Gramin Digital Seva

Employees' Provident Fund Organisation

Multi-Correction Request Form

1. Member Details

Full Name

Father’s/Spouse’s Name

UAN Number

Mobile Number

2. Select Corrections

Date of Birth Correction Name Correction Aadhaar Correction PAN Correction

Wrong DOB (as per PF)

Correct DOB (as per Aadhaar)

Correct Full Name

Correct Aadhaar Number

Correct PAN Number

3. Payment Details

Payment Mode Select Google Pay PhonePe Paytm Transaction ID / UTR

4. Declaration

I hereby declare that all the information provided above is true and correct to the best of my knowledge.

Place

Date