Form CH0-1

National Pension System

Application Form for Corporate Registration
{Please fill all the details in CAPITAL LETTERS & Preferably in BLACK INK.All Fields mark with * are mandatory.}
Corporate Registration Number:
(To be alloted by CRA) I
'------'----'------'------'--'------'-----'

Sir/Madam,
We hereby submit a request to be registered as a Corporate.The necessary details are provided below:
1.Name of the Corporate*:

f t
2. Head Office/ Registered Office Address:
Flat/Unit No/Block no*.
T T T
�I�I�I�I�I- I I I I
T � T

Name of Premise /Building /Village

T T T T
I�I�I�I�I I I I I
Area /Locality/Taluka
�I�I�I�I�I�I�I� I� I� I� I
District/Town/City*

State/Union Territory*
L L I I I I I I I I I I I
Country*
I N D I A I I I I I I I I I I I I
I I I I I I
Pin Code*

I 3. Mobile No. + 9 1

4. Phone No.*:
T T

(STD code)
l[ (Phone No.)
I 5. Fax Number I I l[ I I I

I I I I
6. Email ID*: (Email ID should be of official Email ID & not of any individual person)

tttttttrrrtttrrrtrrrtt
7. Nodal Officer's Details :
First Name*:
I I II II II II II II II I I I I
T
Middle Name:
II II II II II II II II � I � I � I � I
L
Last Name:
IIIIIIIIIIIIIIII I I I I
r r r r

Designation*:
L - - L 1IIIIIIIIIIIIIIII I I I I
L

Phone No.*:
r
STD Code
r
ITr TT r T
Phone Number
Il Mobile No. + 9 1 I I I I I
T T

Email ID*: (Note: Email ID& Phone Number should be Nodal Officer's and not the HO's official Email ID and any Board Number.)

tt tt tt tt tt tt tt tt tt tt tt �t �t �t �t
KCRAOll-1.6 Page 1 of 3
 Form CH0-1
8. Alternate Nodal Officer's Details :
T T T T T
First Name*: l I l I I I I II II II II II II II I
Middle Name: IT IIT IIT IIT IIT IIT IIT IIT IIT IIT II II II II II I
Last Name:
T
IT IT IT IT IT IT IT IT IT IIT II II II II I
Designation*: I I TI I I I 1 1 r 1 II II II II I
T T T
Phone No.*:
T � r � ,

(STD code)
[
r r

(Phone No.)
r
Mobile No. + 9 1
�
I� I� I� I� ]
T r T T T T T r T
Email ID*:
(Note: Email ID& Phone Number should be Nodal Officer's and not the HO's official Email ID and any Board Number.)

l l l l l l
- - - - - -
9. a Corporate PAN* : j
b Corporate TAN : T T T T T T l
10.Corporate Office is Co-Contributor (Please tick only one):
Yes No
11.Retirement Age (in Years)*:

Retirement during the month Retirement at the month end

12. Details of Scheme Preference*: Selection of Scheme Preference by: Subscriber Corporate

13.If choice of investment is to be made by the Corporate on behalf of the employees (selected as Corporate in clause no.12)
then the following fields are mandatory:
(A) PFM Selection*:
Please tick only one
PFM Name (in alphabetical order) (Select only one PFM)

Birla Sunlife Pension Management Limited

- '
HDFC Pension Management Company Limited I
ICICI Prudential pension Funds Management Company Limited l
Kotak Mahindra Pension Fund Limited I
UC Pension Fund Limited
- I
SBI Pension Funds Private Limited I
UTI Retirement Solutions Limited I
(B) Investment option* : In case you do not indicate any investment option, your funds will be invested in Auto Choice.)
Active Choice Auto Choice

Asset Allocation (Please, indicate asset allocation pattern of Active Choice is selected )

Asset Class E(Cannot exceed 75%) C G A(Cannot exceed 5%) Total Please Note
1. Upto 50 years of age, the maximum permited Equity Investment is 75% of
the total asset allocation.
% share 100% 2. From 51 years and above, maximum permited Equity Investment will be as
per the asset allocation matrix provided in CSRF Annexure IV. The tapering off
of equity allocation will be carried out as per the matrix on date of birth.

Auto Choice Option (to be filled up on only in case you have selected the 'Auto Choice' investment option). lncase you do not indicate a
choice of LC, your funds will be invested as per LCS0.

Life Cycle (LC) Funds Please Tick( ) Only One

LC 75 Note: 1. LC 75 - It is the Life cycle fund where the Cap to Equity investments is 75% of the total asset
LC50 2 . LC50 - It is the Life cycle fund where the Cap to Equity investments is 50% of the total asset
3. LC 25 - It is the Life cycle fund where the Cap to Equity investments is 25% of the total asset
LC 25

14.CRA Charges to be borne by* - Employer Employee

KCRA0ll-1.6 Page 2 of 3
 Form CH0-1

We hereby declare and agree that we have read and understood the NPS product and its features. We further declare that
the information supplied in the application, is complete and true. And we will notify Central Recordkeeping Agency {CRA)
immediately about any change in the information provided in the application.

Signature of Authorised Signatory

Name: Place:

Designation : Date:
D D M M y y y y
Corporate Head Office Stamp Department :

To be Filled by POP
A. POP Registration No. r I T
B. Submited KVC documents Yes No

Signature of Authorised Signatory

Name: Place:

Designation : Date:
D D M M y y y y
POP Stamp Department :

To be filled by CRA
Received by: ______________

Received at: -------------- Date: ---------

Document to be Submited to POP :

Documents as a proof for KVC on the status of corporate/entity

KCRA0ll-1.6 Page 3 of 3