NPS PDF
NPS PDF
NPS PDF
Page 1
To affix recent
Coloured photograph
(3.5 cm 2.5 cm)
Receipt No.
(To be filled by POP-SP)
Note:
1. This form is to be used by a subscriber opening a fresh Tier I and Tier II account
2. Pre-existing NPS account holders with a valid PRAN card need to fill up only the NPS Tier II form (Annexure UOS-S10)
Sir/Madam,
Ih
I hereby request that a NPS account be opened in my name and Permanent Retirement Account number (PRAN) be allotted
as per particulars given below:
Kumari
Middle Name
Last Name
Male
Yes
Yes
(If Yes, please provide the details in the annexure UOS-SH1 on Page No. 9)
(If Yes, please provide the details on Page No. 4)
Female
3. Date of Birth *
4. PAN
D D M M
Y Y
Y Y
(Date of birth should be supported by relevant documentary proof).
5. Category:
Government
Private Sector
Self Employed
else,
NRI
Others
Annexure UOS-S1
Page 2
Pin Code
9. Phone No.
STD Code
Phone No.
12. Do you want to subscribe to SMS Alerts (To be made available later, on a chargeable basis):
13. Subscribers Bank Details: (OPTIONAL - please refer to Sr. No. 7 of the instructions)
Bank A/c Number
Yes
No
Savings A/c
Current A/c
Bank Name
Bank Branch
Bank Address
Pin Code
Bank MICR Code*
IFS code (Wherever applicable)
Section B - Subscribers Nomination Details (OPTIONAL - please refer to Sr. No 8 & 9 of the instructions)
1. Name of the Nominee:
1st Nominee
First Name*
First Name*
First Name*
Middle Name
Middle Name
Middle Name
Last Name
Last Name
Last Name
2nd Nominee
3rd Nominee
2nd Nominee
3rd Nominee
4. Percentage Share:
1st Nominee
5. Nominees Guardian Details (in case of a minor):
1st Nominees Guardian Details
First Name*
2nd Nominee
% 2nd Nominee
3rd Nominee
3rd Nominee
Middle Name
Middle Name
Middle Name
Last Name
Last Name
Last Name
Annexure UOS-S1
Page 3
Section C - Subscriber Scheme Preference (Please refer the instructions on Page No. 7 for further details):
(i). PFM Selection for Active and Auto Choice (Select only one PFM)
PFM Name (in alphabetical order)
Please tick only one
(Selection of PFM is mandatory both in Active and Auto Choice. In case you do not indicate a choice of PFM, your
application form shall be summarily rejected).
(ii). Investment Option
Active Choice
Note:1.
2.
Auto Choice
In case you do not indicate any investment option, your funds will be invested in Auto Choice
In case you have opted for Auto Choice, DO NOT fill up section (iii) below relating to Asset Allocation. In case you
do, the Asset Allocation instructions will be ignored 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)
Asset Class
% share
E
(Cannot exceed 50%)
Total
100%
Note:1.
The allocation across E, C and G asset classes must equal 100%. In case, the allocation is left blank and/or does
not equal 100%, the application shall be rejected by the POP.
Annexure UOS-S1
Page 4
TIER II DETAILS
I hereby submit the following details for activation of Tier II account under NPS.
1. Subscribers Bank Details: (MANDATORY - please refer to Sr. No. 7 of the instructions)
else,
Savings A/c
Current A/c
Pin Code*
Bank MICR Code*
IFS code (Wherever applicable)
2. Subscribers Nomination Details (OPTIONAL - please refer to Sr. No. 8 & 9 of the instructions)
If same as Tier I, Please Tick
else,
First Name *
First Name*
Middle Name
Middle Name
Middle Name
Last Name
Last Name
Last Name
2nd Nominee
3rd Nominee
2nd Nominee
3rd Nominee
Percentage Share:
1st Nominee
Nominees Guardian Details (in case of a minor):
1st Nominees Guardian Details
First Name*
2nd Nominee
% 2nd Nominee
3rd Nominee
3rd Nominee
Middle Name
Middle Name
Middle Name
Last Name
Last Name
Last Name
3. Subscriber Scheme Preference (Please refer the instructions on Page No. 7 for further details):
If same as Tier I, Please Tick
else,
(i). PFM Selection for Active and Auto Choice (Select only one PFM)
PFM Name (in alphabetical order)
Annexure UOS-S1
Page 5
Auto Choice
Note:-
1.
2.
In case you do not indicate any investment option, your funds will be invested in Auto Choice
In case you have opted for Auto Choice, DO NOT fill up section (iii) below relating to Asset Allocation. In case you do, the Asset
Allocation instructions will be ignored 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)
Asset Class
E
(Cannot exceed 50%)
% share
Note:1.
Total
100%
The allocation across E, C and G asset classes must equal 100%. In case, the allocation is left blank and/or does not equal 100%,
the application shall be rejected by the POP.
(DD/MM/YYYY)
Signature/Thumb
Impression* of Subscriber
Annexure UOS-S1
Page 6
To be filled by POP-SP
POP-SP Registration Number
KYC Compliance
_____________________________________
_____________________________________
_____________________________________
Yes
PAN Compliance
Yes
Yes
No
To be filled by POP-SP
POP-SP Seal
Name : ___________________________________
Place : __________________
Designation : ________________________________
Date : __________________
Received at:_____________________________________
Date:______________
Annexure UOS-S1
Page 7
INSTRUCTIONS FOR FILLING THE FORM
a)
b)
c)
d)
e)
f)
g)
Form to be filled legibly in BLOCK LETTERS and in BLACK INK only. Please fill the form in legible handwriting so as to avoid errors in your
application processing. Please do not overwrite. Corrections should be made by cancelling and re-writing and such corrections should be countersigned by the applicant.
Each box, wherever provided, should contain only one character (alphabet/number/punctuation mark) leaving a blank box after each word.
The subscriber should affix a recent colour photograph (size 3.5 cm x 2.5 cm) in the space provided on the form. The photograph should not be
stapled or clipped to the form. (The clarity of image on PRAN card will depend on the quality and clarity of photograph affixed on the form.)
Signature /Thumb impression (LTI in case of males and RTI in case of females) should only be within the box provided in the form. The
subscriber should not sign across the photograph. If there is any mark on the photograph such that it hinders the clear visibility of the face of the
subscriber, the application shall not be accepted.
Applications incomplete in any respect and/or not accompanied by required documents are liable to be rejected. The application is liable to be
rejected if mandatory fields are left blank or the application form is printed back to back.
The subscribers thumb impression should be verified by the designated officer of the POP- SP accepting the form.
Subscribers are advised to retain the acknowledgement slip signed/ stamped by the POP-SP where they submit the application.
Sr.
No.
Item No.
1.
2.
3.
4.
5.
6.
9, 10, 11
7.
13 of Tier I
Point No.1 of Tier II
8.
9.
Item Details
For activation of Tier II, bank details are mandatory. The subscribers shall
provide a cancelled cheque, the details of which should match the bank details
provided for Tier II.
Annexure UOS-S1
Page 8
A subscriber opting for Auto Choice must also select a PFM. The application shall be rejected if the subscriber does not indicate
his/her choice of PFM
In case both investment option and the asset allocation at Sr. No. (ii) and Sr. No. (iii) are left blank, the subscribers funds will be invested
as per Auto Choice
For more details on investment options and asset classes, please refer to the Offer Document.
The Subscriber can obtain the status of his/her application from the CRA website or through the respective POP-SP.
For more information
Visit us at http://www.npscra.nsdl.co.in
Call us at 022-24994200
e-mail us at [email protected]
Write to: Central Recordkeeping Agency, NSDL e-Governance Infrastructure Limited, 1st Floor, Times Tower, Kamala Mills
Compound, Senapati Bapat Marg, Lower Parel (W), Mumbai - 400 013.
Annexure UOS-SH1
Page 9
Details for printing PRAN card in Hindi (please provide the details in Devnagri script):
Please note that the manner in which the names are provided in this annexure will be displayed on the
PRAN card. However, date of birth will be printed in English only.
Subscribers Full Name:
First Name *
__________________________
Middle Name
___________________________
Last Name
___________________________
__________________________
Middle Name
___________________________
Last Name
___________________________
Signature/Thumb
Impression* of Subscriber
________________________________________________
Name of the Subscriber:
____________________________