(Under Regulation 8 of PFRDA (Exits & Withdrawals under NPS) Regulations 2015 and amendments thereto)
Partial Withdrawal Form for Tier I account under NPS
(Please fill all the details in CAPITAL LETTERS & in BLACK INK only)
For Nodal Office use:
PAO/DTO/POP/POP-SP Reg. No.:
Receipt No.:
PRAN Ack No. (Generated by CRA System):
Entered By: Date:
Verified By: Date:
Please select your Category (please tick тИЪ)
Government Sector
Corporate Sector
All Citizens of India
NPS Lite / Swavalamban
To, NPS Trust Sir/Madam,
I holding a Permanent Retirement Account under National Pension System, hereby submit partial withdrawal request for withdrawal from my Tier I account under NPS and give below the necessary details:
Section A тАУ SubscriberтАЩs Personal Details:
PRAN*
Name of the Subscriber*
a. % of Partial Withdrawal*: % (Maximum 25% of own contribution (without accrued income earned thereon) only)
b. Purpose of withdrawal* (please tick тИЪ on box below with reason applicable):
1. For Higher education of children including a legally adopted child
2. For the marriage of children, including a legally adopted child
3. For the purchase or construction of a residential house or flat in own name or in a joint name with legally wedded spouse (it is not available for already owned flat/house)
4. For treatment of specified illnesses: for subscriber, his legally wedded spouse, children, including a legally adopted child or dependent parents (please tick тИЪ)
a. Cancer
b. Kidney Failure (End Stage Renal Failure)
c. Primary Pulmonary Arterial Hypertension
d. Multiple Sclerosis
e. Major Organ Transplant
f. Coronary Artery Bypass Graft
g. Aorta Graft Surgery
h. Heart Valve Surgery
i. Stroke
j. Myocardial Infarction
k. Coma
l. Total blindness
m. Paralysis
n. Accident of serious/ life threatening nature
o. COVID-19
5. To meet medical and incidental expenses arising out of the disability or incapacitation suffered by the subscriber
6. For skill development/re-skilling or any other self-development activities (Please refer instruction no 11)
Enter course fee:* Rs. (*mandatory if subscriber opts for withdrawal under skill development)
7. For establishment of own venture or any start-up (Please refer instruction no 12)
c. Bank Account details of the Subscriber (Details of Bank Account registered in CRA system)
Bank Account No.
Bank Name
Type of Account
Savings Account
Current Account
Branch Name & Address
IFS Code
Ver 1.2
Section B тАУ Declarations
Declaration by the Subscriber*:
1. I hereby declare that information stated above is true and correct to the best of my knowledge & belief and that I have completed minimum of three years in to the NPS as required for partial withdrawal and eligible to withdraw the amount requested above due to the urgent need of funds to support the reason mentioned above.
2. I (name) with PRAN agree that in case of any failure of Direct Credit, for any reason whatsoever or wrong credit to another account (but as per my details), NPS Trust / CRA shall not be responsible. I also agree that NPS Trust / CRA shall not be responsible/liable for any losses that may arise due to incorrect Bank Account details registered in the CRA system.
3. Self Declaration - I submit the request for partial withdrawal and the amount thus withdrawn shall be utilised for the purpose of declared reasons as specified by PFRDA exit regulations. I am fully responsible and accountable to spend the amount thus withdrawn for the stated reason.
Date
Place :
Signature / Thumb Impression of the Subscriber**
** Left thumb impression in case of illiterate male claimant and Right thumb impression in case of illiterate female
Declaration by Nodal Office - For Government sector Subscribers (Not Applicable if Subscriber has submitted online request in CRA):*
I/We hereby declare that the subscriber Sh./Smt/Kum with PRAN is employed with us and Self Declaration for partial withdrawal has been accepted by him/her and bank details submitted in respect of partial withdrawal are correct.
Date
Registration No. of DDO:
Signature & stamp of the DDO
Date
Registration No. of PAO/CDDO/DTO:
Signature & stamp of the PAO/CDDO/DTO
Declaration by POP/Aggregator - For Non Government sector Subscribers (Not Applicable if Subscriber has submitted online request in CRA):*
I/We hereby declare that the subscriber Sh./Smt/Kum with PRAN has signed/thumb impressed before me after he/she has read the entries/have been read over by him/her for the request of partial withdrawal under NPS. Self Declaration for partial withdrawal has been accepted by him/her and bank details submitted in respect of partial withdrawal are correct.
Date
Registration No. of POP-SP/NL-CC/CHO:
Signature & stamp of the Authorised person at POP-SP/NL-CC/CHO
Date
Registration No. of POP/NL-AO:
Signature & stamp of the Authorised person at POP/NL-AO
ACKNOWLEDGMENT RECEIPT Acknowledgment slip to the NPS Subscriber on receipt of partial withdrawal application form (To be filled by DDO/CDDO/PAO/DTO/POP/Aggregator)