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File No...... ...... Dated:•••••!Melli OMNI NOM

To PFRDA •

N. Delhi.

Thros:- The Finance Department of the State Government concerns

Sub:- Commitment to discharge all obligations under the Nevi Pension Scheme (NPS).

Heft- Dedsion of the State Government as conveyed. yids communication bstadng Heft .......

...... „ ......... to parties/Sate Inthe itgland:Wound by the NPS " Architecture in toto

Sir,

\\‘1fraft

With refere cewould be b to the above, we hereby undertake to ensure that our employees' recruited on or

er . the directions and scheme of

rough things as env

thisaged

Architecture by the PFRDA. under the NPS Architectur

ee, from

time to time.

t over to e NPS , and that wo shall be governd .by all

We are also aware that consequent upon the

decision of the State Government, as cited above,.the State Government have entered into agreements

with NPS Trust and* CRA in -regard to various commitments to be fulfilled and discharged.

We shall be shifting to the NPS Architecture as opetatIonalised by PFRDAMSDI., and that the exercise of shifting over

to the NPS Architecture shall be completed at the earliest. .

We shall comply with and honour all the requirements in regard to the various arrangements made by PFRDA/NPS Trust with all the NPS Intermediaries. We shall also

- comply with and honour all the

.

requirements and obligations as May be applicable to

JS pursuant to the agreements the State Government with NPS Trust and CltA. We agree for the direct billing by enters Into by CRA, as also by

other NPS intermediaries under the NPS Architectunr and to be bound by the entire framework of

NPS Architecture, from time to time.

We understand that the process flow in respect of our organisation would-be identical to those Presently followed for State Government

Ministries/Departments, and that NSDI. (CRA). would• through multiplepoints.

engage in dialogue with us for determining whether

they would like to upload . data centrally:or

Yours faithfully, &V-

Authorised Signatory of the SAB .

CC to:-

Z rt

Z CD 04 p.) crA 0 go

E co CD Ro

Fp' CD

1-3 e r0 g a n s,_,C

‘.< .z. 15., 0 .0 0

1 R. g a

i:,

P. 0. ts DD

0

:12

Employer

Contribution

A 71y, ex Tl

=am= Page 11 CENTRAL RECOREDIKEE'TING AGENCY

me REGISTRATION FORM (To avoid mistake(s), please read the accompanying instructions carefully before filling up the form)

This form is to be used for the purpose of registration of Drawing and Disbursing Office (DDO) and equivalent entities in State Dovernments and Union Territories.

DDO Registration Number : (To be allotted by CRA) I

We are pleased to inform you that our Drawing and Disbursing Office has decided to join the New Pension System. The details required for registration in the CRA system are as provided •eTotti•

1.DDO TAN (Optional): (Refer to instruction nod I)

2. Name of the DDO Office*:

3. DDO Address: Fiat/Unit No, Block no. * 11 111

T 1 Name of Premise/Building/Village

111 111 1 Area/Locality/Talulca

District/Town/City

State / Union Territory * 1 1 1 1 • 1

Country *

r I Pin Code *

Phone No. *

(STD cede)

Alternate Phone No:

4. Official Email ID* (Refer to instruction no.5

5. Authorised contact persons designation *:

(Phone No.)

6. Name of the Department:

7. (a) Name of the Ministry *: (Refer to instruction no.f)

ODD stamp and Signature of Authorised Signatory

1

Annextire Ntl

(b) Existing DDO Code*:

8. DTO Registration Number*: (To be filled by DTO)

9. Name of the State Govt. / Union Territory*:

I/We hereby agree and declare that the infotmation provided in the application, is complete and true

(Refer instruction no. 7)

(Refer instruction no.8)

DM/ Stomp

Date:

Place:

Signature of Authorised Signaitery of DDO

Name of Authorised als :

et be attested b D'_"'0 Date:

?lace:

Name of Authorised Signatory :

DTO Stab rk Signature of Authorised Signatory

DTO tie;. . No. Allotted b CRA (Refer inatrnnt:an «..-. a I I

Received on

Name of° the ofIcer:

Signature of the officer:

.7xustractions for Mhos the form:

2. The form is to be submitted to the address - Central Recordkeeping Agency, National Securities Depository Limited, 4th Floor, 'A' Wing, Trade World, Kamala Mills Compound, Senapati Bapat Marg, Lower Parel (W), Month - 400 013.

2. Form to be filled legibly in BLOCK LETTERS and in BLACK INK only. 3. The form should be filled up completely. Details marked with (*) are mandatory fields. 4. Each box, wherever provided, should contain only one character (alphabet/number/punctuation mark) leaving a blank box after each word. 5. Email ID should be the official Email ID of the Drawing and Disbursing Officer & not of any individual person. 6. Kindly provide Name of the Ministry under which DOC of is f:nctioning. 7. Kindly mention the DDO code allotted by respective State Governments / Union Territories. 8. Kindly mention DTO Registration No. allotted by CRA to the District Treasury Office. 9. Form has to be duly madam-toed by DTO registered at clix. It has been registered, It then retails the forms. :0. The application font in the prescribed format can be freely downloaded from the CRA website (ottp://envvr.apsera.msali.co .ln). 11. TAN is the Tax Deduction and Collection Account Number allotted. by Income Tax Department. New TAN is a ten

character alphanumeric number with the following structire: First four digits (Alphabets), Next Five digits (Numeric) and last digit (Alphabets). :t is advisable that DDO verifies from the Income Tax website whether TAN has been allotted as per the new format.

'.' 2. For more information contact CRA at 022-24994200 or write to CRA at Central Recordkeeping Agency, National Securities Depository Limited, 4th Floor, 'A' Wing, Trade World, Kzmaia Mills Compound, Senapati Bapat Mug, Lower Patel (W), Mumbai - 400 013.

I. Full Name (Full expanded name: initials are not permitted) ?lease Tick as applicable, Si'Ji 71 San. ; First Name •

Middle Name

Kumar;

INI11111•11111•=1111•11111111

Female Male

L. ?AN MEI UMW

D D M 5 ;ether's Full Name

—inn Name*

M Y Y Y Y (Date of Birth to be Certified by DDO)

F Last Name

6.Present Address: rrlat/Unit No, Block no. •

Name of Premise/Building/Village I [ - .1 I I I I 1 1 1 I I I I Arts/Locali /Taluks

District/Town/C

State / Union Territory

11111111111=111111111111111111111111•111111111

111111111111110•1111=111a11111

cise,

T -1 1-Tr-17

?in Code •

7.Permanent Address: If same as above, Please Tick Flat/Unit No, Block no,' 111111111111111111111111111111111111111101111111111111111111111111 Name of Prennseauddin

Area/Locati cialuka

I I I _u_J

Pin Code*

8. ?hone No. [ Phone No.

111 STD Code

9.Mobile No. 1 1 1

agaitat' 791aZaaatflallarraThiaS_Eadia) (To avoid mistake(s), please follow the accompanying insuuctions and examples carefully before filling up the font)

To affix recent Coloured photograph

(3.5 cm x 2.5 cm) Acknowledgement No. I (To be filled by PC) I

i Permanent Retirement Account Number : 1 1 !----r I (To be filled by FC after ?RAN generation ) 1 i

Sir/Madam,

I hereby request that a permanent retirement account number be allotted to me.

I give below necessary particulars :

Sector. A - St:bur:ben Persona Details ( • Indicates Mandatory Field) Signature/Left Thumb Impression &Subscriber in black ink

Last Name 111111•11•11111111=1 1111111111111111S11111111111

Middle Name

I 2. Gender' Please Tick as applicable,

3. Date of Birth •

Districrown/CitY • 1111 11111111111 State / Union Territo •

County • 11 1 111111

1 TITYMT1

_1 1 11111;1[1

1 1 1 1 1 1 I 1 I I I

II Current A/c Savings Ale 11. Subscribers Bar& Details: Please refer instruction no. (4) Bank A/c Number intlininninineal 11111 Bank Name

11111•111111111=1111111111 Bank Branch

Bank Address

1111 11111

MIIIIIMIIIMINIIIM111111111.1111 11111 111111111111 11111111•11111111111111111111111111

Pin Code

Bank MICR Code

:2. Value Added Services: i) SMS Alert

ii)Email Alen:

(Wherever applicable)

Yes Po., No

Yes No

1•111•1111111-11111111•11•11111

3.DDO Registration Number 9. DID Registration Number

10. Basic Salary

I1. Pay Scale

(Please refer to instructions No.6.)

MIN11111111111111111•11111.11

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 wpployment

; details is as per employee records available with the Department.

Ammar. SI

; 0. Erna ?to. a

1111111111

what is stated above is true to the best of my information & belief. , the applicant, do hereby declare that

Date :

1 1 1111111 D D M M Y YYY

Sects= Subscriber; anp:OyuntrA Signature/Left Thumbb .

Impression of Subscriber e zrd tatestse; by ax.,, (All Details am Mandatory) 1. Date of Joining

11 111111 2. Date of Retirement

3. PPAN

4. Group of the Employee (Please Tick)

5, Office

D D MM YY

-111-1 (Ptease refer to Manual= No.5.)

Group A E Group 13 J Group C L i Group D L j

DDMMY Y Y Y

1111111111

6. Department

7.Minis 1

Signature of the Authorised Person Designation of the Authorised Person

Date :111111 Rubber Stamp of the DDO

Name c: the DDO

DDMMY Y YY Department / Ministry

ye Tin 3rd Nominee

4. Percentage Share ": 1st Nominee I 1 I 1.541 2nd Nominee

• 3. Relationship with the Noni"tree•: 1st Nominee

3rd Nominee 11111 MOO 011100 0 0 ■ ROMOOMMOMOMMMOMO

3rd Nominee 2cd Nominee

1

5. Nominee's Guardian Details (in case of a minor)": 1st Nominee's Guardian Details

First Name •

OMMOMM fiddle Name

6. Conditions rendering nomination invalid: 1st Nominee

First Name •

Last Name :: MMENINMEMEM Ma WEEMMEMM

OM •0.11100

2nd Nominee's Guardian Details First Name

3rd Nominee's Guardian Details

Section D &absentees. Scheme Details

ist Scheme

Mecum St

Scotian C - SLI.Paseller's Nom:math= Details (• Indicates Mandatory Field for nominee) 1.Name of the Nominee ":

1st N F • Lim nominee 3rd Nominee irst Name First Name • First Name ' 1

7 Ma a 7 MM MM. .

NM ROOM MOO OM

Middle Neale Middle Name

MEMO MO 000 NI

OM WM Last Name MI

Last Name Last Name

• En OW M OM A

Ti 0 0 a

2. Date of Birth In case of a minor •*: 1st Nominee r 23nee -7- T---7 I;I I 3rd Nominee

.1cmineme 3rd Scheme Pension Fund

Scheme 1 i

Managers MI

EMI Il

Name/Code

II MIN

Pension Fund Managers Name/Code Pension Fund Managers Name/Code

NMI ID No./Name

MI h Sceme

III 1.0 No./Name

NI ■ II

NI Scheme ID NoJName

I ;

Percentage Share 000all i i 1 1 i 14

Percentage Share Percentage Share 1 1 1 ' °/k 1 1 154 J

Section E - Declaration

I understand that there would be PFRDA approved Terms and Conditions for Subscribers on the CRA website governing 1- PM (to access CIRA / NPSCAN and view details) & 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 Declaration/Undertaking being signed.

what is stated above is true to the best of my information & belief.

Date :

DDMMYY YY

ihe eon:leapt, do hereby declare that

Signature/Left Thumb t ,trn of Subscriber

Anrexttre Si

INSTRUCTIONS FOR MILLING ?RAN FORM

a) This form U to be used by. State Governments and Union Territories employees. b) Form to be filled legibly in BLOCK LETrERS and in BLACK INK only. c) Details Marked with (*) art the mandatory fields, d) Each box, wherever provided, should contain only one character (alphabet/number/punctuation mark) leaving a blank box after each word e) '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 fond. (The clarity of image on PRAN card will depend on the quality and clarity of photograph affixed on the form.) I) 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. g) Thumb inspreselom, if used, should be attested by a Magistrate era Notary ?sib& or n Gazetted Officer order official seal and stamp.

Sr. No.

Item No Item Details Guidelines for Mang the Fonts

Seeder A - Subscribers Personal Details 3. Date °Mirth All Dates Should be in "DDMMYYYY" Format

2 6. Present Address All future communications will be sent to present address.

3 R 9, 10 Phone No., Mobile No, & Email ID

It is advisable to mention either "Telephone number" or "Mobile number" or "Email id" so that Subscriber car be contacted in future for any discrepancy.

4 II Subscriber's Bank Details

If Subscribers mentions any of the bank details, except MICR Code all the bank details will be mandatory.

Section B - Sobscribers 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 Authorized Signatory. DIDO should ratify OvenvritIngh/ Striking off of any of the employment details.

Kindly provide the ?PAN (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.

6 8 & 9 DM Rag. No. & DDO DTO Reg..No. and DDO Reg. No. is the unique Registration number allotted by Reg. No. Central Recordkeeping Agency.

Section C - &inscriber's Nomination Details Subscriber can nominate maximum of three nominees. Subscriber can not fill the same nominee details more than once.

7 4. Percentage Share Percentage share value for all the nominees must be integer. Fractional value will not epted.

. accepted.

Sum of percentage share across all the nominees must be equal to 100. If sum of nercentagc is not equal to 100, entire nomination will be rejected.

8 5. Nominee's Guardian

Details if a nominee is a minor, then nominee's guardian dcMils will be mandatory.

Seeder. 0 - Subscriber schente details

If the Subscriber is unable to mention the Scheme details i.e. ?FM Name, Scheme Name & Percentage Allocation he can contact the nearest Facilitation Centre (PC) for information or the Subscriber can also search for the scheme details on httplAvww.npscransdl.co.in

Subscriber can select maximum three schemes. Details of the schemes am available on http://www.npscra.nsdico.in

9 Scheme Subscriber can not Ell the same scheme details more than once. If a scheme name is filled in the form for scheme setup there must be a PPM name and percentage cant-Mutton filled for that scheme. If the Scheme details arc 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.

10 Percentage Share. Percentage contribution value for all the schemes must be integer. Fractional value will not be accepted. If the sum of contributions (in percentage) across all the schemes is not equal to 100, the balance will be allotted 1 to the default scheme apnroved by ?PRDA. l

8&1/124.1., Ii0ORMDATiON FOR ?RAN a) Subscribers can obtain the application form for PRAN in the format prescribed by PFRDA. (Pension Fund Regulatory & Development Authority)

from IMO or can freely download from the CRA webaite (http://www.optern.nsdIce.in ). b) The request fore reprint of ?RAN card with the saint ?RAN details or/end changes or conceder In PRAN data can he made by Ming tap

'Request for change/correction in obseriber master details and/or re-terse of '. .I.Fin/T-IshaPPRAN card' or/end 'Request For Mange in signature and/or change Its photograph'. The form is available from the sources mentioned in (a) above.

c) The Subscriber can obtain the status of his/her application from the CRA website or through the respective DTO. d) For more information

Visit us at hup://www.npscransdl.co.in Cali us at 022-24994200 e-mail us at Info.cra@kistop.fat

Write to: Central Recordkeeping Agency, National Securities Depository Limited, 4th Floor, 'A' Wing, Trade World, Kamala Mills Compound, Sampan Bapat Marg, Lower Pahl (W), Mumbai -400 013.

1

SN". thine Employee

code

Employee snow

Date of

Binh

Date of Appointment

Month LiFie Pay

DA EllinJoyce . Monthly . Conuilmtlon

Employe Contribution

TM91 DDO Rey. No. with NSDL

(1) (21 (31 (41 (5) (6) (7) OM (9) (10) III) (12)

Financial Year

Annexure

24

Format for Data Collection (Yearwise)

25

Annexure 671

*MN Thlw kot ThAf NEFT/RTGS 1)fira th-T4 vewzrr

Precondition to transfer of funds is preparation and upload of verified contribution file into the NPSCAN system and generation of Contribution Submission Form (CSF). For accessing the NPSCAN/CRA system 1-PINs are provided to Nodal Offices at the time of registration.

Upon successful submission verified file (with extension . FVU) the NPSCAN system will generate the Contribution Submission Form (CSF). Drawing Officer may transfer funds to the Trustee Bank (TB) in the following way :

• Transfer funds through NEFT/RTGS-Please instruct the remitting Bank to write PAOFIN and quote the DTO Registration number and Transaction ID in field 7495 (Sender to receiver information, line No 4) of RTGS Message or in Field 7002 (Origination of remittance) of NEFT Message. The remitting bank should not put any space between the details.

For example, for a DTO with Registration number 2000821 and generating CSF for Transaction id 1001084100012, the note will appear as PAOFIN 20008211001084100012. Please also inform accredited/remitting bank that for RTGS transfers, the transfer should be by R-41 RTGS format only.

19Tkpft-240-111*-Tri4T-31--5-10-1,500.