PENSION FUND REGULATORY AND DEVELOPMENT AUTHORITY

CONSENT DOCUMENT/APPLICATION FOR REGISTRATION AS AGGREGATOR UNDER NATIONAL PENSION SYSTEM (NPS) - LITE FOR MEMBERS OF <ORGANIZATION NAME>

Table of Contents
Table of Contents........................................................................................................................ 2 I.Letter of Consent....................................................................................................................... 3 II.Aggregator Compliance Sheet..................................................................................................5 Annexure 1: etails of Customer !ase an" Ser#ices $en"ere"..................................................% Annexure 3: Commercial &n"erta'ing.......................................................................................11 Annexure (: )ormat for pro#i"ing *o#ernance Structure...........................................................12 Annexure 5: Technical + ,anpo-er Capacit. &n"erta'ing.......................................................13 Annexure/0: )ormat for see'ing exemption1relaxation of an. eligibilit. criteria..........................1( Annexure/2: eclaration of etails of Consortium 3artner.........................................................15

I.

Letter of Consent

(to be provided on company/official letter head) Date DDth Month, YYYY To XYZ Executive Director en!ion "und #e$ulatory Development %uthority !t & "loor, '(%D# )uildin$, lot *o + ,a!ant -un. 'n!titutional %rea ha!e/'', *e0 Delhi/&&1121 3ub4/ 5etter of (on!ent for #e$i!tration a! %$$re$ator under *ational en!ion 3y!tem (* 3) / 5ite for member! of 67r$ani8ation *ame9 Dear 3ir/Madam,

'/0e, the under!i$ned, have examined and familiari!ed me/our!elve! 0ith :#e$ulation! for %$$re$ator! under * 3 5ite ;1&1< and :7peratin$ =uideline! for %$$re$ator!< pre!cribed by "#D%> ;> ?e are de!irou! of bein$ enli!ted a! an :%$$re$ator under * 3 5ite< for providin$ pre!cribed !ervice! to the potential * 3 5ite !ub!criber! belon$in$ to 67r$ani8ation *ame9> ?e hereby a$ree to perform activitie! pre!cribed in :7peratin$ =uideline! for %$$re$ator< and other a!!ociated rule!/$uideline! pre!cribed by "#D% from time to time> @> ?e confirm that 0e have under!tood and a$ree to abide unconditionally by all the reAuirement! a! !et out in :#e$ulation! for %$$re$ator! under * 3 5ite ;1&1<> B> "urther, 0e al!o undertaCe to !i$n !eparate a$reement(!) 0ith "#D% or it! de!i$nated a$ency in the format pre!cribed by "#D%, if reAuired> D> *ece!!ary detail! 0ith !upportin$ document! are attached 0ith thi! con!ent letter in pre!cribed format for con!ideration of our reAue!t> +> '/0e under!tand that "#D% re!erve! the ri$ht to accept or re.ect our propo!al 0ithout a!!i$nin$ any rea!on thereof>

't i! hereby confirmed that '/0e are entitled to act on behalf of our corporation/company/firm/or$ani8ation and empo0ered to !i$n thi! letter a! 0ell a! other !uch letter!/document! 0hich may be reAuired for re$i!tration> Dated thi! Day of ;1&1

(3i$nature)EEEEEEEEEEE

*ame4EEEEEEEEEEEEEEEEEEEEEE

('n the capacity of)EEEEEEEEEEEEEEEEEEEE

Duly authori8ed to !i$n the (on!ent letter for and on behalf of4

(*ame and %ddre!! of 7r$ani8ation)

(3eal/3tamp of 7r$ani8ation)

II.

Aggregator Compliance Sheet

Name of the Entity Entity is Registered with (please tick) Ref: Section 9.1 & 9.2 of the regulations Societies Registration Act 1860 ( or a State amendment of this Act) ndian !rusts Act" 1862 #harita$le and Religious !rusts Act" 1920 ndian #om%anies Act" 19&6 ( section 2&" for not for %rofit com%anies) ndian #om%anies Act 19&6 necessar( certification from R) *)+#s) 'ith (for Attested co%( of such certificate is %ro-ided .es *o

ndian #om%anies Act 19&6" for an( other com%an( ,thers" if an( (%ls. s%ecif() Registered Address

Entity Background Ref: Section 19 of the regulations

/ominant %romoter grou% detail co-ering share holding %atterns

,rgani0ation )rief %ro-ided( on a se%arate sheet) .es *o

Entity is in business As on date of a%%lication" of financial services 2ess than 3 .ears or commodity 3 to & .ears development for Ref: Section 9.1 of the regulations & to 10 .ears 4ore than 10 .ears

)alance Sheet of last 3 (ears %ro-ided .es *o

Entity has net-worth As on date of a%%lication of 2ess than Rs &0 2a5h Ref: Section 9.6 of the Rs &0 2a5h or more regulations 67ual to or more than Rs 1 #rore

*et8'orth #ertificate #hartered Accountant %ro-ided .es *o

from is

E isting customer base and !ervices Rendered

Statement Anne ure %ro-ided .es *o

"

in is

Entity status

financial 9hether entit( has incurred loss in %receding financial (ears .es *o

Ref: Section 9.1 of the regulations #isciplinary $roceedings #eclaration

/irectors :%romoters etc ha-e not $een su$;ected /eclaration to an( disci%linar( %roceeding(s) under the rules" Anne ure % regulations and $(e8la's of an( %ro-ided regulator:disci%lining $od( during the last three Ref: Section 9.10 of .es (ears the regulations *o &ommercial 'ndertaking Ref: Section 1& of the regulations 6ntit( is entitled for recei-ing remuneration as %rescri$ed $( <+R/A #ommercial underta5ing Anne ure ( %ro-ided .es *o )overnance !tructure 6ntit( must ha-e formal go-ernance structure /etails ()oard" 4anaging #ommittee or e7ui-alent) 'ith Anne ure * mem$ers on $oard ha-ing ade7uate e=%erience in %ro-ided Ref: Section 9.& of the financial ser-ices : social de-elo%ment and regulations .es ade7uate ca%acit( to handle financial acti-ities *o +echnical , 6ntit( must ha-e ade7uate technical infrastructure >nderta5ing -anpower &apacity to %erform *<S acti-ities Anne ure . %ro-ided

in is

in is

in is

in is

Ref: Section 9.? of the regulations /ighest daily cash <ls furnish the figure in 'ords and num$ers $oth: collection ( 0n Rs) Ref: Section 10 of the regulations

.es *o Attach certificate from #hartered Accountant

!eeking f entit( is see5ing rela=ation in 6ligi$ilt( criteria" Anne ure 2 is e emption1rela ation %ro-ided of any eligibility .es criteria *o Ref: Section 9.11 of the regulations &onsortium #etails partner f Aggregator is %ro%osing to underta5e *<S 2ite acti-ities in consortium 'ith other entities" Anne ure 3 is %ro-ided .es *o

Ref: Section 1? of the regulations

/ated this

/a( of

2010

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/ul( authori0ed to sign this underta5ing for and on $ehalf of:

(*ame and Address of ,rgani0ation)

(Seal:Stam% of ,rgani0ation)

Annexure 1: Details of Customer Base and Services Rendered

6=isting #ustomer #ount across all Ser-ices (as on date of a%%lication) 'hich 'ould $e co-ered under *<S 2ite !(%es of Ser-ices Rendered to e=isting customer $ase +inancial *on +inancial )oth +inancial & *on +inancial 2ist of Ser-ices <ro-ided (%ls. use additional sheets if necessar()

!hree (ear %ro;ections for #ustomer $ase( for its core co-erage $usiness) and targets for *<S 2ite .ear 1: co-erage .ear 2: .ear 3: /ata demonstrating cash handling ca%acit( An( other details demonstrating customer:cash handling ca%acities

#ore $usiness

*<S

<lease furnish details to demonstrate e=isting ca%a$ilit( and %ro%osed ca%acit( $uilding( if an() to underta5e *<S 2ite 'or5

/ated this

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2010

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/ul( authori0ed to sign this underta5ing for and on $ehalf of:

(*ame and Address of ,rgani0ation)

(Seal:Stam% of ,rgani0ation)

Annexure

: Legal !nderta"ing

t is here$( confirmed that :'e are entitled to act on $ehalf of cor%oration:com%an(:firm:organi0ation and em%o'ered to %ro-ide this underta5ing that" (i)

our

*o %enalties ha-e $een im%osed on our organisation:its %romoters:directors and no ma;or strictures ha-e $een %assed $( an( court of la' or $( an( regulator( $od(:disci%lining authorit( during the last three (ears *o disci%line case is %ending against the organisation or its %romoters:directors as on date of this declaration

(ii)

/ated this

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2010

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/ul( authori0ed to sign this underta5ing for and on $ehalf of:

(*ame and Address of ,rgani0ation)

(Seal:Stam% of ,rgani0ation)

Annexure #: Commercial !nderta"ing

t is here$( confirmed that :'e are entitled to act on $ehalf of our cor%oration:com%an(:firm:organi0ation and em%o'ered to %ro-ide this underta5ing that m( institution" if registered as Aggregator under *<S 2ite $( <+R/A" shall not charge an( fees:ser-ice charge from su$scri$ers for %ro-iding *<S 2ite ser-ices. 9e also confirm that 'e 'ould onl( recei-e fi=ed sum to'ards these ser-ices" as %rescri$ed $( <+R/A in Regulations for Aggregators under *<S 2ite. !his commitment is -alid for the entire duration of the registration %eriod and an( e=tension granted thereto. :9e commit to %ro-ide information regarding ser-ices %ro-ided $( m(:our institution at such inter-als as ma( $e %rescri$ed $( <+R/A from time to time.

/ated this

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2010

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/ul( authori0ed to sign this underta5ing for and on $ehalf of:

(*ame and Address of ,rgani0ation)

(Seal:Stam% of ,rgani0ation)

Annexure $: %ormat for providing &overnance Structure

An entit( should %ro-ide details of its Ao-ernance structure co-ering: 1. )oard structure 2. 2ist of nde%endent directors 3. 4onitoring mechanism 1. #ash handling:monitoring mechanism &. 4echanism for detection:control of frauds etc 6. #ustomer grie-ance redressal %rocess ?. An( other rele-ant matter

Annexure ': (echnical ) *anpo+er Capacit, !nderta"ing

t is here$( confirmed that :'e are entitled to act on $ehalf of our cor%oration:com%an(:firm:organi0ation and em%o'ered to %ro-ide this underta5ing that m(:our institution" is ha-ing necessar( technical & man%o'er ca%acit( for %ro-iding *<S 2ite ser-ices. 9e ha-e in e-er( $ranch" ade7uate ! nfrastructure for accessing the #RA s(stem. 9e also ha-e necessar( infrastructure and ca%a$ilit( to demonstrate and electronicall( transmit *<S su$scri$er contri$ution and information as %er %rescri$ed timelines. 9e also ha-e ca%a$ilit( to esta$lish necessar( $ac5 office s(stems" %rocedures and soft'are for recei-ing transaction re7uests and u%load into #RA s(stem" issuing of ac5no'ledgment etc as laid do'n in o%erating guidelines.

9e also declare that all indi-iduals assigned on *<S related acti-ities ha-e necessar( ca%a$ilit( and 'ould $e trained on all o%erational issues to ensure %ro%er discharge of *<S related res%onsi$ilities $efore their de%lo(ment

/ated this

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2010

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/ul( authori0ed to sign this underta5ing for and on $ehalf of:

(*ame and Address of ,rgani0ation)

(Seal:Stam% of ,rgani0ation)

Annexure-.: %ormat for see"ing exemption/relaxation of an, eligi0ilit, criteria

!4No 1.

Reference in Regulation (&lause No4 , $age No4)

E tent of #eviation

Brief Reason

/ated this

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2010

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/ul( authori0ed to sign this underta5ing for and on $ehalf of:

(*ame and Address of ,rgani0ation)

(Seal:Stam% of ,rgani0ation)

Annexure-1: Declaration of Details of Consortium 2artner

t is here$( confirmed that :'e are entitled to act on $ehalf of our :com%an(:firm:organi0ation and em%o'ered to %ro-ide this underta5ing that m(:our institution" is creating a consortium of one or more entit( for %ro-iding *<S 2ite ser-ices. n *<S 2ite m(:our institution 'ould act as <rimar( Aggregator and details of our consortium %artner(s) is mentioned $elo':

Name Consortium Partner 1 Consortium Partner 2

Registered 'nder

Registered Address

(More rows could be added based on number of consortium partners)

4(:our institution also understands that $eing a <rimar( Aggregator 'e 'ould $e res%onsi$le for meeting all eligi$ilit( re7uirements and all res%onsi$ilities arising out of their enlistment as aggregator under *<S lite. 9e also declare that $elo' details: su%%orting documents of our consortium %artner (s) is %ro-ided along 'ith this consent document: Attested co%( of Registration certificate ,rgani0ation )rief )alance Sheet of last 3 (ears Anne=ure 2 & & /eclaration of consortium <artner #o%( of 4,> $et'een <rimar( Aggregator and #onsortium %artner(s)

9e also declare that in *<S 2ite m(:our institution and our consortium %artner 'ould $e ma%%ed as mentioned $elo'. *<S 2ite ,-ersight ,ffice 'ould $e *<S 2ite Accounts ,ffice 'ould 4(:our nstitution (Only Primary Aggregator would be Oversight Office)

$e *<S 2ite #ollection #entre 'ould $e

/ated this

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2010

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*ame:@@@@@@@@@@@@@@@@@@@@@@

( n the ca%acit( of)@@@@@@@@@@@@@@@@@@@@

/ul( authori0ed to sign this underta5ing for and on $ehalf of:

(*ame and Address of ,rgani0ation)

(Seal:Stam% of ,rgani0ation)