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National Pension System (NPS) - Subscriber Registration Form

This document contains a National Pension System (NPS) subscriber registration form (CSRF form) for Zillha Parishad Pune. The form collects personal details of the subscriber like name, date of birth, gender, identification details like PAN and Aadhaar. It also collects bank details, address and contact details. Further, it collects details of up to 3 nominees nominated by the subscriber including their name, relationship and date of birth. The subscriber needs to fill all the fields in the form and submit it online on Shalarth to register for NPS.

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PratikJagtap
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546 views3 pages

National Pension System (NPS) - Subscriber Registration Form

This document contains a National Pension System (NPS) subscriber registration form (CSRF form) for Zillha Parishad Pune. The form collects personal details of the subscriber like name, date of birth, gender, identification details like PAN and Aadhaar. It also collects bank details, address and contact details. Further, it collects details of up to 3 nominees nominated by the subscriber including their name, relationship and date of birth. The subscriber needs to fill all the fields in the form and submit it online on Shalarth to register for NPS.

Uploaded by

PratikJagtap
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

ZILLHA PARISHAD PUNE (CSRF FORM)

NATIONAL PENSION SYSTEM (NPS) – SUBSCRIBER REGISTRATION FORM


(CSRF FORM)
IMP NOTE - 1. PLEASE FILL THE FORM IN ENGLISH AND BLOCK LETTERS.
2. ALL FIELDS ARE MANDATORY.
[Link] FORM IS USED ONLY TO FILL ONLINE CSRF FORM IN SHALARTH.
TO,
Resp. DDO,
OFFICE NAME : - --------------------------------------------------------
& ADDRESS - ---------------------------------------------------------
---------------------------------------------------------
Signature -

 PERSONAL DETAILS
Salutation ( ी/ ीमती/कुमारी) - ----------------------------------------------------------------------
PPAN NO (शालाथ आयडी) - -----------------------------------------------------------------------
Mother's First Name - -----------------------------------------------------------------------
Full Name - -----------------------------------------------------------------------
First Name - -----------------------------------------------------------------------
Middle Name - -----------------------------------------------------------------------
Last Name - -----------------------------------------------------------------------
Date of Birth - -----------------------------------------------------------------------
Birth Place (पू ण प ा) - -----------------------------------------------------------------------
Gender - Male Female Transgender
Father Name (पूण नाव) - -----------------------------------------------------------------------
SPOUSE Name (पती/प ीचे पू ण नाव) - -----------------------------------------------------------------------
Martial Status - YES NO other

 IDENTITY DETAILS
PAN - -----------------------------------------------------------------------
Aadhaar - -----------------------------------------------------------------------
Subscriber's Date of Joining - -----------------------------------------------------------------------
Subscriber's Date of Retirement - -----------------------------------------------------------------------
Subscriber's Employment Class - -----------------------------------------------------------------------
Basic Salary - -----------------------------------------------------------------------
Payscale - -----------------------------------------------------------------------

 SUBSCRIBERS NOMINEE DETAILS


Name of the Nominee (You can nominate up to a maximum of 3 nominees and if you desire so please
fill in Annexure III (Additional Nomination Form) provided separately) Nominee 1 Detail

Nominee Name - -----------------------------------------------------------------------


Page 1
ZILLHA PARISHAD PUNE (CSRF FORM)

Relationship with the Nominee - -----------------------------------------------------------------------


Date of Birth - -----------------------------------------------------------------------
Nominee Percentage Share - -----------------------------------------------------------------------
Nominee's Guardian Details (in case of a minor) - ----------------------------------------------------------
Nominee Address - --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
Major/Minor - Major / Minor

Nominee 2 Detail
Nominee Name - -----------------------------------------------------------------------
Relationship with the Nominee - -----------------------------------------------------------------------
Date of Birth - -----------------------------------------------------------------------
Nominee Percentage Share - -----------------------------------------------------------------------
Nominee's Guardian Details (in case of a minor) - ----------------------------------------------------------
Nominee Address - --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
Major/Minor - Major / Minor

Nominee 3 Detail
Nominee Name - -----------------------------------------------------------------------
Relationship with the Nominee - -----------------------------------------------------------------------
Date of Birth - -----------------------------------------------------------------------
Nominee Percentage Share - -----------------------------------------------------------------------
Nominee's Guardian Details (in case of a minor) - ----------------------------------------------------------
Nominee Address - --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
Major/Minor - Major / Minor

 SUBSCRIBER BANK DETAILS


Bank A/c Number - --------------------------------------------------------------------------------
Bank Name - --------------------------------------------------------------------------------
Branch Name - --------------------------------------------------------------------------------
Branch Address - --------------------------------------------------------------------------------
PIN Code - --------------------------------------------------------------------------------
Bank State - --------------------------------------------------------------------------------
IFSC Code - --------------------------------------------------------------------------------

 PERMANENT ADDRESS DETAILS


Flat/Room/Door/Block no - --------------------------------------------------------------------------------
Landmark - --------------------------------------------------------------------------------
Page 2
ZILLHA PARISHAD PUNE (CSRF FORM)

Premises/Building/Village - --------------------------------------------------------------------------------
Road/Street/Lane - --------------------------------------------------------------------------------
Area/Locality/Taluka - --------------------------------------------------------------------------------
City/Town/District - --------------------------------------------------------------------------------
PIN Code - --------------------------------------------------------------------------------
State/U.T - --------------------------------------------------------------------------------
Address type - Residential / Business / Registered Office / Unspecified

 CORRESPONDENCE ADDRESS DETAILS


Flat/Room/Door/Block no - --------------------------------------------------------------------------------
Landmark - --------------------------------------------------------------------------------
Premises/Building/Village - --------------------------------------------------------------------------------
Road/Street/Lane - --------------------------------------------------------------------------------
Area/Locality/Taluka - --------------------------------------------------------------------------------
City/Town/District - --------------------------------------------------------------------------------
PIN Code - --------------------------------------------------------------------------------
State/U.T - --------------------------------------------------------------------------------
Address type - Residential / Business / Registered Office / Unspecified

 CONTACT / OTHER DETAILS


Landline Phone (with STD Code) - --------------------------------------------------------------------------------
Mobile - --------------------------------------------------------------------------------
Email ID - --------------------------------------------------------------------------------
Do you want to subscribe to SMS Alerts - Yes / No
Do you want to subscribe to EMAIL Alerts - Yes / No

 OTHER DETAILS
Display Name Flag - --------------------------------------------------------------------------------
(Name to be printed on PRAN Card)
Father Name Mother Name - --------------------------------------------------------------------------------
Date of Birth Proof - AADHAAR Card / PAN Card / Passport / Driving License / Voter ID
Educational Qualification - Below SSC / SSC / HSC / Graduate / Masters / Professionals (CA, CS, CMA etc.)

Income Range - Upto 1 Lac /1 Lac to 5 Lac / 5 Lac to 10 Lac / 10 Lac to 25 Lac / 25 Lac and Above

I hereby declare that, to the best of my knowledge and belief, the particulars. Given above and
the declaration made therein are true.

Signature - -----------------------------------
Name - --------------------------------------------------------------------

Head Master KendraPramukh BEO


Sign with Stamp Sign with Stamp Sign with Stamp
Page 3

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