vert Annexure III to CSRF ADDITIONAL NOMINATION FORM INSTRUCTIONS FOR FILLING IN THE FORM “The detis of rominess fo whom the standing pension woah ofthe subserber ie payable in cas of tho demise ofthe subscriber before entre srocood ae withdrawn st be proves hereunder (Pleas refer ineucion 5), Asa, plea note tai cate of doze ote subscriber ater oping ‘ordsfered whdrawal athe oustanding peion weal poser inte NPS accoun! a tbe subserbe shall be wihdrawn upon ees We request and pald othe nominees as metioned inthis frm and the same would be Weated asl and final dschage of te obigaton ery nominate tne persona) mentones low wn iar member my fei a reele be amount in my PRAN aczount under Naonl Pension System inthe evento my eth, 1. Name ofthe Nominee Mile Name dao Name Miao Name LastName. LastName LastName 2. Present Communication addres ofthe nominees: '3, Data of Bit (Only incase of mio: 4. Relationship with the Nominee: 5. Percentage Sh TetNeminoe na Nomine | [rt Nomnee % 6, Nominee's Guardian Detals (Onn caso ofa minor ‘et Nominge's Guardian De 2nd Nominee's Guardian Det Fret Name Fist Name FirstName: Mile Name ide Name Mia Name Datad tis ____¢ayot__20 at ‘Sigrated Thunb impression’ ofthe SubserbeAnnexure III to CSRF ‘TO BE FILLEDIATTESTED BY POP-SP/DD0 Certied that he above decaaton and nominaton deta has boon signe thumb impressed before me by ShiSmbNés, after ho she have rea the ones entes have been read over fo him herby me and got onemad by Pin he Rubber Stamp of the POP-SPIODO Signature ofthe Authorised Person POP-SPIODO Rogstraton Numbor (@otes by CRA) ate ' 1 Designation of he Authors Person POP-SPIOD0 Office Name ‘TO GE FILLEDIATTESTED BY POP/POP-SPIPAOIDTOIDTAIPrAO Rubber Stamp of the POPIPOP-SPIPAOIDTOIDTAIPAD POPIPOP-SPIPADIOTOIDTAPYAO Registation Number (Altea by CRAY “Slant of he Authored Peon