Any appeal against the order passed by the designated member of the Authority under this regulation shall lie with the Securities Appellate Tribunal, as provided in section 36 of the Act.
HEMANT G. CONTRACTOR, Chairperson [ADVT.-III/4/Exty./203/14] Annexure I. Key details to be captured for filing of grievances with the Ombudsman
1. Name, address, contact number and e-mail address of the complainant
2. Permanent Retirement Account Number (PRAN), if available
3. CRA/POP/Other Intermediary/Other Pension Scheme Acknowledgement Reference Number (in case of reminder)
4. Nature of complaint type/category a. Registration b. Contributions c. Investment option (Tier I/II) d. Subscriber Account e. Investment management i. Disclosures ii. Unit allocation iii. Performance 24 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC. 4] f. Portability of investments i. Change in location ii. Change in fund manager iii. Change in scheme g. Charges and fees h. Annuity and commutation at retirement i. Process ii. Valuation i. Premature Withdrawals i. Process ii. Valuations j. Service quality i. Intermediary ii. Website iii. Key comments k. Any other grievance not listed above.
5. Dates and details of earlier correspondence with the intermediary under National Pension System or any other pension scheme.
6. Dates and details of correspondence of escalation of grievance with the National Pension System Trust
7. Enclosures, if any
SCHEDULE [See regulation 22 (2)] FORM (FOR OFFICE USE ONLY) Complaint Number Year Date of Receipt (TO BE FILLED UP BY THE COMPLAINANT) To The Ombudsman /Pension Fund Regulatory and Development Authority (* give address of the office of the Authority or the address of the Ombudsman having jurisdiction ……) Dear Sir/Madam, Sub: Complaint against …………………….(Name of the intermediary or entity under National Pension System or any other pension scheme)
1. DETAILS OF THE COMPLAINANT:
Sr. No. Particulars Details 1 Name (s) 2 Full Address 3 Contact No. Tel. No.
Mobile No 4 Email ID ¹Hkkx IIIµ[k.M 4º Hkkjr dk jkti=k % vlk/kj.k 25
2. DETAILS OF THE COMPLAINT:
Sr.
No.
Particulars Details Remarks 1 Subject Matter/Grounds of the complaint 2 Details of the complaint If space is not sufficient, please enclose separate sheet 3 Name of the intermediary/entity against which complaint has been made Please enclose a copy of the complaint 4 Address and contact details of the intermediary/entity 5 Date of the Complaint made to the intermediary/entity 6 Unique Grievance Number provided by intermediary 7 Whether any reminder was sent by the complainant YES/NO If yes, please enclose a copy of the reminder
8. Whether any reply has been received by the complainant YES/NO If yes, please enclose a copy of the reply of the intermediary under National Pension System or any other pension scheme
9. If yes, whether the complainant is satisfied with the reply YES/NO 10 Date of representation by the complainant to the National Pension System Trust Please enclose a copy of the representation 11 Whether any reminder was sent by the complainant to the National Pension System Trust YES/NO If yes, please enclose a copy of the reminder 12 Whether the complainant has received any reply of the intermediary or National Pension System Trust after representation with National Pension System Trust YES/ NO If yes, please enclose a copy of the reply of the intermediary or National Pension System Trust
3. NATURE OF RELIEF SOUGHT FROM THE OMBUDSMAN/AUTHORITY…..…………………………………… (Please enclose - a copy of documentary proof, if any, in support of your claim)
4. DECLARATION
1. I/ We, the complainant/s herein declare that:
(a) the information furnished herein above is true and correct; and
(b) I/ We have not concealed or misrepresented any fact stated in aforesaid columns and the documents submitted herewith.
2. The complaint is filed before expiry of prescribed period reckoned in accordance with the provisions of these regulations.
26 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC. 4]
3. (i) The subject matter of the present complaint has never been brought before the Office of the Pension Fund Regulatory and Development Authority/Ombudsman by me/or by any one of us or by any of the parties concerned with the subject matter to the best of my/our knowledge.
(a) The subject matter of the present complaint is not in respect of the same which was settled through the Office of the Pension Fund Regulatory and Development Authority/Ombudsman in any previous proceedings.
(b) The subject matter of the present complaint has not been decided by any forum/court.
OR
(ii) The subject matter of the present complaint is pending since….. (please mention the date when the matter was filed) before …… (*Please mention the name of the forum/court/ before whom pending …. ) and the proceedings are likely to take longer time in its final adjudication as contemplated in the regulations.
4. I/We authorise the intermediary or entity under National Pension System or any other pension scheme provider to disclose any such information/ documents furnished by us to the Pension Fund Regulatory and Development Authority/Ombudsman and disclosure whereof in the opinion of the Pension Fund Regulatory and Development Authority/Ombudsman is necessary and is required for redressal of any other complaint or our complaint.
5. I/We have carefully gone through the provisions of the Pension Fund Regulatory and Development Authority (Redressal of subscriber Grievance ) Regulations, 2015.
Yours faithfully (Signature) (Complainant ) NOMINATION/AUTHORISIATION – (If the complainant wants to nominate/authorise his representative, not being a legal practitioner, to appear and make submissions on his behalf before the Ombudsman, the following declaration should also be submitted.)
I/We the above named complainant/s hereby nominate Shri/Smt…………………………...………………….. who is not a legal practitioner and whose address is …………………………………………………………………………………as my/our REPRESENTATIVE in all proceedings of this complaint and confirm that any statement, acceptance or rejection made by him/her shall be binding on me/us. He/She has signed below in my presence.
ACCEPTED (Signature of Representative) (Signature of Complainant) Printed by the Manager, Government of India Press, Ring Road, Mayapuri, New Delhi-110064 and Published by the Controller of Publications, Delhi-110054.