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NPS Subscriber Registration Form

NPS Subscriber Registration Form

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Published by Pankaj Batra
NPS (New Pension Scheme) Subscriber registration form, India
NPS (New Pension Scheme) Subscriber registration form, India

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Published by: Pankaj Batra on Apr 25, 2009
Copyright:Attribution Non-commercial

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02/18/2013

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AnnexureUOS-S1Page 1
1.Full Name (Full expandedname:Initials are not permitted)Please Tick as applicable ShriSmt.KumariFirst Name *Middle NameLast Name2. Gender * Male Female3. Date of Birth *4.PANDD M M Y Y Y Y(Date of birth should be supported byrelevant documentary proof).5.Category: Government Private SectorSelf Employed NRI Others(Please tick (
 √) any one)
6
. Father’s
FullName:First Name *Middle NameLast Name7.Present Address
*(NRIs may please refer to Sr. No.3 of the instructions)
:Flat/Unit No, Block no.Name of Premise/Building/VillageArea/Locality/TalukaDistrict/Town/CityState / Union TerritoryCountryPin Code8. Permanent Address
*
:If same as above, Please Tickelse,Flat/Unit No, Block no.Name of Premise/Building/VillageArea/Locality/TalukaDistrict/Town/CityState / Union TerritoryCountryPin Code
Subscriber Registration Form
(
* Indicates Mandatory Field
)
(To avoid mistake(s), please follow the accompanying instructionsbefore filling up the form)
ReceiptNo.(To be filled byPOP-SP)Permanent Retirement Account Number :(To befilled byCRA-FCafterPRANgeneration)To affix recentColouredphotograph(3.5 cm × 2.5 cm)Sir/Madam,I hereby request that aNPS account be opened in my name andaPermanentRetirementAccountNumber(PRAN)beallottedas per particulars given below:
Section A
Subscriber
s Personal Details 
Signature/ThumbImpression* of Subscriberin black ink 
 
AnnexureUOS-S1Page 2
9. Phone No.STD Code Phone No.10.MobileNo.11. Email ID12.Do youwant to subscribe toSMS Alerts (To be made available later, on a chargeable basis): Yes No13. Subscribers BankDetails:
(OPTIONAL
please refer to Sr. No.6 of the instructions)
Savings A/c Current A/cBank A/c NumberBank NameBank BranchBank AddressPin CodeBank MICR CodeIFS code (Wherever applicable)
SectionB-
Subscriber’s Nomination Details
(OPTIONAL-please refer toSr. No7 &8 of theinstructions)
1. Name of the Nominee:1st Nominee 2nd Nominee 3rd NomineeFirst NameFirst NameFirst NameMiddle NameMiddle NameMiddle NameLast NameLast NameLast Name2. Date of Birth(In case ofaminor):1st Nominee2nd Nominee3rd Nominee3. Relationship with the Nominee:1st Nominee2nd Nominee3rd Nominee4. Percentage Share:1st Nominee%2nd Nominee%3rd Nominee%5. Nominee
’s Guardian
Details (in case ofaminor):1st Nominee
’s Guardian
Details 2nd Nominee
’s
Guardian Details3rd Nominee
’s Guardian
DetailsFirst NameFirst NameFirst NameMiddle NameMiddle NameMiddle NameLast NameLast NameLast Name
 
AnnexureUOS-S1Page3
SectionC- Subscriber SchemePreference (Please refer to Section C of the instructions for further details):(i).PFMSelection for Active and Auto Choice(Select only one PFM)PFM Name (in alphabetical order)Please tick only one
ICICI Prudential Pension Funds Management Company LimitedIDFC Pension Fund Management Company LimitedKotak Mahindra Pension Fund LimitedReliance Capital Pension Fund LimitedSBI Pension Funds Private LimitedUTI Retirement Solutions Limited
(Selection of PFM is mandatory both in Active and Auto Choice. In case you do not indicate a choice of PFM, yourapplication form shall be summarily rejected).(ii). Investment OptionActive ChoiceAuto Choice(For details on Auto Choice, please referto theOffer Document)Note:-1.In case you do not indicate any investment option, your funds will be invested in Auto Choice2.In case you have opted for Auto Choice, DO NOT fill up section (iii) below relating to Asset Allocation. In caseyou do, the Asset Allocation instructions will beignored and investment made as per Auto Choice.
(iii). Asset Allocation (to be filled up only in case you have selected the ‘Active Choice’ investment option)
Note:-1.The allocation across E, C and G asset classes must equal 100%. In case, the allocation is left blank and/or doesnot equal 100%, the application shall be rejected by the POP.SectionD

I hereby declare and agree that (a) I have read and understood theOfferDocument, terms & conditions or the same wasinterpreted to me, and the answers entered in the application are mine. (b) I am a Citizen of India. (c) I have not been found ordeclared to be of an unsound mind under any law for the timebeing in force. (d) I am not an undischargedinsolvent. (e) I donot hold anypre-existingaccount under NPS.I understand that there would be PFRDA approved
Terms and Conditions
for subscribers on the CRA website
 governing I-pin(to access CRA/NPSCAN and view details) & T-pin
. I agree to be bound by the said terms and conditions and understand thatCRA may, as approved by PFRDA, amend any of the services completely or partially without any newDeclaration/Undertaking being signed.Income Tax Act, 1961: Tax benefits are available as pertheIncome Tax Act, 1961,as amended from time to time.
Declaration under thePrevention ofMoneyLaunderingAct, 2002
I hereby declare that:1.The contribution paid has been derived from legally declared and assessed sources of income.2.I understand that the PFRDA/NPS Trust has the right to peruse my financial profile and also agree that the PFRDA/NPSTrust has the right toclose the NPSaccount in case Iam found guilty ofviolatingthe provisions of any Law, directly orindirectly, by anyCompetentCourt ofLaw, having relation to the laws governing prevention of money laundering in thecountry.
Asset ClassE(Cannot exceed 50%)CGTotal% share100%

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