Page 1 Application form for Corporate Registration


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Annexure CHO-1

Application form for Corporate Registration

(Please fill all the details in CAPITAL LETTERS & in BLACK INK only. All Fields mark with * are mandatory.) CorporateRegistration Number:
(To be allotted by CRA)
Sir/Madam, We hereby submit a request to be registered as aCorporate. The necessary details are provided below: 1. Name of the Corporate*:

3. Head Office/ Registered OfficeAddress*: Flat/Unit No, Block no. * Name of Premise/Building/Village Area/Locality/Taluka
District/Town/City * State / UnionTerritory *
Country *

Pin Code * 4. Phone No. *:
6. Fax No.*:

STD Code

Phone Number

5. MobileNo.

7. Email ID * (Email ID should be official Email ID of the HO & not of any individual person):

8. Nodal Officer’s Details *: Name *: First Name *:
Middle Name:
Last Name:

Designation *:

Phone No. *:

STD Code Phone Number

Email ID *:

Mobile No.

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

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Annexure CHO-1 9.Alternate Nodal Officer’s Details *:
Name * : First Name *:
Middle Name :
Last Name:

Designation *:

Phone No. *: Email ID *:

STD Code

Phone Number

Mobile No.:

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(Note : Email ID & Phone Number should be of the alternate Nodal Officer’s and not the HO’s Email ID and any Board Number.)

10.a Corporate PAN Details:

10.b Corporate TAN Details:

11. Corporate Office is Co-Contributor (Please tick only one):

Yes

No

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

Corporate 0

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:

Please select the type of investment model - Option A (Refer Note No. 1,2 and 3 on page 3)

Option B

Option A: (Central Government Model)

Option B: (In case Option B is selected, indicate your PFM Selection, Investment Option and Asset Allocation)

PFMSelection:

PFM Name (in alphabetical order) ICICI Prudential Pension Funds Management Company Limited

Please tick only one (Select only one PFM)

IDFC Pension Fund Management Company Limited

Kotak Mahindra Pension Fund Limited

Reliance Capital Pension Fund Limited

SBI Pension Funds Private Limited

UTI Retirement Solutions Limited

(i)

Investment option : Active Choice

(ii)

Asset Allocation (Refer Note No. 5 on page 3)

Asset Class % share

E(Cannot exceed 50%)

Auto Choice

C

G

Total 100%

14. CRA Charges to be borne by

-

Employer

15. PRAN card & PIN mailer to be despatched to - Corporate HO/ CBO

Employee Employee’s Address

Annexure CHO-1

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We hereby declare and agree that we have read and understood the Offer Document, terms and condition. 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.

Corporate Head Office Seal

Signature of Authorized Signatory

Name : ___________________________________

Place : __________________

Designation : ________________________________ Department : ________________________________

Date :

-

-

D D MM Y Y

To be Filled by POP

A. POP Registration No.

B. Submitted Certificate of Incorporation: Yes

No

POP Seal

Signature of Authorized Signatory

Name : ___________________________________

Place : __________________

Designation : ________________________________ Department : ________________________________

Date :

-

-

D D MM Y Y

[To be filled by CRA]

Received by: __________________________________

Received at:____________________________________

Date:______________

Acknowledgement Number (by CRA)

_____________________________________________________________________________________________________________________________ Note 1. Option ‘A’ refers to investment model with three PFMs (as is the case for Central Government Model). Option ‘B’ refers to investment model with single PFMs (as is the case for All Citizen Model in NPS)

2. In Option ‘A’ in Central Government Model, funds are distributed to three PFMs viz. LIC Pension Fund Limited, SBI Pension Funds Private Limited and UTI Retirement Solutions Limited as per the allocation ratio prescribed by NPS trust periodically.

3. Examples of E, C and G mix are as follows:-

E (Equity)
50% (max) 50% (max) 0% 0% 0% 30% 20%

C (Fixed Income) 25% 30% 50% 100% 0% 30% 50%

G (Government Securities) 25% 20% 50% 0% 100% 40% 30%

Document to be Submitted to POP : Documents as a proof for KYC on the status of corporate/entity

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Page 1 Application form for Corporate Registration