To,
The Regional Provident Fund Commissioner,
Subject: Extension of Employees’ Provident Funds and Miscellaneous Provisions Act, 1952 under Section 1(4) to M/s (including branches, etc.) – Consent of majority of employees – Regarding.
Sir,
We, the undersigned employees of M/s (including branches etc.) do hereby consent and apply to be covered under the Employees’ Provident Funds and Miscellaneous Provisions Act, 1952 on a voluntary basis with effect from , the last date of the month in which the notification is published in the Gazette of India, and we are willing to pay our share of Provident Fund contribution at the rate of %. We also undertake to abide by the requirements of the said statute and the rules framed thereunder as amended from time to time.
We request that necessary notification under Section 1(4) of the Act may be issued at an early date.
Consent of majority of Employees of M/s for coverage under Section 1(4) (Continued)
| Sl. No. | Name | Father's Name | Date of Birth | Signature |
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I/We . for the Proprietor/Director/Partner of M/s . do hereby apply for coverage under Section 1(4) of the Employees’ Provident Funds and Miscellaneous Provision Act, 1952 on voluntary basis with effect from .the last date of the month in which the Notification is published in the Gazette of India. I/We, as employer(s), do hereby undertake to and will pay my/our share of Provident Fund and Pension Fund contribution at the rate of %.%, as provided under Section 6 and 6A of the said Act read with paragraph 29 and 38 of Employees’ Provident Funds Scheme, 1952 and paragraph 4 of Employees’ Pension Scheme.1995 and Administrative charges as provided under paragraphs 38 and 39 of Employees’ Provident Funds Scheme.1952 and to abide by all provisions and requirements of the said status and the rules frame there under as amended from time to time.
The majority of the employees are willing to pay their shares of contributions at the rate of %. % and have agreed to comply with the provisions of the Employees’ Provident Funds and Miscellaneous Provisions Act, 1952 and the Scheme framed there under. The written consent to this effect is enclosed.
I/We, as employer(s) do hereby undertake to and will pay the Employees’ Deposit Linked Insurance Scheme. 1976 Contributions at the rate of 0.5% as provided under Section 6C of the said Act read with paragraph 7 of the said Scheme and Administrative Charges at the rate of 0.01% as provided under paragraph 3 of the Scheme and to abide by all provisions and requirements and the statute and the rules framed there under from time to time.
I/We, also undertake and agree to extend the benefits under the Scheme framed under the Employees’ Provident Funds and Miscellaneous Provisions Act, 1952 to the employees employed in my/our other branches/offices/units/departments/factories. The majority of the workers employed in the above mentioned concerns have also subscribed to the “consent” by the majority of total employees.
I/We, as employer(s) have no objection to the workers, contribution at the rate of % % and I/We, undertake to pay the necessary administrative charges as fixed by the Central Government from time to time under paragraph 39 of the Employees’ Provident Funds Scheme, 1952 and paragraph 8 of the Employees’ Deposit Linked Insurance Scheme, 1976.Necessary Arrangements may kindly be made to issue the necessary notification under Section 1 (4) of the Act, by the Central Provident Fund Commissioner.
Company:
Date: 03/04/2026
Counter Signed by Employer:
Signature of Employer: ____________________
Seal: ____________________