Employee Break Certificate

This document is a break certificate that provides details of a member's period of non-contributory service or break in service for their PF (Provident Fund) account. It lists the member's name and PF account number, dates of appointment and leaving, and the number of days for which wages/salary were not earned for each year from 1995-1996 to 2013-2014. The total number of days of break in service is also stated. The employer signs off with their official seal to certify the period of non-contributory service.

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Employee Break Certificate

Uploaded by

Rajagopal Raman

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Download as PDF, TXT or read online on Scribd

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BREAK CERTIFICATE

Name & Address of :

Establishment

Name of Member :

Father/Husband’s Name :

PF Account No. :
Date of Appointment : Date of Leaving :

Statement of Period of Non Contributory Service

Year : No. of days for which wages/salary not earned
1995-1996 :
1996-1997 :
1997-1998 :
1998-1999 :
1999-2000 :
2000-2001 :
2001-2002 :
2002-2003 :
2003-2004 :
2004-2005 :
2005-2006 :
2006-2007 :
2007-2008 :
2008-2009 :
2009-2010 :
2010-2011 :
2011-2012 :
2012-2013 :
2013-2014 :

:
Total Break in service Days

Signature of Employer/Authorised Person

With Official Seal of Establishment

M/s. ARP Consulting & Solutions www.arpconsulting.in

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Employee Break Certificate

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Employee Break Certificate

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BREAK CERTIFICATE

Name & Address of :

Statement of Period of Non Contributory Service

Signature of Employer/Authorised Person

M/s. ARP Consulting & Solutions www.arpconsulting.in

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