishment 5. Statutory Rate of Contribution

6. Voluntary Higher NIL Rate of Employee Contribution, if any

Month and Year (1)

Amount of Wages (2)

Dated Place - BARSHI

Director Sanghvi Quality Products Pvt. Ltd. Barshi

(For Unexempted Establishment only)

4. Name and address of the Establishment 5. Statutory Rate of Contribution

6. Voluntary Higher NIL Rate of Employee Contribution, if any

Month and Year (1)

Amount of Wages (2)

Dated Place - BARSHI

Director Sanghvi Quality Products Pvt. Ltd. Barshi

(For Unexempted Establishment only)

4. Name and address of the Establishment 5. Statutory Rate of Contribution

6. Voluntary Higher NIL Rate of Employee Contribution, if any

Month and Year (1)

Amount of Wages (2)

Dated Place - BARSHI

Director Sanghvi Quality Products Pvt. Ltd. Barshi

(For Unexempted Establishment only)

4. Name and address of the Establishment 5. Statutory Rate of Contribution

6. Voluntary Higher NIL Rate of Employee Contribution, if any

Month and Year (1)

Amount of Wages (2)

Dated Place - BARSHI

Director Sanghvi Quality Products Pvt. Ltd. Barshi

(For Unexempted Establishment only)

4. Name and address of the Establishment 5. Statutory Rate of Contribution

6. Voluntary Higher NIL Rate of Employee Contribution, if any