Ver 1.

FORM: 601 PW NATIONAL PENSION SYSTEM (NPS)

(Under Regulation 8 of PFRDA (Exits & Withdrawals under NPS) Regulations 2015 and amendments thereto)

Partial Withdrawal Form for Tier I account under NPS

(Please fill all the details in CAPITAL LETTERS & in BLACK INK only.)
For Nodal Office use
6500384
PAO/DTO/POP/POP-SP Reg. No.

Receipt No.:

110085899670
PRAN
Ack No.
1000872703
(Generated by CRA System)

Entered By: 110085899670 Date: 29/09/2023

Verified By: Date:

Please select your Category (please tick √ )

Government Sector √ Corporate Sector

All Citizens of India NPS Lite/ Swavalamban

To,
NPS Trust
Sir/Madam,

I MANJUNATHSWAMY NAGARAJ HIREMATH holding a Permanent Retirement Account under National Pension
System, hereby submit partial withdrawal request for withdrawal from my Tier I account under NPS and give below the necessary details:

Section A – Subscriber’s Personal Details:

PRAN* 110085899670
Name of the Subscriber* MANJUNATHSWAMY NAGARAJ HIREMATH

a. % of Partial Withdrawal* 25 % (Maximum 25% of own contribution (without accrued income earned thereon) only)
b. Purpose of withdrawal* (please tick √ on box below with reason applicable )

1. For Higher education of children including a legally adopted child

2. For the marriage of children, including a legally adopted child

√ 3. For the purchase or construction of a residential house or flat in own name or in a joint name with legally wedded spouse (it is
not available for already owned flat/house)
4. For treatment of specified illnesses: for subscriber, his legally wedded spouse, children, including a legally adopted child or
dependent parents (please tick √ )

a. Cancer b. Kidney Failure (End Stage Renal Failure)

c. Primary Pulmonary Arterial Hypertension d. Multiple Sclerosis
e. Major Organ Transplant f. Coronary Artery Bypass Graft
g. Aorta Graft Surgery h. Heart Valve Surgery
i. Stroke j. Myocardial Infarction
k. Coma l. Total blindness
m. Paralysis n. Accident of serious/ life threatening nature
o. COVID-19
5. To meet medical and incidental expenses arising out of the disability or incapacitation suffered by the subscriber
6. For skill development/re-skilling or any other self-development activities (Please refer instruction no 11)
Enter course fee:* Rs.
*mandatory if subscriber opts for withdrawal under skill development
7. For establishment of own venture or any start-up (Please refer instruction no 12)

c. Bank Account details of the Subscriber (Details of Bank Account registered in CRA system)

Bank Account No. 06142020000644

Bank Name SYNDICATE BANK

Type of Account Savings Account √ Current Account

Branch Name & Address CHIDRI LOCHANNA COMPLEX HAGARI BOMMANAHALLI

IFS Code CNRB0010614

Form submitted using OTP Authentication (through Email

and Mobile)

2023.09.29.12.38.00

1 of 2
Ver 1.2

Section B – Declarations
Declaration by the Subscriber*:

1. I hereby declare that information stated above is true and correct to the best of my knowledge & belief and that I have completed minimum of three
years in to the NPS as required for partial withdrawal and eligible to withdraw the amount requested above due to the urgent need of funds to support
the reason mentioned above.

2. I MANJUNATHSWAMY NAGARAJ HIREMATH (name) with PRAN 110085899670 agree that in case
of any failure of Direct Credit, for any reason whatsoever or wrong credit to another account (but as per my details), NPS Trust / CRA shall not be
responsible. I also agree that NPS Trust / CRA shall not be responsible/liable for any losses that may arise due to incorrect Bank Account details
registered in the CRA system.

3. Self Declaration:- I submit the request for partial withdrawal and the amount thus withdrawn shall be utilised for the purpose of declared reasons as
specified by PFRDA exit regulations. I am fully responsible and accountable to spend the amount thus withdrawn for the stated reason.

Date 29/09/2023

Place :
Signature / Thumb Impression of the Subscriber**
** Left thumb impression in case of illiterate male claimant and Right thumb impression in case of illiterate female

Declaration by Nodal Office - For Government sector Subscribers (Not Applicable if Subscriber has submitted online request in CRA):*

I/We hereby declare that the subscriber Sh./Smt/Kum

with PRAN is employed with us and Self Declaration for partial withdrawal has been accepted by him/her
and bank details submitted in respect of partial withdrawal are correct.

Date

Registration No. of DDO

Signature & stamp of the DDO

Date

Registration No. of PAO/CDDO/DTO

Signature & stamp of the PAO/CDDO/DTO

Declaration by POP/Aggregator - For Non Government sector Subscribers (Not Applicable if Subscriber has submitted online request in CRA):*

I/We hereby declare that the subscriber Sh./Smt/Kum

with PRAN has signed/thumb impressed before me after he/she has read the entries/have been
read over by him/her for the request of partial withdrawal under NPS.Self Declaration for partial withdrawal has been accepted by him/her and bank details
submitted in respect of partial withdrawal are correct.

Date

Registration No. of POP-SP/NL-CC/CHO

Signature & stamp of the Authorised person at POP-SP/NL-CC/CHO

Date

Registration No. of POP/NL-AO

Signature & stamp of the Authorised person at POP/NL-AO

ACKNOWLEDGMENT RECEIPT
Acknowledgment slip to the NPS Subscriber on receipt of partial withdrawal application form
(To be filled by DDO/CDDO/PAO/DTO/POP/Aggregator)

Received from PRAN

110085899670

DDO/POP-SP/NL-CC Registration Date 29/09/2023

Number: COR650038C

PAO/CDDO/DTO/POP/NL-AO Received at
Registration Number 6500384

Acknowledgement Number
1000872703

2 of 2
Ver 1.2

FORM: 601 PW
(Under Regulation 8 of PFRDA (Exits & Withdrawals under NPS) Regulations 2015 and amendments thereto)

Instructions
Instructions for filling up the form:

1. All fields marked with * are mandatory. All dates should be in DDMMYYYY format.
2. The Subscriber shall initiate the Partial Withdrawal request online in the CRA system (www.cra-nsdl.com) through OTP Authentication/eSign. On
successful OTP Authentication/eSign, submission of physical Form/documents to your Nodal Office and/or authorization of request by Nodal Office is
not required.
3. Subscriber’s Mobile No. and Email ID are mandatory. For updation of Mobile No. and Email ID in CRA records, the Subscriber has an option to update
the same online in CRA system (www.cra-nsdl.com) or submit Form S2 – Subscriber details change Form to associated Nodal Office. The Form S2 is
available on CRA website (www.npscra.nsdl.co.in).
4. No supporting documents (w.r.t. stated withdrawal reason) are required to be submitted by the Subscriber for availing Partial Withdrawal. The
Subscriber is required to accept the “Self-declaration’’ for Partial Withdrawal which is provided on Page 2 under section - Declaration by the
Subscriber.
5. The withdrawal amount shall directly be credited to the bank account of the subscriber as registered in the CRA System. Before submitting the withdrawal
request, subscriber should ensure that the bank account details registered in CRA are correct. If Subscriber wishes to update any other Bank Account
details, then the Subscriber has an option to update the same online in CRA system (www.cra-nsdl.com) or submit Form S2 – Subscriber details change
Form to associated Nodal Office before initiating withdrawal request.

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. Subscriber should specify the purpose of Partial Withdrawal.
8. Subscriber should be in the NPS at least for a period of 3 years. A subscriber shall be permitted to withdraw not exceeding 25% of the contributions
made by such subscriber to his/her individual pension account.
9. In case, the subscriber already owns either individually or in the joint name a residential house or flat, other than ancestral property, no withdrawal under
PFRDA regulations is permitted.
10. Treatment of specific illness covers the subscriber, his legally wedded spouse, children, including a legally adopted child or dependent parents suffer
from the specified illness, which shall comprise of hospitalization and treatment.
11. Withdrawal under skill development/re-skilling is applicable as per following conditions:
• Skill Development program/activities sponsored by employer for employees is not eligible for partial withdrawal.
• Amount which can be released under Skill Development option shall be subject to the actual fee of the course/training, subject to the maximum
ceiling of 25% of employees own contribution without considering returns thereto.
• Duration of the course should be of 3 months or more.
• The course should be either a regular program or distance education program or a skill development program.

12. Withdrawal under establishment of own venture or any start up is applicable to subscribers registered under All India Citizen (UOS) sector only.

13. For further details regarding point no 11 & 12 kindly refer PFRDA Circular No: PFRDA/2018/55/Exit/5 dated August 06, 2018.

14. The permitted withdrawal shall be allowed only if the eligibility criteria and limit for availing the benefit are complied with by the subscriber.

15. Frequency: the subscriber shall be allowed to withdraw only a maximum of three times during the entire tenure of subscription under the National
Pension System.
16. In OTP Authentication, two distinct OTPs will be sent on your registered Mobile Number and email ID respectively. In case, you update Mobile Number
and/or email ID after initiation of request, then OTPs will be sent on updated Mobile Number and/or email ID.
17. For more detailed description of Partial Withdrawal option under NPS, please refer Regulation 8 of PFRDA (Exits & Withdrawals under NPS) Regulations
2015 and amendments thereto.

18. If OTP Authentication/eSign is not possible/not successful or if Subscriber is not able to initiate online request, then,
• The Subscriber shall submit the physical Partial Withdrawal Form to the respective Nodal Office/POP/Aggregator for processing of request.
Subscriber should also attach the bank proof (cancelled cheque/copy of bank passbook/bank certificate) with the Form submitted.
• The Nodal Office/POP/Aggregator must verify the details of the bank account of subscriber. If the Bank Account details given in the application are
different from the Bank Account details registered in CRA system, then request shall be rejected by Nodal Officer/POP/ Aggregator.
• The Nodal Office/POP/Aggregator shall capture and authorise Partial Withdrawal request in CRA system (www.cra-nsdl.com).
19. Physical Withdrawal Form is not required to be submitted to CRA.