2nd Nominee 3rd Nominee 3 Relationship with the Nominee1st Nominee2nd Nominee3rd Nominee 4 Percentage Share1st Nominee2nd Nominee3rd NomineeTotal 100 5 1st Nominee2nd Nominee3rd No ID: 153412
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1. Name of the Nominee:1st Nominee2nd Nominee3rd NomineeFirst NameFirst NameFirst NameMiddle NameMiddle NameMiddle NameSurname/last nameSurname/last nameSurname/last name2. Date of Birth (In case of a minor):1st Nominee 2nd Nominee 3rd Nominee 3. Relationship with the Nominee:1st Nominee2nd Nominee3rd Nominee 4. Percentage Share:1st Nominee%2nd Nominee%3rd Nominee%Total %100 %5. 1st Nominee2nd Nominee3rd NomineeFirst NameFirst NameFirst NameMiddle NameMiddle NameMiddle NameSurname/last nameSurname/last nameSurname/last nameSignature/Left Thumb Impression of the SubscriberSignature of WitnessName and address of Witness402-RN REQUEI, S/o / W/o and holding Permanent Retirement Account vide number (PRAN) do hereby nominate the person(s) more particularly described hereunder on the day of (month & year) in respect of the accumulated pension wealth in my permanent retirement account in the National Pension System in the event of my death. I understand that in the event of my death all rights to the accumulated pension wealth shall Sys 2 : D:\C\2013\C-134-13-NSDL CRA-Subscriber Nomination