i" FAKIR MOHAN UNIISERSITY \ryASA V IHAR

i" FAKIR MOHAN UNIISERSITY \ryASA V IHAR. NUAPADHI. BALASORE - 20 Phone: rob782) . 275768, Fax 116782l - 27576a Schedule LUI - Form No. 198 FORM OF APPLICATION FOR FII{AL PAYMINT / TR]{NSFERTO BODIES CORPORATE OTHER COVERNMtrNTS OF BALANCES Ti,[ THE ...............PROVIDENT FUND ACCOUNT To The Accountant General, (Th;ough the Head of office/Department) I arn due to retire/have retired,/have procee (Extractive summary — verify with official source.)