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Section A: Change in Personal Details

Annexure CS-S2 Page 1 Request For Change /Correction in Subscriber Master Details And/Or Reissue of I-Pin/T-Pin/PRAN Card (To avoid mistake(s), please read the accompanying instructions carefully before filling up the form) PRAN is mandatory. Fill only the field(s)which is/are to be modified with the revised Details . I hereby request for the following Details for the Change . (Please tick ) (A) Changes or Correction in Personal Details (other than DOB) (D) Reissue of PRAN Card (B) Changes or Correction in Nomination Details (E) Changes or Correction in Date of Birth (C) Reissue of I PIN and/or T PIN Permanent Retirement Account Number *: I hereby submit the following Details of Change .

1. Full Name (Full expanded name: Initials are not permitted) Please Tick as applicable Shri Smt. Kumari First Name * Middle Name Last Name If the correction in the name to be made in Hindi, Yes (Please provide the details in the annexure on Page No. 7) 2. Gender : Male Female 3. PAN (PAN should be supported by copy of PAN card) 4.

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