National Pension System
CSRF 1
NATIONAL PENSION SYSTEM (NPS)
SUBSCRIBER REGISTRATION FORM
PleaseSelectyourCategory[Pleasetick(√)]
To, Government Sector Corporate Sector
National Pension System Trust. All Citizen Model NPS Lite/Swavalamban
Dear Sir/Madam,
I hereby request that an NPS account be opened in my name as per the particulars given below:
* indicates mandatory fields. Please fill the form in English and BLOCK letters with black ink pen. (Refer general guidelines at instructions page)
1. PERSONAL DETAILS:
Name of Applicant in full Shri Smt. Kumari
First Name*
Middle Name
Last Name
Date of Birth* d d / m m / y y y y
(Date of Birth should be supported by relevant documentary proof)
Gender [ Please tick (√) ]
Male
Female Others
Father's Name* F i r s t M i d d l e L a s t
(Refer Sr. No. 1 of instructions)
2. IDENTITY DETAILS* (Any one of the documents need to be provided)
PAN Aadhaar Voter ID
Passport
Others Name of the ID I D N u m b e r
Please refer Sr. No. 2 of the instructions.
3. CORRESPONDENCE ADDRESS DETAILS*
Flat/Room/Door/Block no. Landmark
Premises/Building/Village
Road/Street/Lane
Area/Locality/Taluk
City/Town/District PIN Code
State/U.T. C o u n t r y
4. PERMANENT ADDRESS DETAILS Tick (√) in the box in case the address is same as above.
Flat/Room/Door/Block no. Landmark
Premises/Building/Village
Road/Street/Lane
Area/Locality/Taluk
City/Town/District PIN Code
State/U.T. C o u n t r y
Proof of Address (Correspondence/Permanent)
Aadhar card Passport Voter ID card Driving License Ration Card Registered Lease Sale agreement of residence
Latest Gas Bill
#
Electricity Bill
#
Telephone[Landline] Bill
#
Others (please specify)
#
Not more than 3 months old. Please refer Sr. No. 2 of the instructions
5. CONTACT DETAILS
Landline Phone (with STD Code) Mobile + 9 1
Email ID
Do you want to subscribe to SMS Alerts : Yes No
Mobile number is essential for receiving sms alerts regarding your NPS account
6. OTHER DETAILS ( Please refer to Sr no. 3 of the instructions )
Occupation Details [ please tick(√) ]
Private Sector Government Sector Public Sector Business Professional Agriculture
Homemaker Student NRI Other (please specify)
Please Tick If Applicable Politically exposed person Related to Politically exposed Person
Income Range (per annum) Upto 1 lac
1 lac to 5 lac
5 lac to 10 lac 10 lac to 25 lac 25 lac and above
Educational Qualifications
Below SSC
SSC HSC Graduate Masters
Professionals ( CA, CS, CMA, etc.)
7. SUBSCRIBER BANK DETAILS ( Please refer to Sr no. 4 of the instructions )
Account Type [ please tick(√) ] Saving A/c Current A/c
Bank A/c Number
Bank Name
Branch Name
Branch Address PIN Code
State/U.T. C o u n t r y
Bank MICR Code IFSC Code
Afx
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