APPLICATION FOR CONTRIBUTION TOWARDS VCPF (FOR COMPUTER CENTRE)
FOR THE MONTH OF _______________

1. Name of the Employee :

2. Emp.No. :

3. Actual Amount to be recovered : Rs.

Date : Signature of the Employee

Office Supdt./CBS

---------------------------------------------------------------

(for CBS use)

4. Basic Pay :

5. Actual Amount to be recovered :
(Repeat the item No.3)

I declare that I have not increased the VCPF more than TWO times and not decreased more than ONE time during the Financial year.

Date : Signature of the Employee

Name :

Emp.No :

Shop/Tkt.No :

Forwarded to OS/CBS

OS/SSE

Note : Application should be submitted before 10th of the calender month. In case of stop recovery indicate 0000 at the column No.3 & 5.