.
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Ministry of Labour & Employment
Pradhan Mantri Shrarn Yogi Maandhan
Government of lndia
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Shr?n,YoAi Pen{inAccoqnt Nuinber: : : : Fertodiciioicontribuiio*: :,.,'. .
7378519f,1.6?7 l Mmth
Nare of ihe8er*6cbryr'{As on.A"dhar aardl : Datt of girth,i.
Raikumar Sahu .;... Z1'LO-199A
Age: CateSo.y: ;:Ma'ri&lStatu:' :, .:
?6 Male osc Married
,Nameof5pouse::.: - , Ocorpation ::
BHIJAN LAL SAHU Printing prsswork
NedeofNofrihee:: : Noni,ee Relatioi wirh EeneFrcia.y :
ChahdaSahu Deperdeht brother
,AdditionilDetiils tlaciseolMinorNoillihee) ..,, :'
.:.
Oateot8irthr . Guardian'sNrhe.
oL41-!975
lamftotmeeber6fg5lclEPFolNPsorindome-f*::ssessee:, I l
Ys
:l am also:remittinE theMaathly B€nefiqiary Cont.ibttion: l For assured monthly pension amount of :
' tNR85.00l- tNR 3000/-
Bfaration&Autharlzrtiqrbykfleficiaries. , ..:
benefits & notifed
Darsr 3i'O8-2ii?5 Sigmture/tt@b impressiori o{ subsciber
('lTl ;n Ge of Male/RTl in cse of Female)
NortBENEFIctiRt'lsNot rrQutertop*vANyADlrroNAr FEE0RCHARGE FoR ENRoLLMENToTHERTHAN FTRST coNTRIBLrEroN
Thig is gubscription cum(omputerg€neruted dH ffi requiresignature. Shdm
acknowledgement and yogi pension Caralreceiwd.
frid!-fi-dfuolJitt{Rradilr{61€q.qr r'61T r :
r*jw
r aE&,iL$** UMRN Date 31-08-2025
Tick (r',
CREATE{r')
MODTFY . Sponior Bank Code 9 Utiliry Code NACHOOOOOO00022197
CANCEL
LrFE rNsuRAuc€ cT:gRArloN oF tNr''lA lodebit{tick/} 5E1CA"ICC,/5B,NRE/58-NRO/OTHER
authorize
BsnkA/C Number 3rt497525383 : ,
W;th Bank BANK OF INDIA rFsc sBlN0o30230
orMlCR
'TATE
tNR 1020/-
An amounrcf Ruoees Oiie'il$usand Trenty Only.
Frequency Debit Type
Monthly qtiv H-Yrly Yrly Asand vrhen presented : : Fixed Amomt '. MaximumAmounr:
Referwe 1 73745L96L697 Phene No. 79749?4r@
FEEIOD
Fmm
2
31{B-2025
1 1 0 2 o 8
w Rajkumar Sahu
1*
of Until Cenceile.l
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