EPFO revises Composite Claim Form for Death Cases

Employees’ Provident Fund Organisation

(Ministry of Labour & Employment , govt. of India)

Head  Office

Bhavishya Nidhi Bhavan, 14- Bhikhaji Cama Place, New Delhi -110066


No. manual/Amendment/2011/Pt/9536

Date: 21 August 2017


All addl.CPFC(HQ/Zones),

Regional P.F. Commissioners-Inchangeof

Regional Officers

Sub: Composite Claim Form For Death Case to replace erstwhile Form No. 20,10-D& 5-IF – Revised Claim Form thereof

Ref: HO circular No. Manual /Amendement/2011/163 dated 03.03.2017 (Placed on EPFO website at SI. No. 675 ‘Office order/Circulars for the year 2016-17).



The Central Provident Fund Commissioner vide order dated 03.03.2017 had introduced Composite Claim Form for Death case by replacing erstwhile claim From Nos.20,10-D AND 5-IF with a view to simplify the submission of claim forms by the subscribers.

  1. Based on various suggestions the composite claim form for death cases has been reviewed and accordingly a revised Composite claim form for death cases, approved by CPFC , is attached herewith. This claim form shall come into force from the date of issue of this circular.

(This issued with the approval of FA&CAO)


Yours Faithfully,

Encl: As above

(Udita Chowdhary)

Addl., CPFC(F&A)

Download Composite Claim Form in Death Cases 



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