PROVIDENT
FundConfiz-Employee Contributory
Provident Fund- Form “A”

I hereby apply to become a member of Confiz Employees Contributory Provident Fund.

I hereby declare that I have read the Confiz Employees Contributory Provident Fund Rules and I agree to abide by them and by my subsequent additions to and alternations in the same as may, from time to time, hereafter be made.

I hereby permit and authorize you to deduct from my salary every month an amount equivalent to 10% of my basic salary in the concerned month, as my contribution to the fund with effect from:

Provident Fund Nomination: I hereby direct that the amount payable to me from the Confiz Employee Contributory Provident Fund, at the time of my death shall be distributed among the person(s) mentioned below in the manner shown against their names: