Indian Institute of Science Education and Research Bhopal
Joining Report
Dated: _________
The Director
Indian Institute of Science Education and Research, Bhopal
Indore By-Pass Road,
Bhauri,
Bhopal - 462 066
Dear Sir,
With
reference
to
your
appointment
letter
No.
………………….…….dated…,………I report myself on duty in the forenoon /
afternoonof ……………………………………
I thank you once again for providing me the opportunity to serve the
Institute. I will perform my duties sincerely, honestly and to the best of my
abilities.
Yours sincerely,
(Signature)
Name: ……………………………………
Designation …………………………….
Department …………………………….
Date of birth ……………………………
Indian Institute of Science Education and Research Bhopal
MEDICAL EXAMINATION REPORT
(To be issued by a Govt. Civil Surgeon/
Medical Superintendent of Govt. Hospital)
PERSONAL HISTORY
1. Name...........................................................................
2. Designation……………………………………………………….
Photo to be attested
by Medical Officer
3. PF No..........................................................................
4. Parent / Guardian's Name...........................................
5. Date of Birth................................................................
6. Gender……………………………………………………………..
7. Identification Mark on the Body, If any....................................
(This can be a mole, scar or birthmark)
8. Major illness / operation, if any..............................................
(Specify nature of illness / operation)
MEDICAL CERTIFICATE
(The following are to be filled by the Medical Officer Conducting the medical
examination)
1. Height...................cm.
2. Weight.........................kg
3. Past History
4. Chest
a) Mental Disease......................
c) Inspiration...................cm
b) Epileptic Fits.........................
d) Expiration....................cm
5. Blood Group..........................
6. Hearing............................
7. Vision with or without glasses
a) Right Eye................................
b) Left Eye............................
c) Colour Blindness....................
8. Respiratory system.................
9. Nervous system................
10. Heart ……………………………..
11. Abdomen …………………...
a) Sounds...................................
c) Liver..................................
b) Murmur…………………………….
d) Spleen...............................
12. a) Hernia..............................
b) Hydrocele..........................
13. Any other defects.............................................................................
Contd….2….
(2)
Certified that Mr./Ms.________________________S/D of Shri
________________
a. Fulfills the prescribed standard or physical fitness and is FIT for
job/duties at IISER Bhopal.
b. Does not fulfill the prescribed standard of physical fitness and is
unfit/temporarily unfit for joining services/duties at IISER Bhopal.
Signature of the Medical Officer
Candidate
(Minimum qualification MBBS/MD)
Full Name.....................................................
Medical Registration No................................
Address........................................................
….................................................................
Office Seal
Date.......................................
Signature of the
Indian Institute of Science Education and Research Bhopal
CHARACTER CERTIFICATE
Certified
that
Son/daughter
I
have
of
known
Mr./Ms./………………………………………
Shri…..…………………………………………….for
the
last………….years ……………….months. He/She bears a good moral
character and is of ………………….nationality. He/She is not related to me.
Place:
Date :
Signature
___________________________
Name (in Capital Letters)
Designation & Address with Stamp
This certificate should be from any one of the following:
1. Gazetted Officer of Central or State Government;
2. Members of Parliament or State Legislature belonging to the
constituency where the candidate or his parent/ guardian is ordinarily
resident;
3. Sub-Divisional Magistrates/ Officers;
4. Tehsildars or Naib/ Deputy Tehsildars authorized to exercise
magisterial powers;
5. Principal/Head Master of the recognized School/ College/ Institution
where the candidate studied last;
6. Block Development Officer;
7. Post Masters;
8. Panchayat Inspectors
Indian Institute of Science Education and Research Bhopal
Allegiance to the Constitution
I ……………………………………………., do swear in the name of God/solemnly
affirm that I will bear true faith and allegiance to the Constitution of India as
by law established, that I will uphold the sovereignty and integrity of India,
that I will duly and faithfully and to the best of my ability, knowledge and
judgment perform the duties of my office without fear or favour, affection or
ill-will and that I will uphold the Constitution and the laws.
Signature
Name____________________________
P.F.No. __________________________
Designation______________________
Department______________________
Indian Institute of Science Education and Research Bhopal
Oath of Secrecy
Date: __________
I,........................................................................have
……………………..……………..at
been
appointed
as
IISER Bhopal, do swear in the name of
God/solemnly affirm that I will bear true faith and allegiance to the Official
Secrets Act/Statutes and Central Civil Services (CCS) Conduct rules, and
that I will discharge and perform the duties of my office to the best of my
ability, knowledge and judgment, without fear or favour, affection or ill will,
and that I will not directly or indirectly communicate or reveal to any person
any matter which shall be brought under my consideration.
Signature
Name____________________________
P.F.No. __________________________
Designation______________________
Department______________________
Indian Institute of Science Education and Research Bhopal
Dated:
___________
Subject: Declaration regarding bigamous marriage
I hereby declare that I have not entered into or contracted a marriage
with a person having a spouse living, or who, having a spouse living,
have not entered into or contracted a marriage with me.
Signature _______________________
Name____________________________
P.F.No. __________________________
Designation______________________
Department______________________
Indian Institute of Science Education and Research Bhopal
FORM
HOME TOWN DECLARATION
[ OM No. 43/15/57-Estts. (A) dated 24-6-1958]
I, ___________________________hereby declare that my home town is at the
place as shown below for the purpose of availing Leave Travel Concession for
self and family as notified in the Govt. of India, Ministry of Home Affairs,
New Delhi O.M. No.43/1/55/Estts - (A) Part-II dated 11-1-1956.
Home Town/Place of
visit
Nearest Rly
Station
District/Town &
State
Remarks
_______________________
Signature
Name____________________________
P.F.No. __________________________
Designation______________________
Department______________________
Countersigned by
____________________
Head of Office
Indian Institute of Science Education and Research Bhopal
Date:
Declaration on Dependent Family Members
(1) Personal Details:
1
Name
2
Designation
3
Date of Birth
4
PF No.
5
Date of appointment
(2)
Details of the Dependent Family Members:
S.
No.
Name (s) of the
member(s) of the
family*
Date of
Birth
Age
as on
date
Relationship
Marital
Status
Please mention
the category :
(a) Employed
(b) Pensioner
(c) Family
Pensioner
(d) Others
Personal
Annual
Income of
the
dependent
1
2
3
4
5
(*)
(i) I hereby undertake to keep the above particulars up-to-date by notifying to the Head of Office any
addition or alteration.
(ii) Family for this purpose means family as defined in Clause (b) of sub-rule (14) of Rule 54 of the CCS
(Pension) Rules, 1972.[http://persmin.gov.in/pension/rules/pencomp7.htm#Family_Pension,_1964]
(iii) Wife and husband shall include respectively judicially separated wife and husband.
(iv) A self-certified proof of Date of Birth is enclosed in respect of dependent Brothers/Sisters, if any.
Signature of the employee
(3)
For the use of controlling unit/office of the HOD
Forwarded
Section/Unit I/C
(4)
HOD
Administrative Approvals:
Checked
Verified & submitted for approval
Dealing Assistant
Recommended
Assistant Registrar (Admin.)
Approved as per rules
DOFA/Registrar/Director
Indian Institute of Science Education and Research Bhopal
The Director
IISER Bhopal
DECLARATION
I, ……………………………………………………………………. son/daughter
of Shri……………..……………………………………… resident of village/ town/
city
………………………district
…………..………………………
hereby
…………………….………………..
…………….…….……
declare
Community,
that
which
I
is
belong
State
to
recognized
the
as
a
backward class by the Government of India for the purpose of reservation in
services as per orders contained in Department of Personnel and Training
Office Memorandum No. 36012/22/93-Estt.(SCT), dated 08.09.1993. It is
also declared that I do not belong to persons/ sections (Creamy Layer)
mentioned in Column 3 of the Schedule to the above-referred Office
Memorandum, dated 08.09.1993.
____________________________
Date: ___________________________
address
…………………………………..
…………………………………..
…………………………………..
(Note: To be filled only by OBC category)
Signature of the candidate
Name & permanent
Indian Institute of Science Education and Research Bhopal
Date: _________________
DECLARATION
I,
…………………………………………………………………………….
son/daughter
village/town/city
of
Shri……………..………………………resident
……………………district
…………….…….……
of
State
…………..……………………… hereby declare that my spouse is employed/not
employed in Government Service, and she/he is not availing the following
facilities for herself/himself or for any of the family members from the
parent department/Institute working for. I read the enclosed provisions
made in the Government Orders (printed overleaf) in this regard and
undertake to inform the Institute as and when there is any change in the
status of employment of my spouse in respect of the following conditions.
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
Medical Attendance/Treatment
House Building Advance
Children’s Educational Assistance
Family Planning Special Increment
Leave Travel Concession
Traveling Allowance
Family Pension
House Rent Allowance, if residing in Govt. Quarters
Central Government Health Scheme
Allotment of Residence
The relevant rules as summarized in the enclosure (appended overleaf) are
read and certified that the same will be complied from time to time. I/we
understand that any violation will attract legal proceedings and penal
provision as per Govt. rules.
Signature of Spouse,
if employed
elsewhere
in Govt.
establishments.
Name
P.F.No.
Designation
Department
Address
Signature
of
Employee
Name
P.F.No.
Designation
Department
Address
EMPLOYEE DATA SHEET
Affix
stamp size
photograph
P.F. No. _____________
IISER Bhopal
Name in Full (First Surname)
Married
Single
Male
Female
Mother’s Name (First Surname)
Father’s Name (First Surname)
Present Address (for Communication)
PIN
Permanent Address
PIN
Fax
E-mail
Telephone
Mobile
Office:
Day
Month
Residence:
Year
6. Date of Birth
7. (b) Category:
7(a). Nationality:
SC
ST
OBC
Gen
8. Academic Record starting with Secondary Education:
Examination
Branch/
Specialization
College/University/Institute
Year
% of
Marks/
Grade
Division
9. Professional Experience Record:
Name of Institution / University
Position Held
Date of Joining
Date of Leaving
10. Please provide your family details (dependents only)
S. No.
Name
Date of
Relationship
Birth
Present
occupation
DECLARATION
I,
_____________________________________________
hereby,
declare
that
all
entries in this form are true to the best of my knowledge and belief.
Date:
(Signature of the employee)
Place:
FORM-III
LETTER OF ADMISSION AND AUTHORITY
Date: __________
To,
__________________
__________________
__________________
Dear Sir,
Re: Group Savings-Linked Insurance Scheme
I wish to join Group Saving-Linked Insurance Scheme arranged with the Life Insurance
Corporation of India and request you to admit me as an Insured Member of the Scheme with
effect form _____________ . I hereby authorize you to deduct a sum of Rs.__________ as
contribution towards the scheme from my salary starting from the salary for the month of
___.
I further agree that this letter of authority shall not be revoked by me so long as I am a
regular employee. My date of birth, as recorded in ________________ Certificate sent
herewith, is ___________.
.
Yours Faithfully,
_____________
(SIGNATURE)
Name:_____________________________
(In Block Letters)
Badge No. or Salary Roll no. or Membership No._____________________
Designation :_________________________________________________
Department & Office:___________________________________________
FORM – IV
FORM OF APPOINTMENT OF BENEFICIARY
I, ____________________________________________________________________
An Insured Member of the ________________________________________________
___________________Group Saving-Linked Insurance Scheme hereby appoint in terms of
Rule No.13 headed ‘Appointment of Beneficiary’ of the Rules governing the Scheme my
(relationship)______________ named _______________________________ and whose
address is __________________________________________
________________________________________________________
________________________________________________________
as the person to be the beneficiary to whom the moneys payable in terms of the Rules of the
Scheme shall be paid in the event of my death.
Signed at _______________ this __________________day
Of _____________________199_____________.
Signature of Insured Member
Witnessed by :
1) i) Signature _____________
ii) Name ________________
iii) Address _________________________________________________________
_________________________________________________________
2) i) Signature______________
ii) Name ________________
iii) Address _________________________________________________________
_________________________________________________________
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ATTESTATION FORM
WARNING
1. The furnishing of false information or suppression of
any factual information in the Attestation Form would
be a disqualification and is likely to render the candidate
unfit for employment under the Government/Institute.
2. If detained, convicted, debarred etc subsequent to the
completion and submission of the form, the details
should be communicated immediately to the Director,
IISER Bhopal, failing which it will be deemed to be a
suppression of factual information.
Affix a Passport Size
coloured Photograph
(5x7 cms)
3. If the fact that false information has been furnished,
or that there has been suppression of any factual
information in the attestation comes to notice at any time
during the service of a person, his/ her services
would be liable to be terminated.
1. Name in full (in block capitals)
with aliases, if any. (Please indicate
if you have added or dropped at any
stage any part of your name or
surname).
2. Present address in full (i.e.
Village, Thana and District, or
House Number, Lane/ Street/ Road
and Town)
3(a). Home address in full (i.e.
Village, Thana and District, or
House Number, Lane/ Street/ Road
and Town)
3(b). If originally a resident of
Pakistan, the address in that
Country and the date of migration
to Indian Union
SURNAME
NAME
4. Particulars of places (with periods of residences) where you have resided for more
than one year at a time during the preceding five years. In case of stay abroad
(including Pakistan) particulars of all places where you have resided for more
than one year after attaining the age of 18 years should be given.
Residential address in full
Name of the District
(i.e. Village Thana and District, or
Head-quarters of the
From
To
House Number, Lane/Street/Road and Place mentioned in the
Town)
preceding column.
NAME
1
(i) Father (name
with full aliases,
if any)
Nationality
(By birth
& or by
domicile)
Place of
birth
2
3
Occupation
(if
employed,
give
designation
& official
address)
4
Present
postal
address
(if not
alive, give
last
address)
5
Permanent
Home Address
6
(ii) Mother
(iii) Wife/Husband
(iv) Brother(s)
(v) Sisters(s)
(vi) Children
5. Information to be furnished with regard to son(s) and daughter(s) in case
they are studying / living in a foreign country.
Name
Nationality (By
birth and/ or
by domicile)
Place of
Birth
1
2
3
Country in
which
Studying/livin
g with full
address
4
Date from which
studying/ living in the
country mentioned in
previous column.
5
6. Nationality: ______________________
7(a) Date of Birth
7(b) Present age
7(c) Age at Matriculation/ High
School/ Higher Secondary/SSLC
8(a) Place of birth, District and State
in which situated
8(b) District and State to which you
belong
8(c) District and State to which your
father originally belonged:
9 (a) Your religion
9(b) Are you a member of a
Scheduled Caste/ Scheduled
Tribe/ OBC? Answer 'Yes' or 'No'
and if the answer is 'Yes' state
the name thereof
10. Educational Qualification showing place of Education with years in Schools
& Colleges (Matriculation onward)
Name of School/ College with full
address
Date of
entering
Date of
leaving
Examination Passed
11. (A) Are you holding or have at any time held an appointment under the Central
or State Government or Semi -Government or a quasi- Government body, or an
autonomous body, or a public undertaking, or a private firm or institution? If
so, give full particulars with date of employment up to date.
Period
Designation,
Full Name & address
Reasons for leaving
emoluments &
previous service
of employers
From
To
nature of
employment
11 (B) Please state,
(i)
(ii)
If the previous employment was under the Govt. of India, a
State Govt./ an undertaking owned or controlled by the
Govt. of India or a State Govt./ an autonomous body/
University/ Local body?
If you had left the service on giving one month's notice
under rule 5 of the Central Civil Services (Temporary
Service) Rule 1965, or any similar corresponding rules?
(iii)
If any disciplinary proceeding was framed against you?
(iv)
If you were called upon to explain your conduct in any
matter at the time you were given the notice of termination
of service or at a subsequent date, before your services were
actually terminated?
12 (i) (a)
Have you ever been arrested?
Yes/No
(b)
Have you ever been prosecuted?
Yes/No
(c)
Have you ever been kept under detention?
Yes/No
(d)
Have you ever been bound down?
Yes/No
(e)
Have you ever been fined by a court of law?
Yes/No
(f)
Have you ever been convicted by a court of law for
any offence?
(g)
Yes/No
Have you ever been debarred from any examination or
Rusticated by any University or any other educational
authority/ institution?
(h)
Yes/No
Have you ever been debarred/ disqualified by any Public
Service Commission from appearing at its
examination/selection?
(i)
Is any case pending against you in any court of law at the
time of filling up this Attestation Form?
(j)
Yes/No
Yes/No
Is any case pending against you in any University or any
other Educational authority/ institution at the time of filling
up this Attestation Form?
(i)
Note: (i)
(ii)
Yes/No
If the answer to any of the above mentioned questions is 'Yes' give full
particulars of the /fine/conviction/sentence/punishment etc. and/ or
the nature of the case pending in university/educational authority etc.
at the time of filling up this form.
Please also see the 'warning' at the top of this Attestation Form
Specific answer to each of the questions should be given by striking
out 'Yes' or 'No', as the case may be.
13. Name & address of two
responsible persons of your
locality or two referees to whom
you are known.
1.
2.
I certify that the foregoing information is correct and complete to the best of my
knowledge and belief. I am not aware of any circumstances, which might impair
my fitness for employment under Government/ Institute.
Signature of Candidate.............................
Date:
Designation..............................................
Place..............
Department/Section.................................
Indian Institute of Science Education and Research Bhopal
New Pension Scheme
Annexure-I
(Details to be furnished by the Government servant)
Name of the Government servant
(in Block Letters)
Designation
:
Name of Ministry/Deptt./Organization
:
Scale of Pay
:
Date of Birth
:
Date of joining Government service
:
Basic Pay
:
:
Nominee for accumulations the Pension Account :
S
No.
Name of nominee (s)
Age Date of
Birth
(1)
(2)
(3)
Percentage Relationship with
of share of the Government
payable
servant
(4)
(5)
1.
2.
3.
4.
Signature of the Government servant
Registrar/DOFA
Annexure S1
Page 1
Application for Allotment of Permanent Retirement Account Number (PRAN)
(To avoid mistake(s), please follow the accompanying instructions and examples carefully before filling up the form)
Acknowledgement No.
(To be filled by FC)
To affix recent
Coloured photograph
(3.5 cm × 2.5 cm)
Permanent Retirement Account Number :
(To be filled by FC after PRAN generation )
Sir/Madam,
I hereby request that a permanent retirement account number be allotted to me.
I give below necessary particulars :
Section A - Subscribers Personal Details ( * Indicates Mandatory Field)
1. Full Name (Full expanded name: initials are not permitted)
Please Tick as applicable,
Shri
Smt.
First Name *
Kumari
Middle Name
Last Name
2. Gender * Please Tick as applicable,
Male
Female
3. Date of Birth *
4. PAN
D
D
M M
Y
Y
Y
Y
(Date of Birth to be Certified by DDO)
5. Father‟s Full Name:
First Name *
Middle Name
Last Name
6. Present Address:
Flat/Unit No, Block no. *
Name of Premise/Building/Village
Area/Locality/Taluka
District/Town/City *
State / Union Territory *
Country *
Pin Code *
7. Permanent Address: If same as above, Please Tick
Flat/Unit No, Block no. *
else,
Name of Premise/Building/Village
Area/Locality/Taluka
District/Town/City *
State / Union Territory *
Country *
Pin Code *
8. Phone No.
STD Code
9. Mobile No.
Phone No.
Signature/Left Thumb Impression
of Subscriber in black ink
Annexure S1
Page 2
10. Email ID
11. Subscribers Bank Details: Please refer instruction no. f (4)
Bank A/c Number
Savings A/c
Current A/c
Bank Name
Bank Branch
Bank Address
Pin Code
Bank MICR Code
(Wherever applicable)
12. Value Added Services:
i) SMS Alert
Yes
No
ii) Email Alert:
Yes
No
I _____________________________________________________________ , the applicant, do hereby declare that
what is stated above is true to the best of my information & belief.
Date :
D D
M
M
Y
Y
Y
Signature/Left Thumb
Impression of Subscriber
Y
Section B - Subscribers Employment Details to be filled and attested by DDO (All Details are Mandatory)
1. Date of Joining
2. Date of Retirement
D
D
M
M
Y
Y
Y
Y
D
3. PPAN
D
M
M
Y
Y
Y
Y
(Please refer to instructions No.5.)
4. Group of the Employee (Please Tick)
Group A
Group B
Group C
Group D
5. Office
6. Department
7. Ministry
8. DDO Registration Number
9. DTO Registration Number
(Please refer to instructions No.6.)
10. Basic Salary
11. Pay Scale
Certified that the above declaration has been signed / thumb impressed before me by _______________________________________________________
after he / she has read the entries / entries have been read over to him / her by me and got confirmed by him / her. Also certified that the date of birth and employment
details is as per employee records available with the Department.
Signature of the Authorised Person
Designation of the Authorised Person : _________________________________
Rubber Stamp of the DDO
Name of the DDO ______________________
Date :
D
D
M
M
Y
Y
Y
Y
Department / Ministry _______________________
Annexure S1
Page 3
Section C - Subscriber’s Nomination Details (* Indicates Mandatory Field for nominee)
1. Name of the Nominee *:
1st Nominee
First Name *
First Name *
3rd Nominee
First Name *
Middle Name
Middle Name
Middle Name
Last Name
Last Name
Last Name
2. Date of Birth (In case of a minor)*:
1st Nominee
2nd Nominee
3rd Nominee
3. Relationship with the Nominee*:
1st Nominee
2nd Nominee
3rd Nominee
2nd Nominee
4. Percentage Share *:
1st Nominee
% 2nd Nominee
5. Nominee‟s Guardian Details (in case of a minor)*:
1st Nominee‟s Guardian Details
First Name *
2nd Nominee‟s Guardian Details
First Name *
%
3rd Nominee
3rd Nominee‟s Guardian Details
First Name *
Middle Name
Middle Name
Middle Name
Last Name
Last Name
Last Name
6. Conditions rendering nomination invalid:
1st Nominee
2nd Nominee
%
3rd Nominee
Section D - Subscriber Scheme Details
1st Scheme
Pension Fund Managers Name/Code
2nd Scheme
Pension Fund Managers Name/Code
3rd Scheme
Pension Fund Managers Name/Code
Scheme ID No./Name
Scheme ID No./Name
Scheme ID No./Name
Percentage Share
%
Percentage Share
%
Percentage Share
%
Section E - Declaration
I understand that there would be PFRDA approved Terms and Conditions for Subscribers on the CRA website governing IPin (to access CRA / NPSCAN and view details) & T-pin. I agree to be bound by the said terms and conditions and understand
that CRA may, as approved by PFRDA, amend any of the services completely or partially without any new
Declaration/Undertaking being signed.
I _________________________________________________________________ , the applicant, do hereby declare that
what is stated above is true to the best of my information & belief.
Date :
D
D
M M
Y
Y
Y Y
Signature/Left Thumb
Impression of Subscriber
Annexure S1
Page 4
INSTRUCTIONS FOR FILLING PRAN FORM
a)
b)
c)
d)
e)
f)
g)
This form is to be used by State Governments/ Union Territories/State Autonomous Bodies employees
Form to be filled legibly in BLOCK LETTERS and in BLACK INK only.
Details Marked with (*) are the mandatory fields.
Each box, wherever provided, should contain only one character (alphabet/number/punctuation mark) leaving a blank box after each word.
'Individual' 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 /Left thumb impression should only be within the box provided in the form. The signature should not be on 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 will not be accepted.
Thumb impression, if used, should be attested by a Magistrate or a Notary Public or a Gazetted Officer under official seal and stamp.
Sr.
No.
Item No
1
2
3.
6.
3
8, 9, 10
4
11
Item Details
Guidelines for Filling the Form
Section A - Subscribers Personal Details
Date of Birth
All Dates Should be in “DDMMYYYY” Format
Present Address
All future communications will be sent to present address.
Phone No., Mobile No,
It is advisable to mention either “Telephone number” or “Mobile number” or “Email
& Email ID
id” so that Subscriber can be contacted in future for any discrepancy.
Subscriber‟s Bank
Details
If Subscribers mentions any of the bank details, except MICR Code all the bank
details will be mandatory.
Section B - Subscribers Employment Details
It is mandatory to fill the Subscriber‟s Employment details in the application. The employment details should be filled by the respective DDO of the
Subscriber and should be verified by the Authorised Signatory.
DDO should ratify Overwriting / Striking off of any of the employment details.
Kindly provide the PPAN (Permanent Pension Account Number) or equivalent
5
3.
PPAN
number, if it has been allotted to the subscriber by the respective state government /
Union Territory/Central/State Autonomous Bodies.
6
8&9
7
4.
8
5.
DTO Reg. No. & DDO
Reg. No.
DTO Reg. No. and DDO Reg. No. is the unique Registration number allotted by
Central Recordkeeping Agency.
Section C - Subscriber’s Nomination Details
Subscriber can nominate maximum of three nominees.
Subscriber can not fill the same nominee details more than once.
Percentage share value for all the nominees must be integer. Fractional value will not
Percentage Share
be accepted.
Sum of percentage share across all the nominees must be equal to 100. If sum of
percentage is not equal to 100, entire nomination will be rejected.
Nominee‟s Guardian
If a nominee is a minor, then nominee‟s guardian details will be mandatory.
Details
Section D - Subscriber scheme details
If the Subscriber is unable to mention the Scheme details i.e. PFM Name, Scheme Name & Percentage Allocation he can contact the nearest
Facilitation Centre (FC) for information or the Subscriber can also search for the scheme details on http://www.npscra.nsdl.co.in
Subscriber can select maximum three schemes. Details of the schemes are available on
http://www.npscra.nsdl.co.in
Subscriber can not fill the same scheme details more than once.
9
Scheme
If a scheme name is filled in the form for scheme setup there must be a PFM name and percentage contribution
filled for that scheme.
If the Scheme details are not filled, default scheme as approved by PFRDA will be applicable.
Scheme Contribution Value will be in terms of percentage. It cannot be in terms of amount.
Percentage contribution value for all the schemes must be integer. Fractional value will not be accepted.
10
Percentage Share
If the sum of contributions (in percentage) across all the schemes is not equal to 100, the balance will be allotted
to the default scheme approved by PFRDA.
a)
b)
c)
d)
GENERAL INFORMATION FOR PRAN SUBSCRIBERS
Subscribers can obtain the application form for PRAN in the format prescribed by PFRDA (Pension Fund Regulatory & Development Authority)
from DDO or can freely download from the CRA website (http://www.npscra.nsdl.co.in).
The request for a reprint of PRAN card with the same PRAN details or/and changes or correction in PRAN data can be made by filling up
'Request for change/correction in subscriber master details and/or re-issue of I-Pin/T-Pin/PRAN card’ or/and ‘Request For change in
signature and/or change in photograph’. The form is available from the sources mentioned in (a) above.
The Subscriber can obtain the status of his/her application from the CRA website or through the respective DTO.
For more information
Visit us at http://www.npscra.nsdl.co.in
Call us at 022-24994200
e-mail us at info.cra@nsdl.co.in
Write to: Central Recordkeeping Agency, National Securities Depository Limited, 4th Floor, „A‟ Wing, Trade World, Kamala Mills
Compound, Senapati Bapat Marg, Lower Parel (W), Mumbai - 400 013.