Annexure G1
Subscriber Grievance Registration Form
(to be used by subscriber only)
1. Subscriber Information:
NAME
PRAN ( Permanent Retirement Account Number) *
2. Grievance * First Reminder Earliar Grievance No. (If reminder)
3. Nature of the Grievance * : (Please tick the respective block which is applicable to you)
A. Grievance against CRA
1. Incorrect PRAN account details (on registration) 2. Statement of transaction not received.
1.1) Personal 3. Change in signature / photograph request not updated
1.2) Employment
1.3) Nomination
1.4) Scheme setup
B. Grievance against PAO/Nodal Office
1. Change request updated incorrectly 6. Change in subscriber details without subscriber consent
1.1) Incorrect Personal details 6.1) Personal details
1.2) Incorrect Employment details 6.2 Nomination details
1.3) Incorrect Nomination details 6.3) Scheme setup details
1.4) Incorrect Scheme setup. 6.4) Switch instruction
2. Change request given but not updated in account 7. Contribution not reflected
2.1) Personal details 8. Incorrect contribution amount
2.2) Employment details 9. Request for duplicate PRAN card not initiated by PAO
2.3) Nomination details 10. Request for I-Pin reissue not initiated by PAO
2.4) Scheme setup details 11. Request for T-Pin reissue not initiated by PAO
3. Switch instruction executed incorrectly
4. Switch instruction not executed.
5. Delay in executing switch instruction
Provisional Receipt Number/ transaction id(if applicable)
4. Details of the grievance *(Not more than 2000 characters)
Date of Receipt
Signature of the subscriber CRA stamp (to be filled at CRA)
Instructions for filling the form
1. Fields marked as (*) are mandatory.
2. This form is to be used by the subscriber only
3. Please quote the Provisional Receipt Number if available.
4. Please tick the nature of grievance in Sr. No. 3 and mention the details in the Sr. No. 4. If space is insufficient please attach additional sheet
mentioning the PRAN and grievance details.
5. This form is to be submitted at CRA address, NSDL, 4th Floor, 'A' Wing, Trade World, Kamala Mills Compound, Senapati Bapat Marg,
Lower Parel, Mumbai-400013
6. You can check the status of the grievance by quoting the ticket no at the CRA website or enquire at call center
7. The ticket number for reference and grievance resolution letter will be sent at the email id registered with CRA and to the PAO email id. If you
have not registered the email id, please provide the same.