Physical submission of ‘Form A1’ by New Joinees intending to opt for UPS by 30.09.2025 – reg.

aera fafer fafrarse sie fare urfetrpecr PENSION FUND REGULATORY AND DEVELOPMENT AUTHORITY Circular Circular No: PFRDA/2025/11/SUP-CG-SG/04 September 19, 2025 To, All the stakeholders of NPS and UPS Subject: Physical submission of ‘Form Al’ by New Joinees intending to opt for UPS by 30.09.2025 - reg. The Unified Pension Scheme (UPS) has been notified by the Central Government vide notification F. No. FX-1/3/2024-PR, dated 24.01.2025 issued by Dept. of Financial Services, Ministry of Finance. Further, the PFRDA (Operationalization of the Unified Pension Scheme under NPS) Regulations, 2025 were notified on 19.03.2025 and the Central Civil Services (Implementation of Unified Pension Scheme under National Pension System) Rules, 2025 have been notified by DoPPW on 02.09.2025. 2. It has been observed that several New Joinees who entered Central Government service on or after 01.04.2025, and are posted at various locations, may not yet have submitted their form for generation of Permanent Retirement Account Number (PRAN). 3. In view of the impending deadline for exercising the option under the Unified Pension Scheme, i.e., 30th September, 2025, it is hereby brought to the attention of all concerned that: All employees who joined Central Government service on or after 01.04.2025 and intend to opt for the Unified Pension Scheme may physically submit the duly filled Form A1 to their respective nodal offices/ or the Head of the training Institute/ or the Head of their current Institute, as applicable, on or before the specified due date. Thereafter, the Head of Institutes, shall be required to forward the same to the cadre controlling authority or the DDO, where the employees shall be posted. 4. A copy of the Form A1 is annexed to this circular for reference. (Vikas Kumar Singh) Chief General Manager Annexure: Form Al ¥—500, cfax—¥, raat da, ged Se Bex Aish ane aes feceh—110029 GkTy : 91—11— 40717900, daerge : www.pfrda.org.in E-500, Tower -E, Fifth Floor, World Trade Center, Nauroji Nagar, New Delhi-110029 Phone : 91-11-40717900, Website : www.pfrda.org.in140 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II]—SEC.4] Form A1 UNIFIED PENSION SCHEME (UPS) — SUBSCRIBER REGISTRATION FORM - Government Sector Exercise of Option to be covered under Unified Pension Scheme (UPS) and to avail its Benefits Name of CRA Paste recent atid PRAN in Yes No If yes, please submit details as per Annexure I photograph of Select your category [Please tick (V)] 3.5 cm x 2.5 cm Central Government size / passport size To, National Pension System Trust Dear Sir/Madam, Ly oeeecesceeseeesencesecesseeeseeeseecseeesneeenseseeeesaeseaueessesesaeaeseeteneesseenesees Son/Daughter of Mr IMYS... 0. cece ee ceee rec eeecneecnenenseeeeseenses having joined Central Government service on.............. and having read and fully understood the provisions of the Unified Pension Scheme (UPS) as _ notified by the Central Government vide notification F.No. FX-1/3/2024-PR, dated 24/01/2025 and PFRDA (Operationalisation of Unified Pension Scheme under National Pension System) Regulations, 2025, as amended from time to_time, and being eligible to opt for Unified Pension Scheme, do hereby exercise the option to be covered under Unified Pension Scheme (UPS). urther, I hereby acknowledge that this option exercised by me shall be final and irrevocable. I hereby request that an UPS account be opened in my name as per the particulars given below: * indicates mandatory fields. Please fill the form in English and BLOCK letters (Refer general guidelines at instructions page.) 1. PERSONAL DETAILS: (Refer Sr. No. 1 of the instructions) Use Annexure II if name exceeds the space provided below Salutation* | | Shri | | Smt | | Kumari Applicant Name* Father’s Name Mother’s Name Orphan Status* | Yes | | No Either Father’s or Mother’s name is mandatory* Select the name to appear Father’s Mother’s on PRAN Card* Name Name Date of Birth* Lo} mim [ylylyiy] Place of Birth* Country of Birth* PAN* | | | | | | | Nationality* | Applicant Gender* Male Female Transgender Marital Unmarried Married Status* Legally wedded Spouse Male Female Transgender Legally wedded Gender (if married) * Spouse DOB (if married) * Legally wedded Spouse Name (if married)* Income Range (per annum) Below 1 lac to 5 Slacto10 | 10 lac to 25 lac to Above 1 * 1 lac lac lac 25 lac 1 Cr Cr Please Tick if Applicable Politically exposed Related to Politically (Refer instruction person exposed person no. 1) 2. PROOF OF IDENTITY and ADDRESS (POI / POA)* (Any one of the following to be submitted) Passport Passport Expiry Date Driving License Driving License Expiry Date Government ID Voter ID Card Card CKYC Number | National Population Register Proof of possession of Provide last Four Digits. Redact or black-out first 8 digits of the Aadhaar Aadhaar number on submitted copy (Refer Sr. No. 2 of the instruction) 3. ADDRESS DETAILS* Line 1 7 Line 2[aT ave 4] ATST BT UST: TATATOT 141 District State/U.T. | Country PIN Code 4. CONTACT DETAILS* Mobile* | Telephone with STD code | Email ID* | 5. BANK DETAILS* (Proof to be submitted - Refer Sr. No. 3 of the instructions) Account Type Saving A/c Current A/c Bank A/c Number Bank Name [IFS Code I hereby declare that, the bank account detail provided are salary bank account. 6. SELECTION OF PENSION FUND (PF) AND INVESTMENT CHOICE? (Refer Sr no. 4 of the instructions) Default Pattern (pension funds and investment Pattern as determined by the Please Tick (v) one Authority) I would like to choose my Pension Fund and investment choice (Please select below) Pension Fund (Please Tick (V) one) Investment Choice (Please Tick (V) one) Aditya Birla Sunlife Pension Axis Pension Fund Mgmt Mgmt Ltd Limited DSP Pension Fund HDFC Pension Fund Active Choice (i.e. 100% in Govt Managers Pvt Ltd Memt Ltd Securities) ICICI Prudential Pension Kotak Mahindra Pension Funds Mgmt Co Ltd Fund Ltd or LIC Pension Fund Limited Max Life Pension Fund Conservative Mgmt Ltd Auto Choice (LC25) SBI Pension Funds Private TATA Pension Management Moderate Limited Private Ltd (LC50) UTI Pension Fund Limited If no Pattern is chosen, the contributions will be invested as per default Pattern 7, FATCA®* (Foreign Account Tax Compliance Act) & CRS DECLARATION (Refer Sr no. 5 of the instruction): I am a tax resident of India and not resident of any I am a tax resident of the country/ies mentioned other country below US Person Yes | | No Particulars Country (1) Country (2) Country (3) Country/countries of Tax Residency Address Line 1 Address in the City/Town/ jurisdiction for Tax Village Residence State ZIP/Post Code Tax Identification Number (TIN)/Functional equivalent Number TIN/ Functional equivalent Number Issuing Country Validity of documentary evidence provided (Wherever applicable)142 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEc.4] Signature / Thumb I have understood the information requirement of the Form (read along with the FATCA / Impression* of CRS Instructions and Terms & Conditions) and hereby confirm that the information Applicant (refer provided by me/us on this Form is true, correct and complete and hereby accept the same. instructions) 8. DECLARATION BY APPLICANT* (Refer Sr no. 6 of the instructions) I have read and understood the terms and conditions of the Unified Pension Scheme (UPS). The information and documents furnished by me are true and correct, to the best of my knowledge. Any changes in the information furnished by me shall be informed to CRA / NPS Trust. I understand that I shall be fully liable for submission of any false or incorrect information or documents. I authorize the CRA, NPS Trust or any other entity connected with UPS to collect and share data/ details of my necessary personal information for the purpose of the said scheme regulated under the PFRDA Act, 2013 and the relevant regulations notified thereunder. Declaration under the Prevention of Money Laundering Act, 2002 I hereby declare that the contribution paid by me/on my behalf has been derived from legally declared and assessed sources of income. I understand that NPS Trust has the right to peruse my financial profile or share the Signature / Thumb Impression* of information, with other government authorities. I further agree that NPS Trust Applicant has the right to close my PRAN in case I am found violating the provisions of (*LTI in case of males and RTI in any law relating to prevention of money laundering. case of females to be provided. Toe impression in case no hands) Date | | | | | | Place | 9. DECLARATION BY NODAL OFFICER (All * Mark fields are Mandatory) Employment Details (At the time of exercise of UPS option) Date of wee Date of Superannuation* joining Date of commencement of qualifying service* Employee Code/ID* Post (Optional) B B (non- Gr oup Op(tOpitoinonaall ) A (Gazetted)| | Gazetted) other Service(Optional) IAS IPS IFS Group A Group B other Basic Pay* Pay Scale (Optional) Name of the office* Department* Ministry* DDO Registration PAO / CDDO / PrAO Number* Registration Number*[ATT WI—ars 4] ATST BT UST: TATATOT 143 *Qualifying Service as defined in Regulation 2(k) read with Regulation 13 of PFRDA (Operationalisation of Unified Pension Scheme under NPS) Regulations, 2025. It is certified that Shri./Smt./Kumati...........ccccccccscescesccesccesctcceteceeeseesteeseeugeeegens is employed in this office and the details provided in this subscriber registration form have been verified as per service record. The given address and officially valid documents (OVDs) of KYC are verified by this office. Also, it is further certified that he/she has read entries/entries have been read over him/her by us and got confirmed by him/her. Name of DDO Name of PAO Signature of DDO Signature of PAO DDO Code No. PAO Code No. (As per record in CRA (As per record in CRA System) System) Seal of DDO Seal of PAO Date Date Place Place ACKNOWLEDGEMENT Name of the Subscriber PEt TEE ETT EE eee tee te ey ey TE Date of Receipt of Application: INSTRUCTIONS FOR FILLING THE SUBSCRIBER REGISTRATION FORM General guidelines (a) Please fill in legible handwriting to avoid errors. Do not overwrite. Corrections should be countersigned by the applicant. Applications incomplete in any aspect (or) if mandatory fields are left blank (or) with unclear photograph (or) not accompanied by required documents (or) not authenticated by the Nodal Office are liable to be rejected. (b) Copies of documents submitted by the applicant should be self-attested. (c) Applicant is advised to retain the acknowledgement slip signed / stamped by the designated nodal officer where they submit the application. Item SI No Item Details Instructions (a) If the name has more than 30 digits, fill Annexure II for the same. Fathers Name, . . Mother’s Name (o) If the applicant is an Orphan, he/she may leave the fields blank. However, an official document to support the status to be submitted. 1 {1 Politically Exposed Person’s (PEPs) are individuals who are or have been ponucaly entrusted with prominent public functions such as heads of state or of the Porson government, senior politicians, senior government, judicial or military officials, senior executives of state-owned corporations, important political party officials . If the applicant is submitting Aadhaar as proof of Identity, the first 8 digits of 2 |? Proof of Identity the Aadhaar number should be redacted / masked on the submitted copy. For UPS account opening through physical form (FORM A1) bank details and 3 15 Bank Details documentary proof are mandatory. Please submit a cancelled cheque / copy of bank passbook / bank statement / bank certificate / letter from Bank containing applicant’s Name, Bank Name, Bank Account Number and IFS Code. Selection of Government employee/subscribers can exercise choice of Pension Funds and Pension Fund allocate their investments either in Asset Class ‘G’ under ‘Active Choice’ or in 4 16 (PF) & Life Cycle Funds - LC 50 or LC 25 under ‘Auto Choice’. Investment If no choice is provided, the contributions will be distributed among the default Choice Pension Funds and investment pattern selected by the Government.144 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II]—SEC.4] Clarification / Guidelines on filling details if applicant residence for tax purposes in jurisdiction(s) outside India: e Jurisdiction(s) of Tax Residence: Since US taxes the global income of its citizen, every US citizen of whatever nationality, is also a resident for tax purpose in USA. e Tax identification Number (TIN): TIN need not be reported if it has not been issued by the jurisdiction. However, if the said jurisdiction has issued a high integrity number with an equivalent level of identification (a “Functional equivalent”), the same may be reported. Examples of that type of number for FATCA & CRS individual include, a social security /insurance number, citizen/personal identification/services code/number and resident registration number). 5 | 7&8 Declaration / Signature by e In case applicant is declaring US person status as ‘No’ but his/her Country of Applicant Birth is US, document evidencing Relinquishment of Citizenship should be provided or reasons for not having relinquishment certificate is to be provided. e In case applicant is declaring US person status as ‘Yes’, provide PAN and ‘father name’ in addition to details required under section 9 of form. e In case the applicant is unable to affix signature, Left Thumb Impression in case of male and Right Thumb Impression in case of female should be affixed and in case there is no hands, toe impression of the applicant to be provided. The thumb / toe impression should be attested by two persons, one of whom should be the designated nodal officer attesting the same under his/her official seal and stamp. General Information for Subscribers a) The Subscriber can obtain the status of his/her application from CRA and respective Nodal Office. b) Subscribers are advised to retain the acknowledgement slip signed/ stamped by the designated respective nodal office where they submit the application. c) For more information / clarifications, contact CRA: Website: Call: Address of CRA. Annexures - Subscriber Registration Form for Government Sector applicants (Jick and fill applicable annexures below) Annexure I - Print PRAN Card in Hindi (Fill the details in Devanagari script) Applicant’s First Name Middle Name Last Name Father / Mother’s First Name Middle Name Last Name Annexure II - If Alphabets of name exceeded the space provided on page 1 of the application form Applicant’s First Name Middle Name Last Name Father’s First Name Middle Name Last Name Mother’s First Name Middle Name Last Name