Joint Declaration Form
I ___________________________________ having UAN _______________________ PF account
_______________________________________And Aadhar _____________________________
is/was with establishment M/s Nokia Solutions and Networks India Private Limited
The personal details furnished to EPFO earlier were found to be incorrect/blank and therefore request
for change/updation in the member profile as follows:
Sl No PARTICULARS Incorrect details Correct details
1 Name
Nokia Solutions and Networks India Pvt. 2 Gender
Ltd. 3 Date of Birth
(Formerly known as Nokia Siemens 4 Father’s / mother
Networks Pvt. Ltd.) Name
5 Relationship
6 Marital Status
L-5, Manyata Embassy, Business Park, 7 Date of Joining
Hebbal, Outer Ring Road, 8 Reason of leaving
Nagavara, Bangalore-560045 9 Date of Leaving
India 10 Nationality
11 Aadhar No.
Corp Identity No.
U72900DL2006PTC155149 I _______________________________S/O ___________________________________
authorized signatory of the establishment have verified the request documents attached and the
records of the establishment and certify that the facts mentioned above are correct. I am also
enclosing
________________________________________________________________________________
___, (documents of establishment) in support of the request of the employee mentioned above.
We __________________________ (Employee) and _________________________ (Authorized
signatory) hereby declare we have not concealed any facts and the above mentioned facts are
correct. We also indemnify that in case of wrong payment/over payment/under payment because of
the above furnished information shall be jointly held responsible.
Signature Of the authorised Signatory Signature of Member
With seal
Regd. Address :
Nokia Solutions and Networks India Pvt. Ltd.
1507 Regus Business Center
Eros Corporate Tower Level 15,
Nehru Place, New Delhi – 110019, India
© Nokia 2014