NSDL S2
NSDL S2
NSDL S2
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)
I hereby request for the following details for the change. (Please tick )
I hereby submit the following details of change. (Please tick the box on left margin of appropriate row where change/correction is required and provide
the details in the corresponding rows.)
Middle Name
Last Name *
2. PAN No.
Middle Name
Last Name *
Would you like to have a reprint of the card on account of changes in point 1 or 3 (Please tick) Yes No
4. Present Address:
Flat/Unit No, Block no. *
Name of Premise/Building/Village
Area/Locality/Taluka
District/Town/City *
Country *
Pin Code *
Name of Premise/Building/Village
Area/Locality/Taluka
District/Town/City *
Annexure S2 Page 2
State / Union Territory *
Country *
Pin Code *
7. Mobile No.
8. Email ID
Bank Name *
Bank Branch *
Bank Address *
Pin Code *
4. Percentage Share *:
1st Nominee % 2nd Nominee % 3rd Nominee %
T-PIN I-PIN
Date :
Signature/Left Thumb
D D M M Y Y Y Y Impression of Subscriber