Form 41:Form for maintaining accounts of subscribers to a recognised provident fund

Company Name(s): 
Documents: 

FORM NO. 41
[See rule 74]
Form for maintaining accounts of subscribers to a recognised provident fund

Name __________________________________ Date of joining fund ____________ Account closed _____________
Date ______________________
Paid to employee __________________
Lapsed to employer or to fund ____________
Recovery by employer _____________________
Contributions
Year and month Salary Amount transferred
from any other
recognised provident
fund
Contributions by
employee
Regular contributions
by employer
Employer's contribution
of a contingent nature
Total of cols. 3, 4, 5 and
6
Total interest on col. 7
1 2 3 4 5 6 7 8 *
Balance brought forward
April
May
June
July
August
September
October
November
December
January
February
March
Total
Adjustment on account of
temporary withdrawals account
(columns 9, 10 and 11 only)
Adjustment on account of non repayable
withdrawals account
(columns 12, 13 and 14)
Total carried over