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EPF Declaration and Nomination Form

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0% found this document useful (0 votes)
22 views26 pages

EPF Declaration and Nomination Form

Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

New Form No.

11 - Declaration Form
(To be retained by the Employer for future reference)

EMPLOYEES' PROVIDENT FUND ORGANIZATION


Employees' Provident Funds Scheme, 1952 (Paragraph 34 & 57) &
The Employees' Pension Scheme, 1995 (Paragraph 24)
Declaration by a person taking up employment in an establishment on which EPFS 1952 and/or EPS 1995 is applicable

1 Name of the Member YOUR NAME

2 Fathers' Name Husband's Name


FATHER OR HUSBAND'S NAME
(Please tick whichever is applicable)

3 Date of Birth (DD/MM/YYYY) DATE OF BIRTH

4 Gender (Male/Female/Transgender) GENDER

5 Marital Status (Married/Unmarried/Widow/Widower/Divorcee) MARITAL STATUS

(a) Email Id PERSONAL EMAIL ID


6
(b) Mobile No. CONTACT NUMBER
Whether earlier a member of the Employees' Provident
7
Fund Scheme, 1952 ?
Yes No

Whether earlier a member of the Employees' Pension


8
Scheme, 1995 ?
Yes No

Previous employment details [if Yes to 7 &/or 8 above]


a) Universal Account Number
UAN (Only for experienced)
b) Previous PF Account Number PF ACCOUNT NUMBER(Only for experienced)
9
c) Date of exit from previous employment (DD/MM/YYYY) RELIEVING DATE FROM PREVIOUS COMPANY (Only for
experienced)
d) Scheme Certificate No. (if issued)
e) Pension Payment Order (PPO) No. (if issued)

a) Internation Worker Yes No


10 b) If yes, state country of origin(India/Name of other country)
c) Passport No.
d) Validity of passport [(DD/MM/YYYY) to (DD/MM/YYYY)]

KYC Details (attach self attested copies of following KYCs)


a) Bank Account No. & IFS Code
BANK ACC LINKED WITH PF ACCOUN IFSC CODE
11
b) AADHAR No. AADHAAR (Mandatory)
c) Permanent Account No. (PAN), if available PAN NUMBER (Mandatory)
UNDERTAKING
1) Certified that the particulars are true to the best of my knowledge.
2) I authorize EPFO to use my Aadhar for verification/authentication/eKYC purpose for service delivery.
3) Kindly transfer the funds and service details, if applicable, from the previous PF account as declared above to the present PF account
(The transfer would be possible only if the identified KYC detail approved by previous employer has been verified by present employer using his Digital Signature Certificate)
4) In case of changes in above details, the same will be intimated to employer at the earliest.

Date:
Place: DATE & PLACE Signature of the Member
DECLARATION BY PRESENT EMPLOYER
has joined on

and has been allotted PF Number


B. In case the person was earlier not a member of EPF Scheme, 1952 and EPS, 1995:
● (Post allotment of UAN) The UAN allotted for the member is
● Please Tick the Appropriate Option:
The KYC details of the above member in the UAN database

DO NOT FILL
C. In case the person was earlier a member of EPF Scheme, 1952 and EPS, 1995:
The above PF Account Number/ UAN of the member as mentioned in (A) above has been tagged with his/her UAN/Previous
Member ID as declared by [Link] ID as declared by [Link] ID as declared by [Link] ID as declared by member.
● Please Tick the Appropriate Option:
The KYC details of the above member in the UAN database have been approved with DSC and transfer request has been generated on por
As the DSC of establishment are not registered with EPFO, the member has been informed to file physical claim (Form 13) for transfer of f
from his previous establishment.

Date: Signature of Employer with Seal of Establishment


FORM 2 (Revised)

NOMINATION AND DECLARATION FORM FOR UNEXEMPTED/


EXEMPTED ESTABLISHMENTS

Declaration and Nomination Form under the Employees’ Provident Funds and
Employees’ Pension Scheme

(Paragraphs 33 & 61 (1) of the Employees Provident Fund Scheme, 1952 and Paragraph 18 of the Employees’ Pension scheme, 1995)

1. Name (in Block letters) : YOUR NAME

2. Father’s/Husband’s Name : YOUR FATHER / HUSBAND’S NAME

3. Date of Birth : DATE OF BIRTH

4. Sex : GENDER

5. Marital Status : YOUR MARITAL STATUS

6. Account No(UAN) : YOUR UNIVERSAL ACCOUNT NUMBER – NOT APPLICABLE FOR FRESHERS

7. Address : Permanent : PERMANENT ADDRESS

Temporary : MENTION PERMAMNENT ADDRESS IF NO CURRENT ADDRESS

PART – A (EPF)
I hereby nominate the person(s) /cancel the nomination made by me previously and nominate the person(s) mentioned below
to receive the amount standing to my credit in the Employees’ Provident Fund in the event of my death :

Name of
nominee/ Address Nominee’s relation- Date of Total amount of share of If the nominee is a minor,
nominees ship with the member Birth Accumulations in Provi- name & relationship & address
dent Fund to be paid to of the guardian who may
each nominee receive the amount during
the minority of nominee

1 2 3 4 5 6

NOMINEE NOMINEE MOTHER / NOMINEE TOTAL PROPORTION GUARDIAN


NAME ADDRESS FATHER / DOB SHARED = 100% DETAILS IF
SPOUSE / NOMINEE IS
CHILD MINOR

1 * Certified that I have no family as defined in para 2(g) of the Employees’ Provident Fund Scheme, 1952 and should
I acquire a Family hereafter, the above nomination should be deemed as cancelled.

2 * Certified that my father/mother is/are dependent upon me.

x
Signature or thumb impression of the subscriber

*Strike out whichever is not applicable.


Part B (EPS) (Para 18)

Form -2
I hereby furnish below particulars of the members of my family who would be eligible to receive widow/children pension
in the event of my death.

[Link]. Name of the family Address Date of Birth Relationship with the member
member

1 2 3 4 5

1
NOMINEE NAME NOMINEE ADDRESS NOMINEE DOB WIFE / HUSBAND / SON /
DAUGHTER

** Certified that I have no family, as defined in para 2(vii) of Employees’ Pension Scheme, 1995 and should I acquire a family
hereafter I shall furnish particulars thereon in the above form.

I hereby nominate the following person for receiving the monthly widow pension (admissible under para 16 2(a)(i) and (ii)
in the event of my death without leaving any eligible family member for receiving Pension.

Name and Address of the Nominee Date of Birth Relationship with the member

1 2 3

1.
NOMINEE NAME NOMINEE DOB NOMINEE RELATIONSHIP TO YOU

2.

3.

Date :
Signature or thumb impression
of the subscriber
Place :

**Strike out whichever is not applicable.

CERTIFICATE BY EMPLOYER
Certified that the above declaration and nomination has been signed/thumb impressed before me by Shri/Smt./Kum.

employed in my establishment after he/she has read the entries/entries have been read over to him/her

by me and got confirmed by him/her.

Place :
Signature of the employer or other
Authoried Officers of the Establishment.

Designation
Dated the :

Name & Address of the Factory/


Establishment or Rubber Stamp Thereon

Form -2
GUIDANCE FOR FILLING THE FORM No - 2

Employee’s Provident Fund Scheme, 1952:-


(EPF)
Para 33 :- Declaration by persons already employed at the time of institution of the fund :-

Every person who is required or entitled to become a member of the Fund shall be asked forthwith by his employer to
furnish and shall, on such demand, furnish to him, for communication to the Commissioner, particulars concerning
himself and his nominee required for the declaration form in Form 2. Such employer shall enter the particulars in the
declaration form and obtain the signature or thumb impression of the person concerned.

Para 61 : Nomination

1. Each member shall make in his declaration in Form 2, a nomination conferring the right to receive the amount that
may stand to his credit in the Fund in the event of his death before the amount standing to his credit has become
payable, or where the amount has become payable before payment has been made.
2. A member may in this nomination distribute the amount that may stand to his credit in the Fund amongst his
nominees at his own discretion.
3. If a member has a family at the time of making a nomination, the nomination shall be in favour of one or more
persons belonging to his family. Any nomination made by such member in favour of a person not belonging to his
family shall be invalid.
Provided that a fresh nomination shall be made by the member on his marriage and any nomination made before
such marriage shall be deemed to be invalid.
4. If at the time of making a nomination the member has no family, the nomination may be in favour of any person or
persons but if the member subsequently acquires a family, such nomination shall forthwith be deemed to be invalid
and the member shall make a fresh nomination in favour of one or more persons belonging to his family.
4A Where the nomination is wholly or partly in favour of a minor, the member may, for the purposes of this scheme
appoint a major person of his family, as defined in clause (g) of paragraph 2, to be the guardian of the minor
nominee in the event of the member predeceasing the nominee and the guardian so appointed.
Provided that where there is no major person in the family, the member may, at his discretion, appoint any other
person to be a guardian of the minor nominee.
5. A nomination made under sub-paragraph(1) may at any time be modified by a member after giving a written notice
of his intention of doing so in form 2. If the nominee predeceases the member, the interest of the nominee shall
revert to the member who may make a fresh nomination in respect of such interest.
6. A nomination or its modification shall take effect to the extent that it is valid on the date on which it is received by
the commissioner.

Form -2
Para 2(g) : Family Means :-
(i) in the case of a male member, his wife, his children, whether married or unmarried, his dependent parents and
his deceased son’s widow and children;
Provided that if a member proves that his wife has ceased, under the personal law governing him or the
customary law of the community to which the spouses belong, to be entitled to maintenance she shall no
longer be deemed to be a part of the member’s family for the purpose of this scheme, unless the member
subsequently intimates by express notice in writing to the commissioner that she shall continue to be so
regarded; and
(ii) In the case of a female member, her husband, her children, whether married or unmarried, her
dependent parents, her husband’s, dependent parents, her deceased sons’s widow and children;
Provided that if a member by notice in writing to the commissioner expresses her desire to exclude her
husband from the family, the husband and his dependent parents shall no longer be deemed to be a part of
the member’s family for the purpose of this scheme, unless the member subsequently cancels in writing any
such notice.
Explanation :- In either of the above two cases, if the child of a member [or as the case may be, the child of
a deceased son of the member ] has been adopted by another person and if, under the personal law of the
adopter, adoption is legally recognised, such a child shall be considered as excluded from the family of the
member.
EMPLOYEES PENSION SCHEME, 1995
(EPS)
Para 18 : Particulars to be supplied by the Employees already employed at the time of commencement of
the Employees Pension Scheme.
Every person who is entitled to become a member of the Employees Pension Fund shall be asked forthwith by his
employer to furnish and that person shall, on such demand, furnish to him for communication to the Commissioner
particulars concerning himself and his family in the form prescribed by the Central Provident Fund Commissioner.

Para 2(vii) :- Family means :-


(i) Wife in the case of male member of the Employees’ Pension Fund;
(ii) Husband in the case of a female member of the Employees’ Pension fund;and
(iii) Sons and daughters of a member of the Employees Pension fund;
Explanation – The expression “Sons” and “daughters” shall include children [ Legally adopted by the member]
NOTE : Members can nominate a person to receive benefits under the Employees’ Pension Scheme 1995 where a
member is unmarried or does not have any family. Such nominee shall be paid pension equal to widow
pension in case of death of member.

Form -2
FORM – 1
{See Sub Rule (1) under rule of the Tamil Nadu Industrial Establishments
(Conferment of Permanent Status to Workmen) Rules, 1981}
REGISTER OF WORKMEN
(To be Maintained by the employer of Industrial Establishment)

BLANK
1. Employee No :

2. Name : As per aadhar

3. Address of the Workman : your address

4. Designation of the Workman :

5. Whether Temporary, Casual, Badli,


or Apprentice (other than those
covered under the Apprentices
Act, 1961) : on probation

6. Date of first entry into service : Date of joining

7. Date of which he completed 480 days


of Service :

8. Date on which made permanent :

Signature of the workman with


date

Remarks:
FORM 1
Nomination and Declaration Form
(See Rule 3)
1. Name of person making nomination :
(in block letters)

2. Father’s/Husband’s Name :

3. Date of Birth :

4. Sex :

5. Marital Status :

6. Address
Permanent :

Temporary :

I hereby nominated the person(s)/cancel the nomination made by me previously and nominate the person(s) mentioned below to
receive any amount due to me from the employer, in the event to my death.
Name of Address Nominee’s Date of Total amount of if the nominee is minor,
nominee/ relationship birth share of name
nominees with the accumulations relationship and address of
member in credit to be the guardian who may
paid to each receive
nominee the amount during the
minority of nominee

1. Certified that I have no family and should I acquire a family hereafter, the above nomination shall be deemed as cancelled.
2. “Certified that my father/mother is/are dependent upon me.
3. *Strike out whichever is not applicable.

Signature or the thumb impression


of the employed person
Certificate by employer
Certified that the above declaration and nomination has been signed/thumb impressed before me by Sri/Smt./Kum
… ................................employed in my establishment after he/she has read the entry/entries have been read over to him/her by
me and got confirmed by him/her.

Signature of the employer or other authorized


Officer of the establishment and designation
Place :
Date :
Name and address of the factory/
Establishment and rubber stamp thereof
APPLICATION FOR EMPLOYMENT

PERSONAL DETAILS

Name
E-mail ID
Contact Address

Permanent Address

Contact Phone Alternate Phone


Passport # & validity Marital Status

FAMILY BACKGROUND

Members Name / Occupation Dependent? (Y/N) Age


Father
Mother
Spouse
Children
Others

EDUCATION DETAILS

Qualification Major Subject Institution / Course CGPA / Year of


University Duration Grade / % Passing
XII

Graduation /Diploma

Post-Graduation

Certification Courses

PROFESSIONAL TRAINING ATTENDED

Name of the Training Program Period Conducted By


From To
APPLICATION FOR EMPLOYMENT

EMPLOYMENT HISTORY (IN REVERSE CHRONOLOGICAL ORDER)

Name of the Title Period Total Months Compensation Responsibilities


Organization From To

COMPENSATION (Offered in MOVATE Technologies Pvt Ltd)

[Link] Particulars Amount (Rs) Remarks


1 BASIC
2 ALLOWANCES

3 BENEFITS
Medical Reimbursements
Hospitalization
LTA
PF%
4 Performance Bonus
5 Monthly take home
6 Cost to Company (Per Annum) Only fill this

Are you agreeable for a 24-months Training Agreement? Yes/No


Do you have any criminal proceedings pending against you or have you been Yes/No
convicted by police any time before? If yes, provide details

I hereby declare that the information provided by me is correct to the best of my knowledge. I
understand that any wrong information makes me liable for termination forthwith. I also have
noted the mandatory certificate credentials and documents which I need to bring during induction.

Date Signature of the candidate


Certificate of Disability
1. Emp Name : Name as per aadhar
2. Emp ID :
blank
3. Father Name :
father name
4. DOB :
your date of birth
5. DOJ :
date of joining
6. Gender :

7. UDID Number :

8. Disability Certificate Number (If any):

9. Address for Communication :

10. Contact No. :

(A) Please tick the disabilities which are applicable.


Sl. Disability Affected part of body Permanent physical impairment/ mental
No. disability (in %)
1. Locomotor disability @
2. Muscular Dystrophy
3. Leprosy cured
4. Dwarfism
5. Cerebral Palsy
6. Acid attack Victim
7. Low vision #
8. Blindness #
9. Deaf £
10. Hard of Hearing £
11. Speech and Language disability
12. Intellectual Disability
13. Specific Learning Disability
14. Autism Spectrum Disorder
15. Mental illness
16. Chronic Neurological Conditions
17. Multiple sclerosis
18. Parkinson's disease
19. Haemophilia
20. Thalassemia
21. Sickle Cell disease
22 If any other
Reassessment of disability is:
@ - Left/ right/ both arms/ legs ,

# - Single eye £ - Left/ Right/ both ears

(B) Proof of Document:

Document No. Nature of document Date of issue Details of authority issuing certificate

Declaration:

I hereby declare that all particulars stated above are true to the best of my knowledge and belief, I further
state that if any in accuracy is detected in the application, I shall be liable to forfeiture of any benefits
derived and other action as per law.

Date: date of joining Signature of Employee


Form 11 - Declaration Form (Annexure)
The Employee’s Pension Scheme,1995 (Paragraph 24)

Employee ID :

Member Name : Name as per aadhar

UAN Number : not applicable for freshers

Previous employment EPS Account No :

• Whether earlier a Member of Employee’s Pension Scheme (EPS) : Yes/No

and EPS has been remitted in your previous employment Account (No for fresher)

• Whether Previous Employment Employee provident fund and

Employee Pension Scheme Contribution has been withdrawn (No for fresher) : Yes/No

• If any Scheme Certificate have linked with current UAN/ EPS Account (No for fresher) : Yes/No

• If the Previous EPF and EPS contribution has been withdrawn / account closed, then Movate will
consider as fresh employment and will not remit the Contribution into EPS Account. Entire
Employer contribution will be remitted to EPF account only

Undertaking:

Certified that the above give details are True to the best of my knowledge.

Date: Date of joining Signature of Member


FORM -*F°
PAYMENT OF GRATUITY ACT.
[ SEE SUB-RULE (1) of Rule 6 ]
NOMINATION
To,
...............BLANK.....................

[ I Give here name or description of the establishment with full address ]

1. Shri/Shrimati........................NAME...................................................................
[Name in the here]

Whose particulars are given in the statement below. I hereby nominate the person(s)
mentioned below to receive the gratuity payable after my death as also the gratuity
standing to my credit in the event of my death before the amount has become payable or
having become Payable has not been paid and direct that the said amount of gratuity
shall be paid in proportion indicated against the name(s) of the nominee(s)

2. I hereby certify the person (s) mentioned is/are a member (s) of my family within the
meaning of clause (h) of Section (2) of the payment of Gratuity Act. 1972.

3. I hereby declare that I have no family within the meaning of clause (h) of section (2) of
the said Act.

4. (a) My Father/Mother/Parents is/are not dependent on me.

(b) My husband’s/father/mother/parents is/are not dependent on my husband.

5. I have excluded My Husband from my family by a notice dated the .......... to the
controlling authority in terms of the provision to clause (h) of section 2 of the said Act.

6. Nomination made herein invalidates my previous nomination.

NOMINEE'S

Name in full with full Relationship with Age of Proportion by which the
address of nominee(s) the employee nominee gratuity will be shared
(1) (2) (3) (4)
STATEMENT
1. Name of the employee in full...... .....................NAME......... ....................
2. Sex.................................................................................................................
3. Religion...........................................................................................................
4. Whether unmarried/married/widow/widower................................................
5. Department Branch/Section where em oyed...BUSINESS
6. Post held with Ticket No. Serial No. if any... Designation..............................
7. Date of appointment.........Date of joining.........................
8. Permanent address............................................................................................
Village......Blank..................Thana......Blank.........Sub Division......Blank......
Post Office...Blank.......District......Blank.....State.........Blank................
Place- Offer Location
Signature/Thumb Impression
Date... Date of joining.... of the employee

Declaration by witnesses
Nomination signed/Thumb impressed before me
Name in full and full address of witnesses

signature of witnesses
Place: Offer Location

Date...........................

Certificate by the employer


Certified that the particulars of the above nomination have been verified and recorded in this
establishment

Employer's reference No, if any Signature of the employer/Officer authorized


Designation

Name address of the establishment


Date.................... or rubber stamp there of

Acknowledgment by the employee


Received the duplicate of the nomination in Form ‘F’ Filled by me and duly certified by the
employer.

Date........................

Note: Strike out words/paragraph not applicable Signature of the employee


MOVATE TECHNOLOGIES PRIVATE LIMITED

PROPRIETARY INFORMATION AND INVENTIONS AGREEMENT

This Proprietary Information and Inventions Agreement (“Agreement”) dated Date of Joining executed by
Mr./Ms. Your NAME, S/o / D/o / W/o Father’s Name , residing at
Your Permanent Address , now employed as Designation_ with Movate Technologies Private Limited, a
company incorporated under the laws of India, and having its Registered Office at 6th Floor, Ambit IT Park,
No. 32 A & B, Ambit Road, Ambattur Industrial Estate, Chennai 600058 (hereinafter referred to as “Movate”
/ “Company”), represented by its Director – HR, showeth163619 as follows:

Whereas I am a Highest Education Graduate and applied to Movate, for employment as Designation
Whereas Movate has appointed me, as Designation pursuant to the terms and conditions as stated in the Offer
Letter and Employment Services Agreement accepted by me in writing.

As a condition of my employment and in consideration of my employment with Movate, my receipt of salary


and other perks (hereinafter the “compensation”) now and hereafter paid to me by Movate and for other good
and valuable consideration, the receipt of which is hereby acknowledged, I agree to the following.

1. Proprietary Information.

1.1 Restrictions on Proprietary Information. I acknowledge that in the capacity of an employee of the Company
and in connection with and in the course of my employment with the Company: (i) I will help, develop and
create, and will be given access, get familiar, and exposed to, the Company’s business strategies, information
on customers, clients products and solutions, including but not limited to software applications and web site
design, the procedures and methods by which the Company develops and conducts its business, channels for
developing clients and other valuable, confidential, licensed, proprietary and trade secret information of the
Company, whether in oral, visual, written or printed form, and I myself may create and contribute, either
severally or jointly with other persons, in development of like information and materials which, as per the
industry standards and business ethics and practices, ought to be secured and protected in the interest of the
Company, irrespective of its commercial value (as more fully defined further hereunder as, “Proprietary
Information”), (ii) it would be unfair to the Company if I were to appropriate to myself or for others the
benefits of the Company’s resources expended to develop such Proprietary Information and business
relationships, the business, personnel and other Proprietary Information which the Company has developed in
the conduct of its business, and (iii) it is therefore fair that reasonable restrictions should be placed on certain
of my activities during my employment and after my employment with the Company . I understand that any
unauthorized disclosure of the Proprietary Information can cause irreparable damage and loss to the Company
and/or its customers or clients. I therefore agree to hold in strict confidence and in trust for the sole benefit of
the Company all Proprietary Information that I may have access to, including but not limited to the information
and material created or contributed by me, during the course of my employment with the Company. I agree
that except as required in my authorized duties on behalf of the Company, I will not disclose, use, copy, publish,
summarize, distribute, sell, commercially exploit or otherwise make use of the Proprietary Information. I
further agree that I will not remove, damage, delete, or tamper with the machines or premises where such
Proprietary Information is stored.

YOUR SIGNATURE (INKED)


Signature of the employee Signature of the employer

MOVATE TECHNOLOGIES PRIVATE LIMITED


CIN: U72900TN2000PTC115034
Regd. Address: 6th Floor, Ambit IT Park, No. 32A & B, Ambit Road, Ambattur Industrial Estate, Chennai - 600058,
Tamil Nadu, India Tel: +91 44 6632 2000; [Link]
1.2 Definition of Proprietary Information. "Proprietary Information" means all information and
any idea in whatever form, tangible or intangible, whether disclosed to or learned or developed by
me, pertaining in any manner to the business of the Company (or any of its affiliates) or to the
Company's customers, suppliers, licensors and other commercial partners, including without
limitation: (i) client lists, client prospects, and business development information; (ii) company lists,
profiles and reports; (iii) training and research materials and methodologies; (iv) structure, operations,
pricing, financial and personnel information; (v) methods of doing business, information systems
design and procedures; (vi) computer technology designs, hardware configuration systems, and
software designs and implementations; (vii) information databases, interactive procedures,
navigation, functionality, web site design, tests, analysis and studies developed by or for the benefit
of the Company; (viii) plans, designs, inventions, formulas, research and technology developed by or
for the benefit of the Company; (ix) business information and business secrets of the Company and
its clients; (x) trade secrets of the Company; (xi) plans, prospects, policies, practices, and procedures
of the Company which are not generally known in the industry; (xii) licenses and agreements of any
nature; and (xiii) all other proprietary and confidential information of every nature and source.
Proprietary Information does not include information which: (A) is or becomes generally available to
the public through no breach of this Agreement or any other agreement to which the Company is a
party; (B) was received from a third party free to disclose such information without restriction; (C) is
approved for release in writing by the Board of Directors of the Company, subject to whatever
conditions are imposed by such Board; or (D) is required by law or regulation to be disclosed, but
only to the extent necessary and only for the purpose required.

1.2.1 Unfair Competitive Practices. I acknowledge and agree that the pursuit of the activities
forbidden by this Agreement would necessarily involve the use or disclosure of Proprietary
Information in breach of the preceding subsections, but that proof of such a breach would be
extremely difficult to establish. To forestall any such disclosure, use, and breach, and in consideration
of my employment with the Company, I agree that during and after termination of my employment
with the Company for any reason, I shall not, directly or indirectly: (i) divert or attempt to divert from
the Company any business of any kind in which it is engaged, including without limitation by calling
on, soliciting or attempting to call on or solicit any of the Company’s customers and business partners;
or (ii) solicit, induce or influence any person employed by the Company to terminate his or her
employment.

While I am an employee of the Company, I will not, directly or indirectly, either as an employee,
employer, agent, principal, partner, member, stockholder (except as set forth below), corporate officer
or director, or in any other individual or representative capacity, engage in or participate in any
business that is in competition in any manner whatsoever with the business of the Company (a
“Competitive Company”).

YOUR SIGNATURE (INKED


Signature of the employee Signature of the employer

MOVATE TECHNOLOGIES PRIVATE LIMITED


CIN: U72900TN2000PTC115034
Regd. Address: 6th Floor, Ambit IT Park, No. 32A & B, Ambit Road, Ambattur Industrial Estate, Chennai - 600058,
Tamil Nadu, India Tel: +91 44 6632 2000; [Link]
1.2.2 Third-Party Information. I acknowledge that the Company has received and, in the future, will receive
from third parties, including its customers or clients or business partners, their confidential information subject
to a duty on the Company’s part to maintain the confidentiality of this information and to use it only for certain
limited purposes. I agree that I owe the Company and these third parties, during and after my employment
with the Company, a duty to hold all such confidential information in the strictest confidence and not to
disclose or use it, except as necessary to perform my obligations hereunder and as is consistent with the
Company’s agreement with such third parties.

1.2.3 Prior Actions and Knowledge. Except as disclosed on Schedule A, I do not know anything about
the Company's business or Proprietary Information, other than information I have learned from the Company
in the course of being hired and employed.

2. Invention Ideas.

2.1 Defined, Statutory Notice. I agree that during the term of my employment, there will be certain
restrictions on my development of technology, ideas, and inventions, collectively referred to in this Agreement
as “Invention Ideas.” The term “Invention Ideas” means any and all ideas, trademarks, service marks,
inventions, technology, software applications, computer programs, processes, original works of authorship,
writings, designs, formulas, discoveries, patents, copyrights, navigation, functionality, web site design, and all
improvements, rights, business concepts, and claims related to the foregoing that are conceived, developed, or
reduced to practice, relating to any activities of the Company that have been or will be conceived or developed
by me alone or with others (a) during the term of my employment, whether or not conceived or developed
during regular business hours, and whether or not conceived before, on or after the date hereof or (b) if based
on Proprietary Information, after termination of my employment.

2.2 Records of Invention Ideas. I agree to maintain adequate and current written records on the development of
all Invention Ideas and to disclose promptly to the Company all Invention Ideas and relevant records, which
records will remain the sole property of the Company. I further agree that all information and records pertaining
to any idea, process, trademark, service mark, invention, technology, computer program, original work of
authorship, design, formula, discovery, patent, or copyright that I do not believe to be an Invention Idea, but is
conceived, developed, or reduced to practice by me (alone or with others) during my period of employment or
during the one-year period following termination of my employment, shall be promptly disclosed to the Company
(such disclosure to be received in confidence). The Company shall examine such information to determine if in
fact the idea, process, or invention, etc., is an Invention Idea subject to this Agreement.

YOUR SIGNATURE (INKED


Signature of the employee Signature of the employer

MOVATE TECHNOLOGIES PRIVATE LIMITED


CIN: U72900TN2000PTC115034
Regd. Address: 6th Floor, Ambit IT Park, No. 32A & B, Ambit Road, Ambattur Industrial Estate, Chennai - 600058,
Tamil Nadu, India Tel: +91 44 6632 2000; [Link]
2.3 Assignment. Subject to Section 2.4 and in consideration of my employment with the Company, I agree to
assign to the Company, without further consideration, my entire right, title, and interest (throughout the India and
in all foreign countries), free and clear of all liens and encumbrances, in and to each Invention Idea, which shall
be the sole property of the Company, and, to the maximum extent permitted by applicable law, shall be deemed
works made for hire. In the event any Invention Idea shall be deemed by the Company to be patentable or
otherwise registrable, I will assist the Company (at its expense) in obtaining letters patent or other applicable
registrations thereon and I will execute all documents and do all other things (including testifying at the
Company's expense) necessary or proper to obtain letters patent or other applicable registrations thereon and to
vest the Company with full title thereto. Should the Company be unable for any reason to secure my signature
on any document necessary to apply for, prosecute, obtain, or enforce any patent, copyright, trademark, trade
name, service mark or other right or protection relating to any Invention Idea, whether due to my mental or
physical incapacity or any other cause, I hereby irrevocably designate and appoint the Company and each of its
duly authorized officers and agents as my agent and attorney-in-fact, to act for and in my behalf and stead, to
execute and file any such document, and to do all other lawfully permitted acts to further the prosecution,
issuance, and enforcement of patents, copyrights, trademarks, trade names, service marks or other rights or
protections with the same force and effect as if executed and delivered by me. The power-of-attorney granted
pursuant to this Section 2.3 is coupled with an interest and is irrevocable. The compensation paid by the Company
is the sole payment for all services provided by me. I am not entitled to payment of any royalties or other forms
of payment for the Invention Ideas developed by me in the course of my employment with the Company.

2.4 Exclusions. To avoid future confusion, I have listed on Schedule A description of all Invention Ideas,
if any, developed or conceived by me in which I claim any ownership or other right. I understand that, by not
listing an Invention Idea, I am acknowledging that the Invention Idea was not developed or conceived before
commencement of my employment.

2.5 License for Other Inventions. If, in the course of my employment with the Company, I incorporate
into Company property an Invention Idea owned by me or in which I have an interest, the Company is granted
a nonexclusive, royalty-free, irrevocable, perpetual, worldwide
license to make, modify, use and sell my Invention Idea as part of and in connection with the Company
property.

2.6 Patent and Copyright Registration. I agree to assist the Company, or its designee, at the
Company’s expense, in every proper way to secure the Company’s rights in the Invention Ideas and any
copyrights, patents, mask work rights or other intellectual property rights relating thereto in any and all
countries, including the disclosure to the Company of all pertinent information and data with respect thereto,
the execution of all applications, specifications, oaths, assignments and all other instruments which the
Company shall deem necessary in order to apply for and obtain such rights and in order to assign and convey
to the Company, its successors, assignees, and nominees the sole and exclusive rights, title and interest in and
to such Invention Ideas, and any copyrights, patents, mask work rights or other intellectual property rights
relating thereto. I further agree that my obligation to execute or cause to be executed, when it is in my power
to do so, any such instrument or papers shall continue after the termination of this Agreement.

YOUR SIGNATURE (INKED


Signature of the employee Signature of the employer

MOVATE TECHNOLOGIES PRIVATE LIMITED


CIN: U72900TN2000PTC115034
Regd. Address: 6th Floor, Ambit IT Park, No. 32A & B, Ambit Road, Ambattur Industrial Estate, Chennai - 600058,
Tamil Nadu, India Tel: +91 44 6632 2000; [Link]
2.7 ISMS Policy: I hereby undertake to read and understand the ISMS policy of the company and strictly
adhere to the same at all times in the course of carrying out my employment with the company. Further, I fully
understand that in case of any violation of the ISMS policy by me, irrespective of whether it is deliberate or
unintentional, disciplinary action will be initiated, which may include fine, suspension or termination of
employment, depending on the nature of the violation.

3. Former or Conflicting Agreements. I recognize that the Company desires not to improperly obtain or use any
unpublished document, proprietary information or trade secrets of any former employer or other person or entity.
During my employment with the Company, I will not bring onto the premises of the Company, disclose to the
Company, or use or induce the Company to use, any proprietary information, unpublished document or trade
secret in any form of such` former employer or other person or entity. I represent that I have returned all property
of my former employer (including proprietary information) to my former employer and my performance of this
Agreement will not breach any agreement to keep in confidence proprietary information acquired by me in
confidence or in trust prior to my employment by the Company. I certify that I have no outstanding agreement
or obligation that is in conflict with any of the provisions of this Agreement, or that would preclude me from
complying with the provisions hereof, and I agree not to enter into any written or oral agreement in conflict
herewith.

4. Termination.

4.1 Returning of Proprietary Information and Company Property. I agree that, at the time of termination
of my employment with the Company for whatsoever reasons, including resignation, or at any other time the
Company so requests, I will immediately return and deliver to the
Company (and will not keep in my possession, make copies, recreate or deliver to anyone else) all Proprietary
Information and any other property belonging to the Company and all material containing or constituting
Proprietary Information and Invention Ideas, including any copies in any form in my possession or control,
whether prepared by me or others and all paper, laptop, hard drive, disk, or tapes etc.

4.2 Termination Certificate. In the event of the termination of my employment, I agree to sign and deliver
the Termination Certificate attached hereto as Schedule B.

4.3 Subsequent Employers. After the termination of my employment with the Company, I will not enter into
any agreement that conflicts with my obligations under this Agreement and will inform any subsequent
employers of my obligations under this Agreement.

5. Nature of Agreement. This is not an employment contract. This Agreement supersedes and replaces any
existing agreement entered into by Employee and the Company relating generally to the same subject matter
and may be modified only in a writing signed by the Company. Failure to enforce any provision of this
Agreement shall not constitute a waiver of any other provision hereof.

YOUR SIGNATURE (INKED


Signature of the employee Signature of the employer

MOVATE TECHNOLOGIES PRIVATE LIMITED


CIN: U72900TN2000PTC115034
Regd. Address: 6th Floor, Ambit IT Park, No. 32A & B, Ambit Road, Ambattur Industrial Estate, Chennai - 600058,
Tamil Nadu, India Tel: +91 44 6632 2000; [Link]
6. Equitable Relief. I recognize that any violation of this Agreement could cause the Company irreparable
harm and significant injury, the amount of which may be extremely difficult to estimate, thus, making any
remedy at law or in damages inadequate. Therefore, I agree that the Company shall have the right to obtain
from any court of competent jurisdiction a temporary or permanent order or injunction, without the posting of
a bond, restraining any breach or threatened breach of this Agreement and for any other relief the Company
deems appropriate. This right shall be in addition to any other remedy available to the Company in law or
equity.

7. Governing Law. This Agreement is to be construed in accordance with and governed by the laws of India
without giving effect to any choice of law rule that would cause the application of the laws of any jurisdiction
other than the laws of India to the rights and duties of the parties. Any dispute arising out of this agreement
shall be settled only in the courts of Chennai.

8. Severability. If any provision of this Agreement, or its application to any person, place, or circumstance, is
held by an arbitrator or a court of competent jurisdiction to be invalid, unenforceable, or void, such provision
shall be enforced to the greatest extent permitted by law, and the remainder of this Agreement and such
provision as applied to other persons, places, and circumstances shall remain in full force and effect.

9. Agreement Not to Solicit Employees. During the term of Employment with the company and for a period
of one year following the termination of such Employment for any reason whatsoever, the Employee shall not
either directly or indirectly, on the Employee’s own behalf or on behalf of others, solicit, divert or hire, or
attempt to solicit, divert or hire any person employed by the company at any facility where the Employee
performed services for the company or any person with whom the Employee had regular contract in the course
of his employment of any such person is pursuant to a written agreement, for a determined period or at will.

10. Entire Agreement. The terms of this Agreement and any written employment agreement by and between
the Company and me are the final expression of my agreement with respect to the subject matter hereof. This
Agreement and any employment agreement by and between the Company and me supersedes all other prior
and contemporaneous agreements and statements, whether written or oral, express or implied, pertaining to
the subject matter of this Agreement, and they may not be contradicted by evidence of any prior or
contemporaneous statements or agreements. Unless specifically set forth in this Agreement, no
representations, warranties or covenants have been made or agreed to by the Company and no agent of the
Company has been authorized to make or agree to any such representations, warranties or covenants. To the
extent that the practices, policies, or procedures of the Company, now or in the future, apply to me and are
inconsistent with the terms of this Agreement, the provisions of this Agreement shall control. The obligations
and undertakings made by me in this Agreement shall survive the termination of my employment with the
Company.

11. Amendment/Waivers. This Agreement can be amended or terminated only by a written agreement signed
by both parties. No failure to exercise or delay by the Company in exercising any right under this Agreement
shall operate as a waiver thereof.

YOUR SIGNATURE (INKED


Signature of the employee Signature of the employer

MOVATE TECHNOLOGIES PRIVATE LIMITED


CIN: U72900TN2000PTC115034
Regd. Address: 6th Floor, Ambit IT Park, No. 32A & B, Ambit Road, Ambattur Industrial Estate, Chennai - 600058,
Tamil Nadu, India Tel: +91 44 6632 2000; [Link]
12. Assignment. I agree that the Company may assign to another person or entity any of its rights under this
Agreement, including, without limitation, any successor in interest to the Company or its business operations.
This Agreement shall be binding upon me and my heirs, executors, administrators, and successors, and shall inure
to the benefit of the Company's successors and assigns.

YOUR SIGNATURE (INKED)


Signature of the employee Signature of the employer

I HAVE READ THIS AGREEMENT CAREFULLY AND UNDERSTAND ITS TERMS. I HAVE
COMPLETELY NOTED ON SCHEDULE A TO THIS AGREEMENT ANY PROPRIETARY
INFORMATION, IDEAS, PROCESSES, INVENTIONS, TECHNOLOGY, WRITINGS, PROGRAMS,
DESIGNS, FORMULAS, DISCOVERIES, PATENTS, COPYRIGHTS, OR TRADEMARKS, OR
IMPROVEMENTS, RIGHTS, OR CLAIMS RELATING TO THE FOREGOING, THAT I DESIRE TO
EXCLUDE FROM THIS AGREEMENT.

This Proprietary Information and Inventions Agreement is made and entered into as of
Date of Joining, 2025.
YOUR SIGNATURE (INKED

(Employee’s Signature)

Your name

(Employee’s Name)
Date: Date of Joining

Place: Offer location

MOVATE TECHNOLOGIES PRIVATE LIMITED


CIN: U72900TN2000PTC115034
Regd. Address: 6th Floor, Ambit IT Park, No. 32A & B, Ambit Road, Ambattur Industrial Estate, Chennai - 600058,
Tamil Nadu, India Tel: +91 44 6632 2000; [Link]
Schedule A

1. Proprietary Information. Except as set forth below, I acknowledge that at this time I know nothing
about the business or Proprietary Information of the Company, other than information I have learned from the
Company in the course of being hired:
Do not fill

2. Reserved Inventions. Except as set forth below, there are no ideas, processes, inventions, technology,
writings, programs, designs, formulas, discoveries, patents, copyrights, or trademarks, or any claims, rights, or
improvements to the foregoing, that I wish to exclude from the operation of this Agreement (whether conceived
solely by me or jointly with others):
Do not fill

Date: Date of Joining YOUR SIGNATURE (INKED

(Employee’s Signature)

Your name
(Employee’s Name)

MOVATE TECHNOLOGIES PRIVATE LIMITED


CIN: U72900TN2000PTC115034
Regd. Address: 6th Floor, Ambit IT Park, No. 32A & B, Ambit Road, Ambattur Industrial Estate, Chennai - 600058,
Tamil Nadu, India Tel: +91 44 6632 2000; [Link]
To

Human resources

MOVATE TECHNOLOGIES PRIVATE LIMITED

Chennai

Dear Sir,

I, YOUR NAME have accepted the offer from your organization and am joining on DOJ .

I have been working with my previous company NAME OF YOUR PREVIOUS COMPANY from START DATE
and have been relieved from the services as on DATE OF EXIT .

I hereby submit this letter, since I am unable to submit my relieving letter and experience certificate from my
previous employer. By this, I am revoking MOVATE TECHNOLOGIES PRIVATE LIMITED

from all its liabilities towards recruiting me. Only I can be held liable for any claim/ legal action that might be
filed by NAME OF THE PREVIOUS COMPANY for any reasons.

I would also like to inform you that my attempt to get the relieving letter and Experience Certificate would
continue. On receipt of the same I would hand over the same to MOVATE TECHNOLOGIES PRIVATE LIMITED

Thanking you,

Yours Sincerely

Date & Signature


Salary Credit Consent Letter

From Date:

Name:

Emp Id:

Designation:

Team:

To

The HR Department,

MOVATE TECHNOLOGIES PRIVATE LIMITED

Chennai.

Dear Sir/ Madam,

Sub: Credit My salary into HDFC / AXIS/ICICI/IDFC/INDUSIND Account

With reference to above, kindly credit my salary every month to my HDFC / AXIS /ICICI/IDFC/INDUSIND Saving
Account

Account No: .

IFSC : .

Thanking you,

Yours Truly

Place:

Date

Signature
AFFIDAVIT

I YOUR NAME , son of/daughter of FATHER’S NAME , aged about YOUR AGE years, residing at
YOUR ADDRESS , do hereby solemnly affirm and sincerely state as follows:

1. I am an employee of MOVATE TECHNOLOGIES PRIVATE LIMITED w.e.f DOJ and I am offered


appointment as DESIGNATION . I state that I am affirming to this Affidavit voluntarily and of my free will
to reassure my employer of my background and dispel any security concerns.

2. I state that I am an Indian National and have been resident in India since BIRTH YEAR .I state that
till date I have never been convicted of any offence, either in India or abroad and there are no criminal
charges/case pending against me anywhere in the world. I further state that I am a law-abiding citizen of India
and neither I nor any member of my family is associated with any anti-national organization/group.

3. I state that I am not working nor do I intend to work for any organization/group working against the interests
of India or any other Country. I further state that my family members and I have never been involved/charged
for any act of treason/sedition.

4. I further state that I would neither get involved in anti-national activity nor would I use the resources the
Company in any manner to commit any act of sedition/treason. I state that I am a law-abiding citizen and I will
never work against the interests of India.

5. I state that the above facts are true and correct to the best of my knowledge and belief and I have not
concealed anything in this Affidavit. If it is discovered any time that there was any suppression or distortion of
facts related to above declaration, I understand and accept the right of M/s MOVATE TECHNOLOGIES PRIVATE
LIMITED

to take any legal action as it deems fit.

Solemnly affirmed on this:

Signature:

Employee Name:

Employee Number:
Declaration form for Voluntary Provident Fund (VPF) contribution
(Applicable for New Tax regime opted Employees)
Name as per aadhar
1. Emp Name :
blank
2. Emp ID :

3. Father Name :

4. DOB : date of birth

5. DOJ : date of joining


6. Gender :

7. Address for Communication :

8. Contact No. :

9. UAN Number : only for experienced

Would you like to contribute Voluntary Provident Fund (VPF) Yes No

(Please Tick Yes or No, If Yes Please declare the percentage of contribution)

I hereby agree to have deducted towards voluntary PF contribution (VPF) at % from


my Basic (0% to 88%).

Note:

1. Voluntary provident fund (VPF) contribution will be based on earned basic.


2. Please mention the VPF contribution percentage only.
3. VPF will be effective from

Declaration:

I am expressing my interest in utilizing the VPF benefit. I am also aware that once
I choose to participate in the Voluntary Provident Fund (VPF) and deductions begin, I
have to stay in the program at least until the conclusion of the PF financial year or until
I quit.

Date: date of joining Signature of Employee

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