(A STATE GOVT.UNDERTAKING)

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "(A STATE GOVT.UNDERTAKING)"

Transcription

1 r ' HMACHAL PRADESH STATE ELECTRCTY BOA'RD LTD. (A STATE GOVT.UNDERTAKNG) No.HPSEBLlFlJnd/F&A instructions/ ql) 3l/y Oated: Y / To All the Chief Engineers, in HPSEBL All the SE,s/Sr.Xen,s/RE,s in HPSEBL Sub Revision of subscriber registration Form S1. Sir, t is informed that the existing NPS subscriber registration form (S1) has been revised by the NSDL and a new registration form has been notified by the PFRDA. As such all. the DDO's are requested to use the New Registration Form CSRF1" for registration of subscriber in National Pension System in future. t is furiller added that the subscribers are required to submit the selfattested copies of supporting documents which will be verified with the original by the OOO's offices before its submission to CRAFacilitation Centre for processing. The CSRF1 form is enclosed herewith. However the CSRF 1 form can be downloaded on NSOL website. You are therefore, requested to send form CSRF1 duly filled in by the employees appointed on or after for registration with NSDL for allotment of PRAN, so that the same could be forwarded to the concerned agency for allotment of PRAN. OA: as above Yours faithfully,

2 Copy for information and similar necessary action to the following please: 1. The Executive Director (Pers), HPSEBL, Shimla4. 2. The Managing Directors, HPPCLlHPPTCLlBVPCL, Shimla/ Jogindernagar. 3. The Director (Pers) SJVNL, HMFED Building, Shimla9. 4. The Addl. Secretary, HPSEBL, Shimla4 5. The Under Secretary (Gen), Shimla4. ~ SE (T) HPSEB, Shimla. He is requested to upload the above listructions on th e wetjsile of HPSEB L. 6 The Accounts Officer (Admn)! (PG) / NG local. DA: as above O nts ieer (Funds), HPSEB Lr~... Sl1 ml\...l 7 ~. J ~A

3 NATONAL PENSON SYSTEM (NPS) SUBSCRBER REGSTRATON FORM To, NalionaJ Pension System Trust. Dear Sir/Madam. thereby request that an NPS account be opened in my name as per the particutars given below: indicates mandatory fie.lds. Please fill the form in English and BLOCK letters with black ink pen. (Refer general guidelines al instructi ons page) CSRF Affix rec en t colour photograph of 3.5 cm X 2. 5 em size Name of Middle Name Last Name Date of Birth' Gender [Please tick (.J) 1 Male 0 Female 0 Others 0 Father's Name', r,t LU ~,,,...:.M.l...1,;",,1,,=1llJ c..j...1'~...lj...l' L (Refer S~. No. 1 of instruc tions) PAN L 1 Aadhaar 1 1 Voter 10 L J Passport 1 J Others am' ollh~ 10 U N U 1111 b 1e, Please reler Sr. No. 2 of 1M inslru,l;on,. Fla tlroomldoor/block no. Premise./BuildingNiliage Road/Street/Lane Area/Locality/Taluk City/Town/District State/U.T l LLl A L J 1 " PERMANENT ADORESS DETAil S 1 L 1 LL L L L_' L+~~ L 1 1 Landmark 1 LL, L l _l 1 l.ll l L J _1 L L PN Code 11 JJ 'u FlatiRoom/Door/Block no. t ~ J L ~~~~ Premises/BuildingNiliage r 1 Ul;!i..;.!!! Road/Street/Lane Area/Locality/Taluk CityfTown/District State/U.T. i! _!ll!~l!!lill Proof of Address (Correspondence/Permanent) Aadhar card 0 Passport 0 Voter 10 card 0 Driving License 0 Ration Card 0 Registered Lease 0 Sale agreement of residence 0 5, e:; Latest Gas Bill' 0 Electricity Bill' 0 Telephone[Landlinel Bill' 0 Others (please specify) L...J 'Not more han 3 months old. Please refer Sr. No.2 of the instructions Landline Phone (with STD Code) 1 1 Mobile [ J _~1 _U Do you want to subscribe to SMS Alerts:, Yes 0 OTHERD No 0 Mobile number is essential for receiving sms alerts regarding your NPS account ~ Occupation Details [ptease tick( ) 1 Private Sector 0 Governmenl Sector 0 Public Sector 0 Business 0 Professional 0 Agricullure 0 Homemaker 0 Siudent o NR 0 Olher (please specify) 1'.. ~ Please Tick f Applicable Politically exposed person 0 Related to Politically exposed Person 0 ~ ncome Range (per annum) Upto 1 lac 0 1 lac to 5 lac 0 5 lac to 10 lac 0 10 lac to 25 lac 0 25 lac and above 0 ~ Educational Qualifications Below SSC 0 SSC 0 HSC 0 Graduate 0 Masters 0 Professionals ( CA, CS, CMA, etc. ) 0 Account Type [ please tick( V} 1 Saving Nc Current Nc 0 Bank Nc Number Bank Name.++:!~+L_LLL Branch Name. L, Branch Address L!, 1 StalelU,T 1! Bank MCR Code FSC Co~ 1 1 of 3

4 CSRF 1 Name of the Nominee (You can nominate up to a maximum of 3 nominees and if you desire so please fill in Annexure (Additional Nomination Form) provided separalely) Nominee Name j~l"l \ U U ~~ 1~U!.. J!:laklt l~ 1 LLLL Relationship with the Nominee ~ Date of Birth (n case of Minor) (j d rr1 ft' '1 y y y Nominee's Guardian Details (in case of a minor) Nominee's Guardian ~ rj" l.!. ~ LUliU_ would like to subscribe for Tier Account also YES 0 NO 0 f yes, please submit details in Annexure. (Tier i account is not available for NPS Litel Swavalamban subscribers). would like my PRAN to be printed in Hindi YES 0 NO 0 t Yes, please submit details on Annexure i o (i) PENSON FUND SELECTON (Tier ) : The names of the all PFs are mentioned in the instructions page and are available to the all sector subscribers with following conditions: (i) Government Sector: For Governmenl Subscribers, the lollowing PFs act as delaul! PFs as per he guidelines issued by he Governmenl: (a) L1C Pension Fund Limited (b) S81 Pension Funds Pvl. Limiled (c) UT Reliremenl Solutions Lid. (i) NPS Lite/Swavalamban: NPS lite'swavalamban is a group choice model where subscriber has a choice of PF and nvestment option as available with Aggregntor. (iii) Ali Citizen Model: Subscrib rs under A! Citizen model has he oplion 10 choose he available PFs as per heir choice in the lable beloly. (iv) Corporate Model : Subscribers shall ~1ave the option to choose he available PFs as per the below table in consultation with tneir r(;!spcclive Employer. Available to Gov.."m""t Sector \'1;:: (.()nsenlod (ii) NVESTMENT OPTON (Available for All Citizen Model and Corporate Model Subscribers) ( Please Tick (..J) in the box given below showing your investment option). Active Choice l Auto Choice cl For del~ils 011 AulO Choice, please refer 10 the Offer Document. Please nole: 1. n r.ase VOU do no t i nul t::~ (j. any inveslmelit optio:l, your funds will be invest din AU!(l Ct,oice L. tn case you have opted tor Auto ChOice. DO NO T up section below r ~l a t ~ n 10 A. sel Alloca tion. f! case you do, the AS6ut Alto ~ l lo n instruc:uons Wll be ignored 3ncl nves, 1menl Will be made as pe r Auto Choice. (iii) ASSET ALLOCATON (to be filled up only in case you have selected the 'Active Choice' investment option) Asset Class (Cannol e~eed 50%) C G Total Note: The total allocation across E, C and G asset classes musl be equal to j +'+ \+ j 100%. n case, the allocalion is left blank and/or does not equal 100%, the % application shall be rejected. Declaration & Authorization by au subscribers have read and understood the terms and conditions of the National Pension System and hereby agree to he same and declare thallhe information and documenls furnished by me are true and correct, to the best of my knowledge and belief. undertake 10 inform immediately he Cenlral Record Keeping Agency/National Pension System Trusl, of any change in the above information furnished by me. t do not hold any preexisling account under NPS. understand hat shall be lully liable for submission of any false or incorrect information or documents. further agree 10 be bound by the terms and oonditions of provision of services by CRA, from time 10 time and any amendmenl hereof as approved by PFRDA, whether complele or partial wilhoul any new declaralion being furnished by me. shall be bound by he lerms and conditions for he usage of pin (10 access CRAlNPSCAN and view details) & Tpin on the CRAwebsile ~ Additional declaralion by Swavalamban subscriber havereadlexplained to me and understood the Swavalamban guidelines and meet the prescribed eligibility crileria for assislance under he scheme. also undertake to adhere to he prescribed contribution limit of minimum Rs. 1000/ and maximum of Rs /, failing which the Central Government oontribution credited to my accounl ~y be forfe i~d along wilh such interest rates as may be prescribed. Declaration under the Prevention of Money Laundering Act, 2002 hereby declare hat the contribution paid by me/on my behalf has been derived from legally declared and assessed sources of income. understand thai NPS Trusl has he right to peruse my financial profile or share he information, with other government authorities. further agree that NPS Trust has he righl to close my PRAN in case am lound violating the provisions of any law relating 10 prevention of money laundering. Date ptace: rf, 11 m, y y 1y y SignaturelThumb mpression" of Subscriber in black ink (" LT in case of male and RT in case of female) ACKNOWLEDGEMENT Name of the Subscriber: ~ ''1,>1<_.1 ~ LLL1L..J.lLJ Contribution Amount Remitted: ~ 1 1! 1 Date of Receipt of Application and Contribution Amount: dl dl / lmlml ' ly l ylvlyl Stamp and Signature of the Employer/PoP/Aggregator: 2 of 3

5 ~.1., L.&. (Subscribers Emptoyment Details to be led and attested by the Deplt. (All Details are Mandatory) Date of Joining ~ ~n11 1 y y LL Date of Retirement ~~ " ". 1~1Y.i.'Lh Employee Code/lD Group of Employee (Tick as applicable) GroupA D GroupB D GroupC 0 GroupD D Ollice,,,, Department ~_LlJ Minislry 1 LJ LLLL l~ DDO Registnalion Number L U DTO/PAO/CDDO/DTAPrAO Registration. Number l Basic Pay ~LLj _1 Pay Scale j L 1 L L is certified that the delails provided in this subscriber reglstralion form by employed with us, including he adrlress and employment details provided above are as per the service record of the employee maintained by us. Also, it is further ce rtilied that he/she has read entrieslentries have been read over to himlher by us and got confirmed by him/her. CSRF Signature of the Authorised person Rubber Stamp of tho 000 Signature of the Authorised person Tubber Stamp of the DTO/PAO/CDDeS! (n the box abo'!.e) (n the box ab~e L 1 iln the box above) DTAPrAO lin 11e!lox ~bov e)_ Deslgna!io n of the Authoflsed P rs on Designation of he Authorised P e rson ' l N"me of the 000 L J Name of D10/PAO/CDDO/DTAPrAO DeptUMln lstry j Dille j '" J, 1[." :..,, : "t'...t' ;.' (Subscribecs Employment Delails 10 be filled and attested by Carpanale (All Details are Mandatory)) Dale of Joining r, L Di'!e of Reliremenl 1 n Employp 10 L L 1 CorporEte Regd. No Allalled by CRA LJ CBO No. allolled by CRA Certified thallhe delails provided in this subscriber regis ra lion form by employed with us, including the employmenl delails provided above are as per the service record of he employee maintained by us. Also, il is furlher cerlified tha he she has read the enlries entries h3ve been mad over 10 him her by us nd gal confirmed by him her.! ~ Date l. ' L \ \ j Slgnaturl': ot the AUlllonred Person (n th~ hox above) Place Rllbh(tr Stamp of th Corporala Deslynation at th e Authorized Person: ( the box nljove).firi:.:l.:.e::~c'g~.~~~~;':::j~i ',,:,",pn;:7:' '":"'.1.~~~~~ Receipt No. (17 digits) Ll POPSP Registnalion Number! Document accepted for date 01 Birlh Proof: Copy of PAN card submitted YES 0 No D KYC Compliance YES 0 No D Existing Bank Customer: /we hereby certify/canfinm that Shri/SmllKum is an existing customer of the Bank having fully operative Saving Bank ac.count no " at..... brnnch and KYC norms required for opening Bank AccDunl which match he requirements for opening NPS account have been fully complied with. We further confinm that the S. B. alc of Sh/SmllKum " , is not a 'Basic Savings Bank Deposit Ac=unl'. Adhaar Based KYC Certificate: of Sh/SmUKum has been l!we hereby certify thai Aadhaar Number... checked and the name and address menlianed on the anginal Aadhaar card are matching with that menlianed on NPS applicallan form. To be nll.d by POPSP Name: Designation: POPSP Seal ' Signature 01 Authorized Signatory Date u d 1m, ' ' ~ t, ~~t:il:~ntr'~~:'jr:r:::::ta:'; 1'.::;;0:...:", "::i '!'.i::!; ::r.j» Authorisation by Aggregator'. office (NL AO) Certified that he subscriber is registered wilh the aggregator and helshe has opted to join NPS. hereby declare hat the subscriber is eligible to join NPS and he above declaration has been signed!thumb impressed before me by "... aller (s)he has read the entries! entries have been read over to her/hlm by me. Place: Signature of the Authoflsed person (n the box above) Name of the Aggregalar Rubber Stamp of the Aggregalor (n the box above) t NPS Lite Accounl Office (NLAO) Registration Number t t NPS Lite Collection Centre (NL, CC) Registralion Number Membership No. allotted by Aggregator (if any) Place Date " " m 1"1 y y '/! 'lto be 111MY CRA n~c~)r 1 Received by CRAFC Registration Number i i Received at Date 111 J '" "' V ~! y y Acknowledgement Number (by CRAFC) PRANAliaied 3 of 3

6 CSRF 1 NSTRUCTONS FOR FLLNG THE SUBSCRBER REGSTRATON FORM General Guidelines (a) Please fill the form in legible handwriling so as to avoid errors in your application processing. Please do not overwrite. Corrections should be made by cancelling and rewriting and such corrections should be countersigned by the applicant. Each box, wherever provided, shoutd contain only one character (alphabet / number / punctuation mark) leaving a blank box aner each word. (b) 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 len btank or the apptication form is printed back to back (c) The subscriber Should not sign across the photograph. The photograph should not be stapled or clipped to the form. f there is any mark on th e photograph such that it hinders the clear visibility of the face of the subscriber, the application shall not be accepted. (d) Copies of all the documents submilted by the applicant should be selfaltested and accompanied by originals for verification by the nodal office. (e) Name end Address of the appticant mentioned on the form, shoutd match with the documentary proof submitted. (f) The subscriber's thumb impression should be verified by the DDO/PAO/DTO/designated officer of POPSP/Aggregator (g) Government employees (mandatorily covered under NPS) may submit their application for Tier to any POPSP of their choice. The list of POPSPs rendering services under NPS is available on CRA website hltp:/ h S.No tem No. tem Details nstructions. Date of Birth Ptease ensure that the date of birth matches as indicated in he document provided in the support. i. f falher's name has more han 30 digits, you may fill Annexure for he same 1 1 ii. Father's name is mandatory. However, if applicant does nol wanl to provide father's name, hc::/sh e has an option to provide Falher's Name mother's name on Annexure and the mother's name will be printed on PRAN card i. f the arplicant "ants molher's neme to be printed in stead of F_alher' s l1 ame on PRAN Card. he/she mus l fill Annexure 2 2,3 & 4 S. No Proof of dentity (Copy of anyone) S.No Proof 01 Add ress (Copy of anyone) 1 Passport issued by Government 01 ndia. 1 Passport issued by Government of ndta 2 R~ lio n Gm d with pholograph 2 Ra lion card wi th photograph and rosldenhal address Bank Pass book or certlfteat with pholograph and 3 BHnk Pass book or certificate wll" Photograph. 3 residenlial address ~. CorHncate of loe POP bank for an existing Bank cu s tom~'4 ~ Certlflca le of the POP bank lor on existing Bank CUbtomar. 5 Volers denlily card with photograph and residential address. 6 Valid Driving license with photograph 6 5 Voters tdentity card with photograph and residential address Valid Driving license with photograph and residential address i r ~ 7 Lelier from any reco{jnlzed puollc a,,'horily at the level C ortifica te 0 1 identity with photog rfl ph signed by a Member 01 G;u etled officer like 7 Dlstnci Maglstrole, DiviSona l of Parlio m or Memher of Legislativ e t\ss cmb l~ 1 com n'lis!"o lonch, BOO. T c h~ l i d i'1 Mandai Reyenue OlflCer, Judicial Magistrate etc, Certificale of address with photograph signed by a Member denlity, 8 PAN Card issued by ncome tax department 8 of Parliament or Member of Legis lative Assembly Correspondence & Aadhar Card / leller i~ $ ued by Unique dentification Aadhar Card / lener ssued by Unique denlification Permanent address 9 9 Authority of ndia Authority of ndia clearly showing the add ress dc <'lils Job cards issued by NREGA duly s'gned by an of ~cer of Job cards issued by NREGA duly sig ned by an officer of ~ Slate Govnmment the Stale Governmelll nlity card ls. uea by CenTnlllSta le 90voll1ln r,t and lis TM,' dunl1ty card/document w'th aoares5. ued by Departments, statuary! Regulatory Authorities, Public any of t'l& fallowing: C An tra lls lale G. vernmenl ilnd ts Sector Undertakings, Scheduled commercial Banks, Public Departments, Sk, tuaryfregulatory AuthorTt ies, Public 11 Financial nstitutions, Colleges affiliated to universities Sector Undertakings, Scheduled Commercial Banks, and Professional Bodies such as CA, CWA, CS, Bar Pubtic Financial nstitutions for their employees. Council etc. Photo dentity Card issued by Defence, Paramilitary and Police departments. ExService Man Card issued by Ministry of Defence to their employees Latest Electricity/water bill in the name of the Subscriber showing the address (tess than 3 months old) Latest Tetephone bill in the name of the Subscriber showing the address (tess than 3 months old) Latest Property/house Tax receipt (not more than one 14 year old) 14 Photo Credit card. Existing valid registered lease agreement of he house on 15 stamp paper ( in case of rentedlleased accommodation) Note: () f the address on the document submitted for identity proof by the prospective cuslomer is same as that declared by him/her in the account opening form, the document may be accepted as a valid proof of both identity and address. (i) f the address indicated on the document submiued for identity proof differs from the current address mentioned in the account opening form, a separate proof of address should be obtained. All future communications will be sent to correspondence address. f correspondence & Permanent address are different, then proof for both have to be submilted. (iii) n Case of Govemment subscribers, the. KYC documents may be submitted within a period of 30 days after generation of PRAN. Other Details Al NR subscriber would need to furnish an ndian address for communication and bank delaits within ndia. Fund transfers by NRls (Occupalion Details) would be subject to regutatory requirements as prescribed by RB from lime to time and FEMA requirements. 3 6 Politically Exposed Persons' (PEPs) are individuals who are or have been entrusted with prominent public functions in a foreign Potitically Exposed country, for example heads of state or of the government. senior politicians, senior government. judiciat or military officials, senior Person executives of stateowned corporations, important political party officials Subscriber's Bank Details Fa, Tier, bank details are optional. For activation of Tier, bank details are mandatory. Please attach a Cancelled cheque (containing Subscriber Name, Bank Account Number and FS Code) or Bank Certificate containing Name, Bank Account Number and FS code, for direcl credit or electronic transfer. n case if the cheque is not preprinted with name, additionally. a copy of the bank passbook or bank certificate containing Name, Bank Account Number and tfs code should be submitted. n case of more than one nominee, percantage share value for all the nominees,,,ust be integer. Decimals/Fractional values shall Subscriber's Nomination not be accepted in the nomination(s). Sum of percentage share across all the nominees must be equal to 100. f sum of percentage Details is not equal to 100, entire nomination will be rejected. Declaration by Subscriber Signature / Thumb impression should only be withi" the box provided in the form. Thumb impression, if used, should be attested by the "odal officer with the official seal and stamp. Left Thumb mpression in case of male and Right Thumb mpression in case of femate. General nformation for Subscribers a) The Subscriber can obtain the status of his/ller application from CRA and their designated nodal officer. b) Subscribers are advised to retain the acknowledgement slip signed/ stamped by the designated nodal officer where they submit the application. cj For more information clarifications, contact era: Website: Call : Address: Central Recordkeeping Agency, NSDL egovernance nfrastructure Limited, 1st Floor. Times Tower, Kamala Mills Compound, Senapati Bapat Marg, Lower Paret (W), Mumbai