Form 121 Filled Sample for PF Withdrawal in 2026

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Form 15G/15H has been replaced by Form 121 since 01 April 2026. If your total service in PF is less than 5 years, but your total EPF amount is above 50,000 Rs, you should submit Form 121 while withdrawing the PF amount on the UAN member portal or the Umang mobile App.

Form 15G and 15G replaced by form 121 for PF withdrawal
Download Form 121 for PF withdrawal

Form 121 for PF Withdrawal Filled Scanned Copies (2026)

Form 121 filled sample for PF withdrawal May 2026
Form 121 filled sample part B for PF withdrawal May 2026

Sample Filled Form 121 for PF Withdrawal

Part A

Sample filled form 121 for PF withdrawal 2026 (Part A)

Part B

Sample filled form 121 for PF withdrawal (Part B)
  • How to Fill Form 121 for PF Withdrawal
  • Form 121 has two parts: Part A and Part B.
  • EPF member needs to fill only Part A.
  • Part B will be filled by the PF department, but you have to upload the blank copy of Part B as well when uploading the scanned Form 121 while withdrawing the PF amount.

Field 1 (Name): Your name as per the EPF account.

Field 2 (Address): Your current address (No need to match with the PF account)

Field 3 (Permanent Account Number: Your PAN number

Field 4 (Status): Individual

Field 5 (Residential Status): Indian

Field 5(a): If your age is 60, tick Yes, or tick No

Field 6 (Email ID): Your email ID

Field 7 (Contact Number): Your mobile number

Field 8 (Tax year): 2026-2027

Field 9 (Nature of income): EPF

Field 10 (Estimated income for which declaration made): Your PF amount Ex: 85,000

Field 11: If you haven’t submitted any Form 121s for other income sources like fixed deposit interests, dividends, leave this field blank; otherwise, write the number of Form 121s you have submitted.

Field 12: Again, write your PF amount 

Field 13: Your estimated total annual income + PF amount.

For example, if you mentioned your PF amount as 85,000 in field 10, and your annual salary is 1,00,00, then write 1,85,000 Rs

Field 14: If you have filed any previous IT returns, then mention those details; if not, leave this field blank.

FAQs

1. What is Form 121 for PF withdrawal?

Form 121 is a declaration you give to say your total income is below the taxable limit, so no TDS should be deducted on your PF withdrawal.

2. When should I submit Form 121?

You should submit it when withdrawing PF, and your total yearly income is below the taxable limit.

3. What are the taxable income limits for Form 121 under the old and new tax regimes in FY 2026-2027?

• Under the old tax regime, income up to ₹2.5 lakhs is tax-free (₹3 lakhs for senior citizens 60 to 80 years)
• Under the new tax regime, income up to ₹4 lakh is tax-free.

4. Should I submit Form 121 if my income is above the income tax slab limit?

If your final tax is zero after utilising any deductions and debate, then you can submit 121. You have to plan this before the end of the financial year.

5. I don’t know which tax regime I will choose while filing ITR. How should I decide my income limit for Form 121?

• You should estimate your income in both regimes and check where your tax becomes zero.
• If tax is zero in any one regime, you can safely submit Form 121 based on that calculation.
• In most companies, employees are asked to submit an income declaration form every year at the start of the new financial year; at that time, you have to complete all these calculations.

6. What if I provide incorrect income details on Form 121 when claiming the PF amount?

Giving wrong details is considered a false declaration and may lead to a penalty or legal action.

7. How many pages are there in Form 121?

Form 121 has 3 pages: Part A, Part B, and instructions.
EPF members usually need to fill in and submit only pages 1 and 2, and can ignore the instructions page

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