FORM A: PERSONAL DETAILS APPLICANT CO-APPLICANT GUARANTOR

Existing Customer:  Yes  No

If Yes, CIF No/ Account No. 
First Name Middle Name Last Name

Name: 
Date of Birth:  PAN: 

Mobile: 
e-mail: 
Name of Spouse: 

Name of Father: 

Gender:  Male  Female  Third Gender

Marital Status:  Single  Married  Divorced  Widowed

Details of KYC (Minimum one to be filled)

1) Aadhaar / UID No. 

2) Voter ID No. 
3) Passport No.: 
4) Driving License No. 
5) MGNREGA Job card No. 
6) Letter issued by National Population Register Containing Name and Address: 

Residential Status:  Resident Indian (RI)  Non-Resident Indian (NRI)
 Person Of Indian Origin (PIO)  Foreign Citizen

FOR DEFENCE PERSONNEL:

 Indian Army  Indian Navy  Indian Air force

IS YOUR SERVICE UNDER:

Defined Benefit Pension  New Pension Scheme 

Residential Address:

Permanent Address:

Address 1: 
Address 2: 

Address 3: 

Village:  City: 

District:  State: 
Country:  Pin Code: 

Current address same as the permanent address  Yes  No

Current Address:

Address 1: 
Address 2: 

Address 3: 

Village:  City: 

District:  State: 
Country:  Pin Code: 

Address type for communication:  Permanent  Current

Residential type  Rented  Company lease  Owned

Years residing in current address:  Months residing in current address: 

Relationship with Primary Applicant:

 Spouse  Father  Mother  Brother  Sister  Son  Daughter  Daughter-in-law

 Others, Please specify_____________
No. of existing house/plot owned individually or jointly by the customer: 
No. of units acquired in single residential housing project/co-operative residential complex: 
Is the customer, who is Builder/ Partner/Director/Owner/Promoter acquiring at/house /unit/plot in the

project developed by them /their Company?  Yes  No

Power of attorney provided:  Yes  No

If Yes:

Name of the POA Holder: 

Contact no. of POA Holder: 

Is Applicant / co-Applicant / Guarantor a director including Chairman and Managing Director) in another

bank or specified near relative of any of the director ((including Chairman and Managing Director) of SBI/Other Bank
 Yes  No

Name of the Chairman/ MD or other director: ccccccccccccccccccccccc

Indicate Name of Bank/ Subsidiary/ Schedule co-operative Banks/ Trustees of Mutual Fund/ Venture

Capital Fund: ccccccccccccccccccccccccccc

 FORM B: EMPLOYMENT DETAILS APPLICANT CO-APPLICANT GUARANTOR

Is income considered for loan eligibility?  Yes  No

OCCUPATION:  Salaried

 Self-Employed Professional (Doctor/Engr/Architect/CA)

 Self-Employed Professional other than Doctor/Engr/Architect/CA

 Business  Agriculturist  Retired

 Pensioner  Student

 Home Maker  Unemployed

SALARIED:

Organization Type:  Central Govt  State Govt  Quasi Govt Public Sector Units  Defence  Corporates  Other Institutions

Employment Status:  Permanent  Contractual Retainership  Part Time

Total work experience (Years):  Total work experience (Months): 

Is Service Under Defined Benefit Pension:  Yes  No

Date Of Retirement: 

Employer’s Name: 
Industry: 
Gross Monthly income: Rs 

Net Monthly Income: Rs 

Is checkoff available:  Yes  No

Is there a break in service beyond the period of 3 months in last 2 years  Yes  No

NON-SALARIED:

Work Experience In Business /Profession:

 Years  Months
Net Profit Earned In Last Two Years:
 Yes  No
Gross Monthly Income: Rs  Net Monthly Income: Rs 

Business Name: 

Industry Name: 

Office / Business Address

Address 1: 
Address 2: 

Address 3: 

Village:  City: 

District:  State: 
Country:  Pin Code: 

Telephone (Landline): 

(Mobile): 
SALARY/ BUSINESS ACCOUNTS DETAILS
ACCOUNT TYPE IFSC CODE BANK NAME BRANCH NAME ACCOUNT NUMBER

EXISTING LOANS (IF ANY)

LOAN ACCOUNT NO. BANK / FI PRODUCT NAME SANCTIONED AMOUNT PRESENT OUTSTANDING EMI
 FORM C: LOAN DETAILS

Purpose:  Purchase of Plot for construction of a House  Purchase of a new House /Flat  Purchase of old House / Flat  Construction of a new House/Flat
 Extension of existing old House/ Flat  Repair or Renovation an existing old House / Flat  Takeover of Home Loans from other Banks / HFCs/FIs  Reimbursement
of investment made for House /Flat/Construction of house/Repair and Extension of house-

Requested Loan Amount: Rs 

Repayment Mode:  Standing instruction linked to salary accounts
 Standing instruction linked to other accounts
 ECH/NACH linked to salary account
 ECH/NACH linked to other accounts
 Checkoff
Tenure:  Months
Moratorium:  Months
Whether interest to be capitalized during moratorium period:  Yes  No

Disbursement Schedule:

No. of Tranches: 
SELLERS / BUILDERS DETAILS:

NAME OF SELLER/ BUILDER ACCOUNT NO. BANK NAME BRANCH NAME IFSC CODE

FORM D: PROPERTY DETAILS

RERA Registration No. (If applicable): 

Project Name (If applicable): 
Property Type:  Self constructed / Independent House
 Small project not covered under RERA
 Property not identified
 Ready for possession
Property Status:  Ready for possession
 Under construction
 Construction not started
Is property in Tribal Area:  Yes  No

Property Value: Rs. 

Property held / to be held in the name of: 

Sale transaction Category:  Normal sale  POA Sale  Gift deed  Sale through third party Guarantor

Net Rental income expected from the proposed house property (Monthly): Rs. 

Property holding status:  Lease  Free Hold

Lease period:  Years  Months

Built up area (Sq Ft): .
Building name: 
Wing name: 
Flat No: 
Carpet area (sq ft): .
Super built-up area (sq ft): .

Address 1: 

Address 2: 

Address 3: 

Pin Code:  City: 

District:  State: 

Location of Plot (Applicable for SBI Realty Loan):

 Within the Municipal Corporation area of population >=1 lac

 Within the Municipal Corporation area of population > 10,000 up to 1 lac

 Outside Municipal / Corporation area and plot developed or allotted by Government Body or Development Authority

 Outside Municipal Corporation area

CONSTRUCTION /PURCHASE Details:

Amount as per Agreement to Sale: Rs


Date of Agreement to Sale: 
Estimated Cost of Construction: Rs 

Reimbursable Investment (if applicable): Rs 

Cost of Extension: Rs 

Improvement Cost: Rs 

Cost of Furnishing /Interior: Rs 

Cost of Solar Photo Voltaic Lighting System: Rs 

Registration Charges: Rs  Stamp Charges: Rs 

GST Charges: Rs 

Premium for insurance of Mortgaged property: Rs 

Other Amenities: Rs 

Amount of margin money: Rs 

Source of Margin Money:  Own savings  From friend and relatives  Realty gold loan  Other loan  Others

COLLATERAL DETAILS:

(Applicable, if collateral required other than Primary Security)

Collateral type:  Term Deposit  NSC/KVP  Life Insurance Policy  Govt. Promissory Note  Immovable Property  Third Party Guarantee
Collateral Owner Collateral Description Collateral Value Collateral Lien Value Address

FORM E: INSURANCE & DECLARATIONS

INSURANCE:
For your benefit and convenience, the following group insurance plans underwritten by SBI Life Insurance Company Ltd are available for your consideration. If you opt for cover,
SBI would administer your enrolment for the chosen plan, please note that insurance cover is optional for the purpose of the loan application and may also be obtained from other
providers.

SBI Life RiNn Raksha Policy – RiNn Raksha Policy (RRP) is a group mortgage reducing term life insurance policy underwritten by the SBI Life Insurance Company Limited, which
covers you against death and/or disability (as defined in the policy) to protect your dependents from the liability of the loan outstanding. The policy covers the outstanding loan
balance for the entire tenor of the loan for upfront premium payable in 5 yearly installment.

SBI Life Saral Shield Policy (available for loan limit below Rs.25 Lacs, subject to minimum loan limit of Rs.7.5 lacs) - This is an individual reducing term insurance policy
underwritten by the SBI Life Insurance Company Limited, which covers you against death and/or disability (as defined in the policy) to protect your dependents from the liability
of the loan outstanding. The policy covers the outstanding loan balance for the entire tenor of the loan for an up-front one time premium.

SBI Life Smart Shield Policy (available for loan limit of Rs. 25 lacs & above) – This is an individual reducing term insurance policy like SBI Life Saral Shield for customers with limit
of Rs. 25 Lacs and above.

Do you wish to be covered by Home Loan insurance cover by SBI Life insurance:  Yes  No
Need Loan for SBI Life premium:  Yes  No
SBI General insurance required:  Yes  No
IMGC Guarantee required:  Yes  No
 DECLARATION
I/We certify that the information and particulars provided by me/us in this application form (and all documents referred or provided herewith) are true, correct, complete and up
to date in all respects and I have not withheld any information. I/ We authorize State Bank of India to make inquiries related to or verify said information directly or through any
third party. I/We further acknowledge the Bank’s right to seek any information from any other source in this regard. I/We understand that all of the above-mentioned information
shall form the basis of any facility that the Bank may decide to grant to me/us at its sole discretion.

I/We understand that the Bank will use the information furnished by me/us in accordance with the applicable laws of India and any other foreign laws to which I/we/the Bank may
be subject to. The said information will be used solely for the purpose of processing, sanctioning, updating, maintaining, and operating my/our account/s or facility/ies availed by
me/us and processing transactions initiated by me/us in such account/ pursuant to such facility.

I/We agree and undertake to provide any further information that Bank may require. I/We agree and understand that Bank reserve the right to retain the application form, and the
documents provided therewith and will not return the same to me/us.

I/We further agree that any facility that may be provided to me/us shall be governed by the rules of the Bank that may be in force from time to time. I/We will be bound by the
terms and conditions of the credit facility/ies that may be granted to me/us. I/We authorize the Bank to debit my home loan account with the Bank for any fees, charges, interest
etc. as may be applicable.
I/We undertake and declare that I/we will comply with the Foreign Exchange Management Act, 1999 (”FEMA”) and the applicable rules, regulations, notifications, directions or
orders made there under and any amendments thereof. I/We undertake to intimate the Bank before proceeding overseas on permanent employment and/or emigrating and/or
changing my/our nationality.

I/We acknowledge that the Bank remains entitled to assign any activities to any third-party agency at its sole discretion. I/ We hereby consent to, agree and authorize the
Bank to disclose information and data relating to me/ us and details of my/our account to third party agencies including Bank’s group entities, without any specific consent or
authorization from me/us, for the purpose of any services in connection with the facility/ies availed by me/ us and I/we shall not hold the Bank liable for use of this information.

I/We hereby agree and give consent for the disclosure or obtention by the Bank of all or any such; (a) information and data (including personal data) relating to me/us (b) the
information or data relating to any credit facility availed of/to be availed of by me/us and (c) default, if any, committed by me/us in discharge of my/our such obligation, as the Bank
may deem appropriate and necessary, to Credit Information Companies, Information Utilities, and/or any other agency authorised in this behalf by Government of India/ Reserve
bank of India /any other statutory or regulatory authority for purposes of credit decision, prevention of fraud and money laundering, reporting obligations or any other related
and ancillary matters. I/We shall not hold the Bank liable for use of this information. I/We understand and agree that such Credit Information Companies, Information Utilities,
and/or other agencies may use or process the said information and data disclosed by the Bank; and/or furnish, such information and data (including the processed information/
data) or products thereof prepared by them to banks/financial institutions and other entities, as may be specified by the concerned statutory/ regulatory authority in this behalf.

I/We agree to receive SMS alerts/Phone calls related to my/our application status and account activity as well as product use messages/calls that the Bank will send/make, from
time to time, on the mobile/phone number/ email as mentioned in this application form. I/We undertake to intimate the Bank in the event of any change in the mobile/ phone
number/ email and residential address furnished by me/us.

I/We understand that option exercised between the three life insurance product offered by SBI life is final and cannot be changed at a later stage.

I/We further acknowledge that I/ we have read, understood and agree with the Most Important Terms and Conditions governing the home loan product chosen by me/us.

I/We authorize the Bank to share, disclose, exchange, or use in any manner whatsoever, without any further specific consent or authorisation from me/us, the information/data
provided by/related to me/us to the Group Companies/Associates/Subsidiaries/Affiliates/Joint Ventures of State Bank of India/ any person with whom the Bank has entered/
propose to enter into contracts for provision of “services/products” for the purpose of marketing/offering/selling any such product/services and / or availing support services
of any nature by the Bank.

SBI may send its NRI Newsletter (or) marketing information and/or any special offers I/we may be entitled to or about products and services available from SBI / SBI Group that
may be of interest to me/us (Applicable in case of NRI customers only).

(Please mention “Yes”, if interested and “No”, if not interested)

If interested, please tick the relevant boxes. I/We prefer following mode of communication. (Customer may tick anyone/ two (or) all boxes)
 Email  Phone  SMS
For EU/UK NRI applicants:
• By signing this Declaration/Form, I/we confirm that I/we have read the Privacy Notice provided to me/us and consent to SBI collecting, transferring, holding
and processing my/our personal data as indicated therein.
• I/We further understand that as and when SBI updates its Privacy Notice, it will publish the same on its website. I/We undertake to consult SBI’s website at
regular intervals and confirm any new version of the Privacy Notice will apply from the date it is published thereon.
• I/We understand that under the conditions defined by the General Data Protection Regulations GDPR (or) similar foreign regulations, unless otherwise
provided I/we have the rights:
a. To withdraw my/our consent at any time.
b. To obtain confirmation from SBI, whether it processes my personal data (PD) (or) not and, if it processes, details thereof, like the purpose, categories
of PD concerned, recipients or categories of recipients to whom my personal data have been or will be communicated etc,
c. The retention period of the personal data envisaged or, where this is not possible, the criteria used to determine this duration, etc.
d. Access, rectification and/or erasure of my personal data, subject to relevant regulatory guidelines.

e. In certain circumstances, receive my/our personal data provided to SBI, in a structured, commonly used and legible format, and the right to transfer
this data to another data controller However, we understand that the right to data portability is dependent on regulatory instructions & system
enablement that are still evolving.
f. In certain circumstances object to the processing of my/our personal data
g. To lodge a complaint with the relevant data protection authority of my/our jurisdiction.
For all other customers:
• By signing this Declaration/ Form, I/we consent to SBI collecting, transferring, holding and processing my/our information including personal data as indicated
herein.
By signing below, I/we indicate my/our acceptance, hereof

Signature of Applicant / Co applicant / Guarantor

Place:
Date:

.....................................................................................................................................................................................................................................................................................................

ACKNOWLEDGMENT RECEIPT

Loan application received on , complete document set received on , cheque received towards payments of processing
fee, Valuation fee and Legal fee amounting to Rs , Rs  and Rs  respectively vide cheque no. ,

 and  dated , drawn in favour of “State Bank of India” and payable at 

Request will be disposed off and acceptance / rejection notification would be mailed within 15 days from completed application form with supporting documents on behalf of
State Bank of India

Date and place ……………………..

Authorised Signatory
 FORM-D
(See sub-rule (1) of rule 3 and rule 10)
PAY – IN – SLIP FOR DEPOSITS
UNDER SENIOR CITIZENS SAVINGS SCHEME, 2004
COUNTERFOIL – 1 COUNTERFOIL-2

DEPOSITOR’S COPY BANK’S COPY

SBI BRANCH NAME : SBI BRANCH NAME :
NAME & ADDRESS OF DEPOSITOR: NAME & ADDRESS OF DEPOSITOR:
__________________________________________ __________________________________________
__________________________________________ __________________________________________

FATHER/HUSBAND NAME : FATHER/HUSBAND NAME :

SCSS A/C NO : SCSS A/C NO :

AMOUNT OF DEPOSIT AMOUNT OF DEPOSIT

CHEQUE / DD REALISATION CHARGE CHEQUE / DD REALISATION CHARGE

ACCOUNT TRANSFER FEES ACCOUNT TRANSFER FEES

DUPLICATE PASSBOOK FEES DUPLICATE PASSBOOK FEES

OTHER CHARGES IF ANY OTHER CHARGES IF ANY

TOTAL AMOUNT TOTAL AMOUNT

(Rupees________________________________ (Rupees________________________________
_________________________) _____________________________)
DETAILS OF CASH DEPOSIT AMOUNT DETAILS OF CASH DEPOSIT AMOUNT
1000 X 1000 X
500 X 500 X
100 X 100 X
50 X 50 X
20 X 20 X
10 X 10 X
Total By Cash Total By Cash
Cheque / Demand Draft No & Date Cheque / Demand Draft No & Date
……………………….. & ……/……/20……… ……………………….. & ……/……/20………
Bank / Branch on Which Drawn Bank / Branch on Which Drawn
…………………………………………………………………………. ………………………………………………………………………….

Depositor’s Signature Depositor’s Signature

For the Use of Branch For the Use of Branch

Received ________ (Rupees _____________ Received ________ (Rupees _____________

_______________________________Only) as _______________________________Only) as
detailed herein above. For deposit in SCSS detailed herein above. For deposit in SCSS
A/c No ________________ A/c No ________________

Teller /Cashier Service Manager Teller /Cashier Service Manager

NOTE: NOTE:
1. The cheque/demand draft should be in favour of the 1. The cheque/demand draft should be in favour of the
“YOURSELF FOR SCSS DEPOSIT” or in favour of the “YOURSELF FOR SCSS DEPOSIT” or in favour of the
“Depositor SCSS A/c” endorsed in favour of the SBI. “Depositor SCSS A/c” endorsed in favour of the SBI.
2. Cheques / Demand Drafts are subject to realisation of 2. Cheques / Demand Drafts are subject to realisation of
the proceeds. the proceeds.

SBI FORMS BY 4577825

 FORM-C

APPLICATION FOR WITHDRAWALS UNDER THE

PUBLIC PROVIDENT FUND SCHEME, 1968

The Chief / Branch Manager

State Bank of India
____________________
____________________

I wish to withdraw from my Public Provident Fund Account No…………….………..…………

A sum of .................... (Rupees……………………………………………………..…Only). A period
of ………. years has expired from the end of the Financial Year in which initial subscription was
made.
2. *Certified, that the amount sought to be withdrawn is required for the use of
………………………………………who is alive and still a Minor.
*(To be given only when withdrawal is sought from a Minor’s PPF Account)
3. The Pass Book is enclosed.

Date:……/……/20… Signature / Thumb Impression of

(Subscriber / Guardian)

FOR OFFICE USE ONLY

 Date of Initial Subscription ……/……/………….

 Amount Available in PPF Account …...………………..

 Date on which last withdrawal was allowed ……/……/………….

 Amount Available for withdrawal in accordance

with paragraph 9(1), 9(3) of the Scheme …………………..

Withdrawal of a sum of ………………. Sanctioned.

Date: ……/……/20….. Branch / Service Manger

Received a sum of ……………/- (Rupees……………………………………………………………..)

by way of withdrawal from Public Provident Fund Account No…………………………………
( ) *Credit the Amount to my SB A/c No_____________________
Revenue
Stamp
( ) *Issue a DD/BC Favouring ____________________________

* Tick any One

Signature / Thumb Impression of
Date :……/……/20..… (Subscriber / Guardian)

SBI FORMS BY 4577825

Annexure B
KYC UPDATION FORM INDIVIDUAL
Date: D D M M Y Y Y Y

Branch Name : Branch Code

Fields marked asterix (*) are mandatory.Please fill up in BLOCK letters only and use black ink for signature Bank/Branch to affix rubber stamp of
name and code no.
(For office use only)
Customer ID:

Account No.: CKYC No.:

(Mandatory for CKYC update request)

1 Personal Details

Existing Customer ID: (If applicable)

Name*: F I R S T N A M E M I D D L E N A M E L A S T N A M E

(Same as ID Proof) Prefix

Maiden Name : F I R S T N A M E M I D D L E N A M E L A S T N A M E

Date of Birth*: D D M M Y Y Y Y Gender* Male Female Transgender Marital Status* Married Unmarried Others
Prefix
Name of Father/Mother F I R S T N A M E M I D D L E N A M E L A S T N A M E

/Spouse* (Please Tick One) (Father's name is mandatory if PAN is not provided)
No. of Dependents
Illiterate YES NO if yes : Identification Marks :
Prefix
Name of Guardian F I R S T N A M E M I D D L E N A M E L A S T N A M E

(In Case Of Minor*) Relationship with Guardian

Nationality*: In-Indian Others Country Name:

Occupation Type* S-Service Private Sector Public Sector Government Sector

O-Others Professional Self employed Retired House Wife Student

B-Business X-Not categorised-Please specify……………………………………………………………………………………………….

Monthly Income*: Rs. Net Worth(approx value) Rs.

Source of Income Salary Business Income Agriculture Investment Income Pension Others
(Please tick all applicable)

Religion: Hindu Muslim Christian Sikh Others …………………………………………………………………………..

Category: General OBC SC ST

Person with disability Yes No If yes, i. Visually impaired ii. Differently abled
Educational Qualification: Below SSC SSC HSC Graduate Post Graduate Professional Others

Organization's Name: Designation/Profession: Nature of Business:

Please Tick the Applicable box*: Politically exposed Person Related to politically Exposed Person None

ISO 3166 Country Code of Jurisdiction of Residence* (Code for India is IN)

Place/City of Birth* ISO 3166 Country of Code of Birth* Citizenship

Country of Tax Residence in India only and not in any other country or territory outside India* Yes No (If No, please fill the FATCA details form - Annexure II)

PAN*/Tax Identification Number or equivalent (If issued by jurisdication) (If PAN is not submitted, submit Form 60 - Annexure I)

2 Contact Details (All communications will be sent on provided Mobile No./Email-ID)

Mobile No. Email ID

S T D Tel.(Off): S T D

Tel.(Res):
3 Proof of Identity/Address (Please tick the appropriate Box (any one ID type) and give details)*

A-PASSPORT B-VOTER'S IDENTITY CARD C-DRIVING LICENCE D-UID(AADHAR)

E-NREGA JOB CARD F-LETTER ISSUED BY NATIONAL POPULATION REGISTER CONTAINING DETAILS OF NAME & ADDRESS

Document No/Identification Number*

Issue Date:* D D M M Y Y Y Y Expiry Date (If applicable):* D D M M Y Y Y Y

4 Address details Current Permanent Overseas

Address type* Residential/Business Residential Business Registered Office Unspecified

Address*

City/Village*: District*:

State:* Pin:*

5 Address details Correpondence Local Same as Current/Permanent Address

Address type* Residential/Business Residential Business Registered Office Unspecified

Address*

City/Village:* District*:

State:* Pin:*

6 If the Proof of Address(OVD) provided does not contain current address-please provide any of the documents below.

Utility Bill PPO/FPPO Property or Municipal tax receipt

Letter of allotment of accomodation issued by employer/ issued by State or Central Government departments, statutory or regulatory bodies, Public sector
undertaking, scheduled commercial banks, financial institutions and listed companies. Similarly, leave and license agreements with such employers allotting official
accomodation.
Document No Date: D D M M Y Y Y Y

7 DECLARATION CUM UNDERTAKING CUM SELF–CERTIFICATION

I have read the copy of Terms and Conditions of the Account Opening given to me. The Terms and Conditions have been explained to me/us and

having understood, I accept the same.

1 I hereby declare that I have submitted the Aadhaar Card issued by UIDAI voluntarily for identification and /or address proof towards the compliance of KYC norms under the PMLA, 2002
2 I hereby consent that the Bank may verify the same with the UIDAI and authorise the UIDAI expressly to release the identity and address through biometric authentication to the Bank

YES NO

3. I agree that my personal KYC details may be shared with Central KYC registry or any other competent authority.I hereby consent to receive information from the Bank/Central KYC Registry/GoI/
RBI or any other authority through SMS/e-mail on my registered mobile number/ e-mail address. I also agree that the non-receiptof any such SMS/e-mail shall not make the Bank liable for any
loss or damage whatsoever in nature.

PHOTO*

Please Paste Signature/Thumb impression of the Applicant

Please sign in black ink only

Recent passport Size

(Do not Staple)

Place: Date: D D M M M Y Y Y Y

8 FOR OFFICE USE/ATTESTATION

1. PAN details (if available) have been verified from database issuing authority.
2. Information submitted by the customer verified & updated in the CBS. .
3. KYC updation date entered in CBS.
Maker……………………….. Checker……………………………
PF No.......................... (S.S. No______________)
(This form is to be sent to LCPC for digitisation and storage)
(Ver-2) CSRF 1
NATIONAL PENSION SYSTEM (NPS)
SUBSCRIBER REGISTRATION FORM
Affix
Please Select your Category [ Please tick(√) ] recent colour
photograph
To, Government Sector Corporate Sector of
3.5 cm X 2.5 cm
National Pension System Trust. All Citizen Model NPS Lite/Swavalamban size
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

1 of 3
(Ver-2) CSRF 1
8. SUBSCRIBERS NOMINATION DETAILS* (Please refer to Sr. No . 5 of the instructions)
Name of the Nominee (You can nominate up to a maximum of 3 nominees and if you desire so please fill in Annexure III (Additional Nomination Form) provided separately)
Nominee Name F i r s t M i d d l e L a s t
Relationship with the Nominee Date of Birth (In case of Minor) d d / m m / y y y y
Nominee’s Guardian Details (in case of a minor)
Nominee’s Guardian F i r s t M i d d l e L a s t

9. NPS OPTION DETAILS (Please tick (√) as applicable)

I would like to subscribe for Tier II Account also YES NO If yes, please submit details in Annexure I. (Tier II account is not available for NPS Lite/
Swavalamban subscribers).
I would like my PRAN to be printed in Hindi YES NO If Yes, please submit details on Annexure II

10. PENSION FUND (PF) SELECTION AND INVESTMENT OPTION*

(i) P
 ENSION FUND SELECTION (Tier I) : The names of the all PFs are mentioned in the instructions page and are available to the all sector
subscribers with following conditions:
(i) Government Sector: For Government Subscribers, the following PFs act as default PFs as per the guidelines issued by the Government:
(a) LIC Pension Fund Limited (b) SBI Pension Funds Pvt. Limited (c) UTI Retirement Solutions Ltd.
(ii) NPS Lite/Swavalamban: NPS Lite Swavalamban is a group choice model where subscriber has a choice of PF and investment option as available with Aggregator.
(iii) All Citizen Model: Subscribers under All Citizen model has the option to choose the available PFs as per their choice in the table below.
(iv) Corporate Model: Subscribers shall have the option to choose the available PFs as per the below table in consultation with their respective Employer.

Name of the Pension Fund Please Tick (√) Availability of the Pension Funds
LIC Pension Fund Limited
Available to
SBI Pension Funds Private Limited Government
Sector
UTI Retirement Solutions Limited
Available to Available to
Available to All
ICICI Prudential Pension Funds Management Company Limited NPS Lite/ Corporate
Citizen Model*
Swavalamban Model*
Kotak Mahindra Pension Fund Limited
Reliance Capital Pension Fund Limited
HDFC Pension Management Company Limited
* Selection of Pension Fund is mandatory both in Active and Auto Choice. In case, you do not indicate a choice of PF, please note that it is deemed that you have consented
for the default PF specified by PFRDA. Currently, SBI Pension Funds Private Limited is the default PF.

(ii) INVESTMENT OPTION (Available for All Citizen Model and Corporate Model Subscribers)
( Please Tick (√) in the box given below showing your investment option).
Active Choice Auto Choice
For details on Auto Choice, please refer to the Offer Document. Please note:
1. In case you do not indicate any investment option, your funds will be invested in Auto Choice
2. In case you have opted for Auto Choice, DO NOT fill up section below relating to Asset Allocation. In case you do, the Asset Allocation instructions will be ignored
and investment will be made as per Auto Choice.
(iii) ASSET ALLOCATION (to be filled up only in case you have selected the ‘Active Choice’ investment option)
E
Asset Class C G Total Note:- The total allocation across E, C and G asset classes must be equal to
(Cannot exceed 50%)
100%. In case, the allocation is left blank and/or does not equal 100%, the
% application shall be rejected.

11. DECLARATION BY SUBSCRIBER* ( Please refer to Sr no. 6 of the instructions )

Declaration & Authorization by all subscribers
I have read and understood the terms and conditions of the National Pension System and hereby agree to the same and declare that the information and documents furnished
by me are true and correct, to the best of my knowledge and belief. I undertake to inform immediately the Central Record Keeping Agency/National Pension System Trust,
of any change in the above information furnished by me. 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.
I further agree to be bound by the terms and conditions of provision of services by CRA, from time to time and any amendment thereof as approved by PFRDA, whether
complete or partial without any new declaration being furnished by me. I shall be bound by the terms and conditions for the usage of I-pin (to access CRA/NPSCAN and view
details) & T-pin on the CRA website.
Additional declaration by Swavalamban subscriber
I have read/explained to me and understood the Swavalamban guidelines and I meet the prescribed eligibility criteria for assistance under the scheme. I also undertake to
adhere to the prescribed contribution limit of minimum Rs. 1000/- and maximum of Rs. 12000/-, failing which the Central Government contribution credited to my account
may be forfeited along with such interest rates as may be prescribed.
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 financial profile 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 Subscriber in black ink

(* LTI in case of male and RTI in case of female)

ACKNOWLEDGEMENT
Name of the Subscriber:
Contribution Amount Remitted: `

Date of Receipt of Application and Contribution Amount: d d / m m / y y y y

Stamp and Signature of the Employer/PoP/Aggregator:

2 of 3
(Ver-2) CSRF 1
12. DECLARATION BY EMPLOYER/POP/AGGREGATOR
Applicable to Government Subscribers only
(Subscribers Employment Details to be filled and attested by the Deptt. (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
Group of Employee (Tick as applicable) Group A Group B Group C Group D
Office

Department

Ministry

DDO Registration Number

DTO/PAO/CDDO/DTA/PrAO Registration Number Basic Pay

Pay Scale

It is certified that the details provided in this subscriber registration form by ______________________________________________________ employed with us,
including the address and employment details provided above are as per the service record of the employee maintained by us. Also, it is further certified that he/she has
read entries/entries have been read over to him/her by us and got confirmed 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/
(In the box above) (In the box above) (In the box above) DTA/PrAO (In the box above)
Designation of the Authorised Person Designation of the Authorised Person
Name of the DDO Name of DTO/PAO/CDDO/DTA/PrAO
Deptt/Ministry Date d d / m m / y y y y

Applicable to Corporate Subscribers only

(Subscribers Employment Details to be filled and attested by Corporate (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 ID

Corporate Regd. No Allotted by CRA CBO No. allotted by CRA

Certified that the details provided in this subscriber registration form by ________________________________________________________ employed with us, including
the employment details provided above are as per the service record of the employee maintained by us. Also, it is further certified that he / she has read the entries / entries
have been read over to him / her by us and got confirmed by him / her.

Date d d / m m / y y y y

Signature of the Authorized Person (In the box above) Place Rubber Stamp of the Corporate
Designation of the Authorized Person: (In the box above)

To be filled by POP-SP (Only in case of All Citizen Model or Corporate subscribers)

Receipt No. (17 digits) POP-SP Registration Number

Document accepted for date of Birth Proof:

Copy of PAN card submitted YES NO KYC Compliance YES NO
Existing Bank Customer:
I/we hereby certify/confirm that Shri/Smt/Kum …..…………..........................................…………….......... is an existing customer of the Bank having fully operative Saving
Bank account no ...………......…....................................at ………......………..... branch and KYC norms required for opening Bank Account which match the requirements
for opening NPS account have been fully complied with. We further confirm that the S. B. a/c of Sh/Smt/Kum ……........….............................................................…..........
is not a ‘Basic Savings Bank Deposit Account’.
Adhaar Based KYC Certificate:
I/we hereby certify that Aadhaar Number ...………......…....................................of Sh/Smt/Kum………………….......................................................................…..has been
checked and the name and address mentioned on the original Aadhaar card are matching with that mentioned on NPS application form.

To be filled by POP-SP Name:

Designation: Place:

POP-SP Seal Signature of Authorized Signatory Date d d / m m / y y y y

Declaration by the Aggregator (Only in case of NPS Lite/Swavalamban Subscribers)

Authorisation by Aggregator’s office (NL - AO)
Certified that the subscriber is registered with the aggregator and he/she has opted to join NPS. I hereby declare that the subscriber is eligible to join NPS and the above
declaration has been signed /thumb impressed before me by ...................................................after (s)he has read the entries/ entries have been read over to her/him by me.

Signature of the Authorised person (In the box above) Rubber Stamp of the Aggregator (In the box above)
Name of the Aggregator

NPS Lite Account Office (NL-AO) Registration Number NPS Lite - Collection Centre (NL - CC) Registration Number
Membership No. allotted by Aggregator (if any)
Place Date d d / m m / y y y y

[To be filled by CRA - Facilitation Centre (CRA-FC)]

Received by CRA-FC Registration Number
Received at Date d d / m m / y y y y
Acknowledgement Number (by CRA-FC)
PRAN Alloted

3 of 3
(Ver-2) CSRF 1
INSTRUCTIONS FOR FILLING THE SUBSCRIBER REGISTRATION FORM
General Guidelines
(a) Please fill the form in legible handwriting so as to avoid errors in your application processing. Please do not overwrite. Corrections should be made by cancelling and re-writing
and such corrections should be countersigned by the applicant. Each box, wherever provided, should contain only one character (alphabet / number / punctuation mark) leaving
a blank box after each word.
(b) Applications incomplete in any respect and/or not accompanied by required documents are liable to be rejected. The application is liable to be rejected if mandatory fields are
left blank or the application form is printed back to back
(c) The subscriber should not sign across the photograph. The photograph should not be stapled or clipped to the form. If there is any mark on the photograph such that it hinders
the clear visibility of the face of the subscriber, the application shall not be accepted.
(d) Copies of all the documents submitted by the applicant should be self-attested and accompanied by originals for verification by the nodal office.
(e) Name and Address of the applicant mentioned on the form, should match with the documentary proof submitted.
(f) The subscriber’s thumb impression should be verified by the DDO/PAO/DTO/designated officer of POP-SP/Aggregator
(g) Government employees (mandatorily covered under NPS) may submit their application for Tier II to any POP-SP of their choice. The list of POP-SPs rendering services under
NPS is available on CRA website http://www.npscra.nsdl.co.in

S.No Item No. Item Details Instructions

Date of Birth Please ensure that the date of birth matches as indicated in the document provided in the support.
i. If father's name has more than 30 digits, you may fill Annexure II for the same.
1 1 ii. Father’s name is mandatory. However, if applicant does not want to provide father’s name, he/she has an option to provide
Father's Name
mother’s name on Annexure II and the mother’s name will be printed on PRAN card
iii. If the applicant wants mother’s name to be printed instead of Father’s name on PRAN Card, he/she must fill Annexure II
S.No Proof of Identity (Copy of any one) S.No Proof of Address (Copy of any one)
1 Passport issued by Government of India. 1 Passport issued by Government of India
2 Ration card with photograph. 2 Ration card with photograph and residential address
Bank Pass book or certificate with photograph and
3 Bank Pass book or certificate with Photograph. 3
residential address
4 Certificate of the POP bank for an existing Bank customer. 4 Certificate of the POP bank for an existing Bank customer.
Voters Identity card with photograph and residential Voters Identity card with photograph and residential
5 5
address. address
Valid Driving license with photograph and residential
6 Valid Driving license with photograph 6
address
Letter from any recognized public authority at the level
Certificate of identity with photograph signed by a Member of Gazetted officer like District Magistrate, Divisional
7 7
of Parliament or Member of Legislative Assembly commissioner, BDO, Tehsildar, Mandal Revenue Officer,
Judicial Magistrate etc.
Certificate of address with photograph signed by a Member
Identity, 8 PAN Card issued by Income tax department 8
of Parliament or Member of Legislative Assembly
Correspondence &
2 2, 3 & 4 Aadhar Card / letter issued by Unique Identification Aadhar Card / letter issued by Unique Identification
Permanent address 9 9
Authority of India Authority of India clearly showing the address
details
Job cards issued by NREGA duly signed by an officer of Job cards issued by NREGA duly signed by an officer of
10 10
the State Government the State Government
Identity card issued by Central/State government and its The identity card/document with address, issued by
Departments, statuary/ Regulatory Authorities, Public any of the following: Central/State Government and its
Sector Undertakings, Scheduled commercial Banks, Public Departments, Statuary/Regulatory Authorities, Public
11 11
Financial Institutions, Colleges affiliated to universities Sector Undertakings, Scheduled Commercial Banks,
and Professional Bodies such as ICAI, ICWAI, ICSI, Bar Public Financial Institutions for their employees.
Council etc.
Photo Identity Card issued by Defence, Paramilitary and Latest Electricity/water bill in the name of the Subscriber
12 12
Police departments. showing the address (less than 3 months old)
Ex-Service Man Card issued by Ministry of Defence to their Latest Telephone bill in the name of the Subscriber showing
13 13
employees. the address (less than 3 months old)
Latest Property/house Tax receipt (not more than one
14
year old)
14 Photo Credit card.
Existing valid registered lease agreement of the house on
15
stamp paper ( in case of rented/leased accommodation)
Note:
(i) If the address on the document submitted for identity proof by the prospective customer is same as that declared by him/her in
the account opening form, the document may be accepted as a valid proof of both identity and address.
(ii) If the address indicated on the document submitted for identity proof differs from the current address mentioned in the account
opening form, a separate proof of address should be obtained. All future communications will be sent to correspondence
address. If correspondence & Permanent address are different, then proof for both have to be submitted.
(iii) In case of Government subscribers, the KYC documents may be submitted within a period of 30 days after generation of PRAN.
Other Details An NRI subscriber would need to furnish an Indian address for communication and bank details within India. Fund transfers by NRIs
(Occupation Details) would be subject to regulatory requirements as prescribed by RBI from time to time and FEMA requirements.
3 6 Politically Exposed Persons’ (PEPs) are individuals who are or have been entrusted with prominent public functions in a foreign
Politically Exposed
country, for example heads of state or of the government, senior politicians, senior government, judicial or military officials, senior
Person
executives of state-owned corporations, important political party officials.
For Tier I, bank details are optional. For activation of Tier II, bank details are mandatory. Please attach a Cancelled cheque (containing
Subscriber’s Bank Subscriber Name, Bank Account Number and IFS Code) or Bank Certificate containing Name, Bank Account Number and IFS code,
4 7
Details for direct credit or electronic transfer. In case if the cheque is not preprinted with name, additionally, a copy of the bank passbook or
bank certificate containing Name, Bank Account Number and IFS code should be submitted.
In case of more than one nominee, percentage share value for all the nominees must be integer. Decimals/Fractional values shall
Subscriber’s Nomination
5 8 not be accepted in the nomination(s). Sum of percentage share across all the nominees must be equal to 100. If sum of percentage
Details
is not equal to 100, entire nomination will be rejected.
Signature / Thumb impression should only be within the box provided in the form. Thumb impression, if used, should be attested
Declaration by
6 12 by the nodal officer with the official seal and stamp. Left Thumb Impression in case of male and Right Thumb Impression in case of
Subscriber
female.

General Information for Subscribers

a) The Subscriber can obtain the status of his/her application from CRA and their designated nodal officer.
b) Subscribers are advised to retain the acknowledgement slip signed/ stamped by the designated nodal officer where they submit the application.
c) For more information / clarifications, contact CRA:
Website: https://www.npscra.nsdl.co.in
Call: 022-2499-4200
e-mail: [email protected]
Address: C entral Recordkeeping Agency, NSDL e-Governance Infrastructure Limited, 1st Floor, Times Tower, Kamala Mills Compound, Senapati Bapat Marg,
Lower Parel (W), Mumbai - 400 013.