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NATIONAL PENSION SYSTEM (NPS) – SUBSCRIBER REGISTRATION FORM - Government Sector
Protean eGov Technologies Limited (formerly NSDL e-Governance Infrastructure Ltd.)
Print my PRAN in Hindi
Yes No If yes, submit details as per Annexure I
Select your category [Please tick (√ )]
Central Government State Government
Central Autonomous Body State Autonomous Body
To,
National Pension System Trust
Dear Sir/Madam,
I hereby request that an NPS account be opened in my name as per the particulars given below:
* indicates mandatory elds. Please ll the form in English and BLOCK letters (Refer general guidelines at instructions page.)
1. PERSONAL DETAILS: (Refer Sr. No. 1 of the instructions)  Use Annexure II if name exceeds the space provided below
Salutation* Shri   Smt.          Kumari
Applicant Name* F i r s t M i d d l e L a s t
Father’s Name F i r s t M i d d l e L a s t
Mother’s Name F i r s t M i d d l e L a s t
Either Father’s or Mother’s name is mandatory*     Select the name to appear on PRAN Card Father’s name Mother’s Name
Date of Birth* d d m m y y y y
Place of Birth*
Country of Birth*
Gender* Male Female Transgender Nationality*
Marital Status* Unmarried Married Widow/Widower Divorcee
Spouse Name* (if married) F i r s t M i d d l e L a s t
PAN* or Form 60 furnished
Submission of PAN or Form 60 is mandatory
Income Range (per annum) Below 1 lac 1 lac to 5 lac 5 lac to 10 lac 10 lac to 25 lac 25 lac to 1 Cr Above 1 Cr
Please Tick if Applicable Politically exposed person Related to Politically exposed person (Refer instruction no. 1)
2. PROOF OF IDENTITY (Pol)* (If PAN is not provided, any one of the following documents to be submitted)
Passport Passport Expiry Date d d m m y y y y
Driving License Driving License Expiry Date d d m m y y y y
Government ID Card Voter ID Card
National Population Register
Proof of possession of Aadhaar
Provide last Four Digits. Redact or black-out rst 8 digits of the Aadhaar number on submitted copy
3. ADDRESS DETAILS* (To be attested by the Nodal Ofce)
Line 1
Line 2 V i l l a g e / C i t y
District
State/U.T.
Country
 PIN Code
4. CONTACT DETAILS
Mobile* 9 1
Telephone with STD code
Email ID
5. BANK DETAILS* (Proof to be submitted - Refer Sr. No. 3 of the instructions)
Account Type Saving A/c Current A/c 
Bank A/c Number
Bank Name IFS Code
6. NOMINATION DETAILS* (Refer Sr. No. 4 of the instructions)
A. The nomination shall be in favour of one or more persons belonging to his/her family. For nominating more than one person, submit Annexure III
  B. A fresh nomination shall be made by the subscriber on his/her marriage.
  C. Before lling up the details, please refer Nomination relationship matrix provided on the instructions page.
Nominee Name F i r s t M i d d l e L a s t
Relationship Age
  Date of Birth (In case of Minor)
d d / m m / y y y y
Name of Guardian F i r s t M i d d l e L a s t
(if nominee is a minor)
7. SELECTION OF PENSION FUND (PF) AND INVESTMENT CHOICE* (Refer Sr. No. 5 of the instructions)
Please Tick (√ ) one
Default option (3 Pension Funds - SBI/UTI/LIC and default Govt. Scheme)
I would like to choose my Pension Fund and investment choice (Please select below)
Pension Fund* (Please Tick (√) one) Investment Choice (Please Tick (√) one)
Aditya Birla Sunlife Pension Mgmt Ltd   Axis Pension Fund Management Limited
HDFC Pension Mgmt Co Ltd 
ICICI Prudential Pension Funds Mgmt Co Ltd
Kotak Mahindra Pension Fund Ltd  LIC Pension Fund Limited
 Max Life Pension Fund Mgmt Ltd SBI Pension Funds Private Limited
 TATA Pension Mgmt Ltd   UTI Retirement Solutions Limited
Active Choice (i.e. 100% in Govt Securities)
Or
Auto Choice
Conservative (LC25)
Moderate (LC50)
If no option is chosen, the contributions will be invested as per default option
Paste
recent
photograph of
3.5 cm × 2.5 cm size /
Passport size
(Do not sign across /
stapple / clip)
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8. Tier-II Choice (Please tick (√) to activate)   Providing PAN is mandatory
Tier-II Tier II - Tax Saver (only for Central Government employees)
As per the details given in Annexure IV
With same bank, nominee details
Please write name of Pension Fund
With different bank/nominee/investment details as per Annexure IV
9. FATCA* (Foreign Account Tax Compliance Act) & CRS DECLARATION (Refer Sr no. 6 of the instruction):
I am a tax resident of India and not resident of any other country I am a tax resident of the country/ies mentioned below
US Person Yes     No.  
Particulars
Country (1) Country (2) Country (3)
Country/countries of Tax Residency
Address in the jurisdiction for Tax
Residence
Address Line 1
City/Town/Village
State
ZIP/Post Code
Tax Identication Number (TIN)/Functional equivalent Number
TIN/ Functional equivalent Number Issuing Country
Validity of documentary evidence provided (Wherever applicable)
ddmmyyyy ddmmyyyy ddmmyyyy
I have understood the information requirement of the Form (read along with the FATCA / CRS Instructions and Terms & Conditions) and
hereby conrm that the information provided by me/us on this Form is true, correct and complete and hereby accept the same.
10. DECLARATION BY APPLICANT* (Refer Sr no. 7 of the instructions)
I  have  read  and  understood  the  terms  and  conditions  of  the  National  Pension  System.  The  information  and  documents 
furnished by me are true and correct, to the best of my knowledge. Any changes in the information furnished by me shall be 
informed to CRA / NPS Trust. I do not hold any pre-existing account under NPS. I understand that I shall be fully liable for 
submission of any false or incorrect information or documents.
Declaration under the Prevention of Money Laundering Act, 2002
I hereby declare that the contribution paid by me/on my behalf has been derived from legally declared and assessed sources
of  income.  I  understand  that  NPS  Trust has  the  right  to  peruse  my  nancial  prole  or  share  the  information,  with  other 
government authorities.  I  further  agree  that  NPS Trust has  the  right  to  close  my  PRAN  in  case  I  am  found  violating  the 
provisions of any law relating to prevention of money laundering.
Date:
d d m m y y y y Place:
Signature / Thumb Impression* of Applicant
(*LTI in case of males and RTI in case of females to be 
provided. Toe impression in case no hands)
11. DECLARATION BY NODAL OFFICE (All Details are Mandatory)
Date of Joining
d d m m y y y y
Date of Retirement
d d m m y y y y
Employee Code/ID (If applicable)
PPAN (If applicable)
Name of the ofce
Department
Ministry
DDO Registration Number DTO/PAO/CDDO/DTA/PrAO Registration Number
It is certied that  is employed with us and the details provided in this subscriber registration form including the address and employment details
provided above are as per the service record of the employee maintained with us. The given address and the documents are veried by this ofce. Also, it is further certied that 
he/she has read entries/entries have been read over to him/her by us and got conrmed by him/her.
Signature of the Authorised person Rubber stamp  of  the DDO Signature of the Authorised person Rubber stamp  of  the DTO/PAO/CDDO
Name of the Authorised Person Designation of the Authorised Person
Name of the DDO Name of DTO/PAO/CDDO/DTA/PrAO
Deptt / Ministry Date
......................................................................................................................................................................................................
ACKNOWLEDGEMENT
Name of the Subscriber
Date of Receipt of Application: d d m m y y y y
Stamp and Signature of Nodal Ofcer
Signature / Thumb Impression* of
Applicant (refer instructions)
Employee Code/ID and PPAN are optional. If you intend to provide,
mention any one.
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INSTRUCTIONS FOR FILLING THE SUBSCRIBER REGISTRATION FORM
General guidelines
 (a)   Please ll in legible handwriting to avoid errors. Do not overwrite. Corrections should be countersigned by the applicant. Applications incomplete in any 
aspect (or) if mandatory elds are left blank (or) with unclear photograph (or) not accompanied by required documents (or) not authenticated by the 
Nodal Ofce are liable to be rejected.
(b)  Copies of documents submitted by the applicant should be self-attested.
(c)  Applicant is advised to retain the acknowledgement slip signed / stamped by the designated nodal ofcer where they submit the application.
SI
Item
No
Item Details Instructions
1 1
Fathers Name,
Mother’s Name
(a) If the name has more than 30 digits, ll Annexure II for the same.
(b) If the applicant is an Orphan, he/she may leave the elds blank. However, an ofcial document to support the status to be submitted.
Politically Exposed 
Person
Politically Exposed Person’s (PEPs) are individuals who are or have been entrusted with prominent public functions such as heads of state or 
of the government, senior politicians, senior government, judicial or military ofcials, senior executives of state-owned corporations, important 
political party ofcials.
2 2 Proof of Idenity
If the applicant is submitting Aadhaar as proof of Identity, the rst 8 digits of the Aadhaar number should be redacted / masked on the submitted 
copy.
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Bank Details
For Tier I & Tier II account, bank details and documentary proof are mandatory. Please submit a cancelled cheque / copy of bank passbook / 
bank statement / bank certicate / letter from Bank containing applicant’s Name, Bank Name, Bank Account Number and IFS Code.
4 6 Nomination Details
(a) If a subscriber has family at the time of making a nomination, the nomination shall be in favour of one or more persons belonging to his/
her family. Any nomination made in favour of a person not belonging to family shall be invalid; A fresh nomination shall be made by the 
subscriber upon marriage and any nomination made before such marriage shall deemed to be invalid; If at the time of making a nomination 
the subscriber has no family, the nomination may be in favour of any person or persons but if the subscriber subsequently acquires a family,
such nomination shall forthwith be deemed to be invalid and the subscriber shall make a fresh nomination in favour of one or more persons
belonging to his family.
(b) In case of more than one nominee, the percentage share for each nominee should be in whole numbers and must be equal to 100.
(c) Please refer nomination relationship matrix provided below.
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Selection of
Pension Fund
(PF) & Investment 
Choice
Government employee/subscribers can exercise choice of Pension Funds and allocate their investments either in Asset Class ‘G’ under ‘Active 
Choice’ or in Life Cycle Funds - LC 50 / LC 25 under ‘Auto Choice’. The choices exercised by applicants from State Government/Autonomous 
body shall be ignored if the choice is not extended by the respective employer and the contributions shall be invested as per the default choice.
If no choice is provided, the contributions will be distributed among the three default Pension Funds (SBI/UTI/LIC) selected by the Government.
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FATCA & CRS 
Declaration
Clarication / Guidelines on lling details if applicant residence for tax purposes in jurisdiction(s) outside India:
•   Jurisdiction(s) of Tax Residence : Since US taxes the global income of its citizen, every US citizen of whatever nationality, is also a resident 
for tax purpose in USA.
•   Tax identication Number (TIN) : TIN need not be reported if it has not been issued by the jurisdiction. However, if the said jurisdiction has 
issued a high integrity number with an equivalent level of identication (a “Functional equivalent”), the same may be reported. Examples 
of that type of number for individual include, a social security/insurance number, citizen/personal identication/services code/number and 
resident registration number).
•   In case applicant is declaring US person status as ‘No’ but his/her Country of Birth is US, document evidencing Relinquishment of Citizenship 
should be provided or reasons for not having relinquishment certicate is to be provided.
•  In case applicant is declaring US person status as ‘Yes’, provide PAN and 'father name' in addition to details required under section 9 of form.
7 9 & 10
Declaration /
Signature by
Applicant
In case the applicant is unable to afx signature, Left Thumb Impression in case of male and Right Thumb Impression in case of female should 
be afxed and in case there is no hands, toe impression of the applicant to be provided. The thumb / toe impression should be attested by two 
persons, one of whom should be the designated nodal ofcer attesting the same under his/her ofcial seal and stamp.
Nomination Relationship Matrix (Please mention relationship as per details given below)
Marital Status Male Female Transgender
Unmarried
1. Mother
2. Father
3. 
Please specify the relationship
if any other person
1. Mother
2. Father
3.
Please specify the relationship
if any other person
1. Mother
2. Father
3.  
Please specify the relationship
if any other person
Married
1. Spouse
2. Son
3. Daughter
4. Mother
5. Father
6. Daughter in Law
7. Grandson
8. Granddaughter
1. Spouse
2. Son
3. Daughter
4. Mother
5. Father
6. Mother in Law
7. Father in Law
8. Daughter in Law
9. Grandson
10. Granddaughter
1. Spouse
2. Son
3. Daughter
4. Mother
5. Father
6. Mother in Law
7. Father in Law
8. Daughter in Law
9. Grandson
10. Granddaughter
Widow/
Widower
1. Son
2. Daughter
3. Mother
4. Father
5. Daughter in Law
6. Grandson
7. Granddaughter
1. Son
2. Daughter
3. Mother
4. Father
5. Mother in Law
6. Father in Law
7. Daughter in Law
8. Grandson
9. Granddaughter
1. Son
2. Daughter
3. Mother
4. Father
5. Mother in Law
6. Father in Law
7. Daughter in Law
8. Grandson
9. Granddaughter
Divorcee
1. Son
2. Daughter
3. Mother
4. Father
5. Daughter in Law
6. Grandson
7. Granddaughter
1. Son
2. Daughter
3. Mother
4. Father
5. Mother in Law
6. Father in Law
7. Daughter in Law
8. Grandson
9. Granddaughter
1. Son
2. Daughter
3. Mother
4. Father
5. Mother in Law
6. Father in Law
7. Daughter in Law
8. Grandson
9. Granddaughter
General Information for Subscribers
a)  The Subscriber can obtain the status of his/her application from CRA and respective Nodal Office.
b)  Subscribers are advised to retain the acknowledgement slip signed/ stamped by the designated respective nodal ofce where they submit the application.
c)  For more information / clarications, contact CRA:
Website: https://www.npscra.nsdl.co.in
Call: 022-4090 4242
Address: Central Recordkeeping Agency (CRA)
               Protean eGov Technologies Limited
(formerly NSDL e-Governance Infrastructure Limited)
               1st Floor, Times Tower, Kamala Mills Compound, Senapati Bapat Marg, 
               Lower Parel (W), Mumbai - 400013
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Annexures - Subscriber Registration Form for Government Sector applicants (Tick and ll applicable annexures below)
Annexure I - Print PRAN Card in Hindi (Fill the details in Devnagri script)
Applicant's First Name
Middle Name
Last Name 
Father / Mother's First Name
Middle Name
Last Name 
Annexure II - If alphabets of name exceeded the space provided on page 1 of the application form
Applicant's First Name
Middle Name
Last Name 
Father's First Name
Middle Name
Last Name 
Mother's First Name
Middle Name
Last Name 
Annexure III - Additional Nomination For Tier - I For Tier - II For Tier - II Tax Saver
Percentage Share Nominee I Nominee II Nominee III   Total should be equal to 100%
Nominee I
Nominee I - Name 
F i r s t M i d d l e L a s t
Relationship
Age Date of Birth (in case of Minor)
D D / M M / Y Y Y Y
Name of Guardian
F i r s t M i d d l e L a s t
(if nominee is a minor)
Nominee II
Nominee II - Name 
F i r s t M i d d l e L a s t
Relationship
Age Date of Birth (in case of Minor)
D D / M M / Y Y Y Y
Name of Guardian
F i r s t M i d d l e L a s t
(if nominee is a minor)
Nominee III
Nominee III - Name 
F i r s t M i d d l e L a s t
Relationship
Age Date of Birth (in case of Minor)
D D / M M / Y Y Y Y
Name of Guardian
F i r s t M i d d l e L a s t
(if nominee is a minor)
Annexure IV -  tick and ll as applicable      Activate Tier - II Activate Tier - II Tax Saver
#
(available to Central Govt employees only)
PAN*
No change in Bank details Bank details for Tier-II are as under:
Account Type Saving A/c  Current A/c
Bank A/c Number 
Bank Name  
IFS Code
No change in Nominee details Nominee details for Tier-II are as under:
Nominee Name
F i r s t M i d d l e L a s t
Relationship
Age Date of Birth (in case of Minor)
D D / M M / Y Y Y Y
Name of Guardian
F i r s t M i d d l e L a s t
(if nominee is a minor)
In case you desire to nominate more than one person, ll Annexure III above
Investments details for Tier-II are as under:
#
only selection of PF is required
Pension Fund* (Please Tick (√) one) Investment Choice (Please Tick (√) one)
Aditya Birla Sunlife Pension Mgmt Ltd   Axis Pension Fund Management Limited
HDFC Pension Mgmt Co Ltd 
ICICI Prudential Pension Funds Mgmt Co Ltd
Kotak Mahindra Pension Fund Ltd  LIC Pension Fund Limited
 Max Life Pension Fund Mgmt Ltd SBI Pension Funds Private Limited
 TATA Pension Mgmt Ltd   UTI Retirement Solutions Limited 
Active Choice mention the % share in applicable asset class below
E (upto 100%) C (Upto 100%) G (Upto 100%) Total
% Equity % Corp Bonds % Govt. Sec. 100%
OR
Auto Choice Select one life cycle fund below
 Conservative (LC25)      Moderate (LC50)      Aggressive (LC75) 
Name of the Applicant
Place
Date
D / D/ M/ M/ Y/ Y/ Y/ Y
Signature / Thumb Impression* of Applicant
(refer instructions)