Annexure UOS-S12
Withdrawal form for Tier II account under NPS
(Please fill all the details in CAPITAL LETTERS & in BLACK INK only)

Sir/Madam,
I hereby submit withdrawal request for Tier II and give below the necessary details:
PRAN :
Name of the Subscriber : ___________________________________________________________________________________
Type of withdrawal (Please Tick):
Partial Withdrawal Amount to be withdrawn:
(In Figures)
Amount in words : _________________________________________________________________
Complete Withdrawal
Preferred Mode of Withdrawal ECS Account Payee Cheque
(Refer to Instruction No. 7)
Instruction for filling the Form:
1. All fields marked with are mandatory. All dates should be in DDMMYYYY format.
2. The Subscriber shall submit the application only to the POP-SP with which they are currently registered with CRA for Tier 1I
3. Before submitting the withdrawal form, Subscriber should ensure that the Subscriber's bank account is active. If he/she intends to
make any correction in the details he/she can submit Subscriber Details Change Request and should get all the details updated prior
to submission of withdrawal request form.
4. In case of complete withdrawal, the total contributions under Tier II will be remitted to the Subscriber.
5. Partial withdrawal request shall be rejected if sufficient balance is not available in Subscriber’s Tier II account.
6. Withdrawal amount received after the execution of the withdrawal request can be different from the requested amount to the extent
of difference in NAV of two different days.
7. (i). In case of ECS, the amount shall be directly credited to the bank account of the subscriber as per details available in the CRA
database
(ii). In case of account payee cheque, it shall be sent to the present address of the subscriber registered in the CRA. The Trustee
Bank shall deduct the postal charges, as applicable, and forward the cheque for the net amount to the subscriber.
Date : Acknowledgement Number :
(Generated by NPSCAN)
Signature/ Thumb
Impression of the Subscriber
I _____________________________________________________________ , the applicant, do hereby declare that
Information stated above is true to the best of my information & belief.
Date :
D D M M Y Y Y Y
TO BE FILLED/ATTESTED BY POP-SP
Rubber Stamp of the POP-SP Name and Signature of the POP-SP
For POP-SP use:
POP-SP Registration No.:______________
Receipt No.:
Entered By: ___________________________ Date: __________________
Verified By: ___________________________ Date: __________________