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Annexure NCIS To be used for subscribing under NPS National Pension System NPS NPS Contribution Instruction Slip NCIS - All fields marked with are mandatory. Subscriber Details Subscriber s PRAN / New Application Name of the Subscriber Are you a Govt* Employee with date of joining pre-1-1-2004 See instructions at Sr. No 1 2 Phone No/ Mobile No* Yes No Payment Details Cheque/ DD/Cash No* Bank Name Branch City mandatory in case of Amount to be invested in Tier 1 Total Amount to be invested Amount to be invested Amount in words Instructions 1. Post 01. 01. 2004 Govt* employees can contribute only for Tier 2 vide this NCIS* 2. Pre 1st Jan 2004 Govt* employees can contribute for both Tier 1 and Tier 2 vide this NCIS 3. Please quote your 12 digit PRAN allotted by Central Recordkeeping Agency CRA also on the reverse of the cheque/DD. In case of new application please mentioned New Application on the reverse of the cheque/DD. 4. Cheque/DD should be drawn in favor of POP Name of the POP Collection Account - NPS Trust and crossed A/c payee only. Please ensure sufficient balance is available in the bank account before submitting the 5. Copy of PAN should be enclosed in case of cash contribution of Rs. 50 000 and above. Signature/Left Thumb Impression of Subscriber 6. Each contribution i*e* contribution under Tier I and Tier II will be treated as a separate transaction and will be charged separately. For details of the charge structure please refer to the PFRDA offer document at www. pfrda*org. To be filled by POP/POP-SP Received by POP-SP Registration Number Date Time Stamp Receipt Number To be provided by POP-SP -------------------------------------------------------------------------------------------------------------------------------------------------- ---------- Perforation - NCIS Acknowledgement to the Subscriber PRAN Cheque/DD Number Cheque/DD date Date // Time Stamp Drawn on 1. Amount received Tier I Rs. 3. POP Registration Charges one time 5. Service Tax as applicable 6. Amount invested 1 2 - 3 4 5 4. POP Transaction Charges Signature/Stamp of POP/POP-SP/Place charge structure please refer to the PFRDA offer document at www. Subscriber Details Subscriber s PRAN / New Application Name of the Subscriber Are you a Govt* Employee with date of joining pre-1-1-2004 See instructions at Sr. No 1 2 Phone No/ Mobile No* Yes No Payment Details Cheque/ DD/Cash No* Bank Name Branch City mandatory in case of Amount to be invested in Tier 1 Total Amount to be invested Amount to be invested Amount in words Instructions 1. No 1 2 Phone No/ Mobile No* Yes No Payment Details Cheque/ DD/Cash No* Bank Name Branch City mandatory in case of Amount to be invested in Tier 1 Total Amount to be invested Amount to be invested Amount in words Instructions 1. Post 01. 01. 2004 Govt* employees can contribute only for Tier 2 vide this NCIS* 2. Pre 1st Jan 2004 Govt* employees can contribute for both Tier 1 and Tier 2 vide this NCIS 3. Post 01. 01. 2004 Govt* employees can contribute only for Tier 2 vide this NCIS* 2. Pre 1st Jan 2004 Govt* employees can contribute for both Tier 1 and Tier 2 vide this NCIS 3. Please quote your 12 digit PRAN allotted by Central Recordkeeping Agency CRA also on the reverse of the cheque/DD.