How to Fill PF Form 10C Sample

PF form 10C is used to claim pension amount of EPF members when they have less than 10 years of service. As we know every employer will contribute 8.33% of employee basic salary to the pension account of the employee in EPF. In order to withdraw this pension amount, EPF members need to submit PF form 10C. Don’t be confused between form 10C and 19. Form 19 is used to withdraw PF amount of the employee and form 10C is used to withdraw pension amount of employee, when the service is below 10 yrs.

Download PF Form 10C PDF

Form 10 C consists of 4 pages, an employer needs to do 3 signatures and the employee also needs to do 3 signatures. There is no need to attest revenue stamp on Form 10 C

Form 10C Filled Sample 2018

Sample Filled PF Form 10 C Page 1

Sample Filled PF Form 10 C Page 1

PF Form 10 C Page 2

Sample Filled PF Form 10 C Page 2

PF Form 10 C Page 3

Sample Filled PF Form 10 C Page 3

PF Form 10 C Page 4

There is no need to fill anything on Page 4


↓  Download Sample Filled PF Form 10 C

How To Fill PF Form 10C

  • Field 1 name of the member or name of the claimant, write the name of the member who is claiming for pension amount if the member dies then write the name of the claimant such as nominee.
  • Field 2 date of birth, write the date of birth of the member.
  • Field 3 Father’s name or husband’s name, write father’s name or husband’s name of the EPF member who is claiming pension amount.
  • Field 4 name and address of the establishment, put address stamp of the establishment.
  • Field 5 PF account number, mention your PF account number.
  • Filed 5 A date of joining, mention your date of joining in the establishment.
  • Field 6 reason for leaving service and date of leaving, mention the reason for leaving such as resigned or retirement etc… and mention the date of exit.
  • Field 7 Full Address, write your complete address here, in case your claim get rejected then rejected claim forms will be sent to this address.

Now sign on the first page of PF form 10C and take your employer attestation also.

  • Field 8  Are you willing to accept scheme certificate, if you don’t have 10 yrs of service then tick no.
  • Field 9 & 10 leave this fields blank, these are required when EPF member dies and his family members claim the pension amount.
  • Filed 11 bank account details, write your bank account details such as the name of the bank, bank a/c number, IFSC code and address of the bank. Bank account details are very important because if you write incorrect bank account details then your claim will not get settled.
  • Field 12 are you availing pension under EPS 95, tick this field No.

Now sign on the Second page & Third page of PF form 10C and take your employer attestation also. There is no need to fill page 4 in PF form 10C.

Note: Recently Employee Provident Fund Organization(EPFO) has introduced new EPF composite claim forms, you can use either those EPF composite claim forms or old PF form 19 and 10 C to claim your PF amount and pension amount.

Here are the differences between PF form 10C, Form 10C UAN and PF composite claim forms Aadhar & Non Aadhar.

Form 10C Form 10C UAN EPF Composite Claim forms Aadhar & Non Aadhar
  • Form 10C is old Pension withdrawal form. Still it is in use, employees can submit this form to PF office to withdraw their pension amount below 10 yrs of service.
  • Employees can also submit form 10C online at UAN member portal
At present UAN based form 10C is not in use.
  • PF composite claim forms are new PF withdrawal forms. Employees can submit PF composite claim form Aadhar or non Aadhar to claim their pension and PF amount.
  • These are single page forms and easy to fill.
  • PF composite claim form Aadhar doesn’t require employer attestation also, but employee KYC has to be linked with UAN.

How To Fill PF Form 10C In Online

  • Login to UAN member portal with UAN number and password.
  • Now go to online services in primary menu and click on claim form 31, 19 & 10C.
  • Now in new page you will find your details like name, dob, father name or husband name and mobile number along with your KYC details like Aadhar, bank account details and also your service details.
  • If you find everything is correct then click on proceed for online claim.
  • Now you have to choose the type of the claim i.e whether it is PF advance withdrawal (Form 31) or PF withdrawal(Form 19) or pension withdrawal(Form 10C).
  • After selecting the claim an OTP will be sent to your registered mobile number, now enter that OTP and submit your claim.
  • After successful submission of claim, you will receive an SMS confirmation to your mobile number.
  • Remember you need to submit both form 19 and form 10C separately in online PF withdrawal process.

Still, if you have any question on filling PF form 10C then ask those questions in below comments section.

42 thoughts on “How to Fill PF Form 10C Sample”

  1. Hi,
    I worked for around 4 years 8 months and i am no more working now. It been around 4+ months that i resigned my job. Could you please suggest me if i have to apply for both form 19 and form 10C?

    My claim when claimed for form-19 alone got rejected with following reason “Claim Rejected SUBMIT REVISED 3A SHOWING CORRECT CONTRIBUTIONS THROUGH EMPLOYER”
    I tried applying for form-10C and form-19 together, then form 10C got rejected with reason “Claim Rejected SUBMIT REVISED 3A SHOWING CORRECT CONTRIBUTIONS THROUGH EMPLOYER” and form 19 claim status is under process.
    Can you let me know the solution for the same?

  2. Sir, how we can get a address seal and signature from the employer as the office is far away and i need to make settled my complete pf withdrawal along with the pension amount asap

    kindly share the ideas about it


Leave a Comment