Intimation by Pension Fund of investment under Schedule V [Table: Sl. No. 7] (within one month from the end of the quarter ending on 30th June, 30th September, 31st December and 31st March of the financial year)

Part A: Particulars ofthe Pension Fund

1.

Name:

(refer Note 1)

2.

Address:

(refer Note 2)

3.

Permanent Account Number (PAN):

4.

E-mail Id:

5.

Contact Number:

Country

Code

Number

Part B: Other Details

6.

Notification Number:

7.

Notification Date:

8.

Quarter Ending:

(refer Note 3)

9.

Financial Year:

Part C: Particulars of Investment

Sl. No.

Date of

investment

Amount of

investment

Nature of

investment

(refer Note 4)

Nature of

income

(refer

Note 5)

Details of the entity in which Investment made

Nature of

entity

(refer

Note 6)

Name

PAN

A

B

C

D

E

F

G

H

1.

2.

(Repeat, if

required)

Total

Verification

I, , solemnly affirm that to the best of my knowledge and belief, the information provided in this form is correct and complete and particulars shown therein are truly stated. I further declare that to the best of my knowledge, I have not concealed any relevant fact or information.

I also declare that I am making this intimation in my capacity as (designation) and that I am holding PAN and I am competent to verify and submit this intimation.

Nature of Investment

Code

Debt

1

Equity

2

Preference Shares

3

Others (Please specify)

4

Nature of Income

Code

Interest

1

Dividends

2

Capital Gains

3

Others (Please specify)

4

Nature of entity in which investment is made

Code

Business Trust referred to in Schedule V [Table: Sl. No. 7.D(a)(iii)(A)]

1

Eligible Infrastructure Facility referred to in Schedule V [Table: Sl. No. 7.D(a)(iii)(B)]

2

Eligible Alternative Investment Fund referred to in Schedule V [Table: Sl. No. 7.D(a)(iii)(C)]

3

Eligible Domestic Company referred to in Schedule V [Table: Sl. No.

7.D(a)(iii)(D)]

4

Eligible Non-Banking Financial Company referred to in Schedule V [Table: Sl. No. 7.D(a)(iii)(E)]

5