Common Application Form
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1
2COMMON APPLICATION FORM
Please read instructions before filling the Form
FOR LUMPSUM AND SIP INVESTMENTS
Application No :
Key Partner / Agent Information
For Office Use Only
Distributor / Broker ARN
Sub-Broker Code
Unique Identity No.
ARN -
E027111
64615
(Of Individual ARN holder or Of employee / Relationship
Manager / Sales Person of the Distributor)
I/We hereby confirm that the EUIN box has been intentionally left blank by me/us as this is an “execution-only” transaction without any interaction or advice by the employee/relationship
manager/sales person of the above distributor or notwithstanding the advice of in-appropriateness, if any, provided by the employee/relationship manager/sales person of the distributor
and the distributor has not charged any advisory fees on this transaction. (Please refer Instruction no. 1 (f) on Page no. 21)
Upfront commission shall be paid directly by the investor to the AMFI registered Distributors based on the investors’ assessment of various factors including the service rendered by the distributor.
For details on trasaction charges payble to distributors, plese refer to KIM.
Transaction Charges
1
Default
(Please tick any one of the below. For details refer Page No.13)
I am an existing investor in Mutual Funds
1
I am a first time investor in Mutual Funds
OR
(Rs. 100/- will be deducted as transaction charges for subscription of Rs. 10,000/- and above)
(Rs. 150/- will be deducted as transaction charges for subscription of Rs. 10,000/- and above)
Existing Unitholder Details : Pl. fill in Folio Number below. Pl. furnish PAN details in section 1 and then proceed to section 2.
Name of Sole /
Folio Number, if any
First Unitholder
1. Applicant’s Personal Details
4
(Mandatory for Minor)
D D
M M
Y Y Y Y
Date of Birth
Mr. / Ms. / M/s.
Name
PAN/KRN
3
Enclosed (please 3)
KYC Compliance Proof
2
Guardian (if Sole / First applicant is a Minor) Contact Person (in case of Non-individual Investors only)
Mr. / Ms. / M/s.
D D
M M
Y Y Y Y
Name
Date of Birth
Enclosed (please 3)
KYC Compliance Proof
2
PAN/KRN
3
Relation
Father
Mother
Court appointed Guardian
4
Mailing Address [Please provide full address. P. O . Box Address is not sufficient. Indian Address in case of NRIs / FIIs]
Overseas Address (Mandatory in case of NRI / FII applicant)
City
PIN
City
PIN
State
Country
State
Contact Details
Phone
Residence
Fax
Office
Mobile
I/we wish to receive Account Statements / Allotment Advice, Annual Reports and other statutory as well as
other information documents by email in lieu of physical documents (Please 3)
Yes
No
(Where the investor has not specified any choice or has applied for both the choices, the application
E-mail
will be processed as if the investor has opted for default choice i.e. Yes)
Individual
Partnership
Company
Society / Club
HUF
FII
Trust
Minor
Body Corporate
Status (please 3)
NRI Repatriable
NRI Non - Repatriable
Others
(Please specify)
Occupation
Private Sector Service
Public Sector / Government Service
Business
Professional
Agriculturist
Retired
(please 3)
Housewife
Politically Exposed Person
Forex Dealer
LLP
Others (Please specify)_________________________________
Mode of holding (please 3)
Single
Joint
Anyone or Survivor (Default Option is Anyone or Survivor)
(Only for non - demat mode)
SECOND APPLICANT
(No joint holderwhere minor is First holder)
D D
M M
Y Y Y Y
Date of Birth
Mr. / Ms. / M/s.
Name
Enclosed (please 3)
KYC Compliance Proof
2
PAN/KRN
3
ThIRD APPLICANT
(No joint holderwhere minor is First holder)
D D
M M
Y Y Y Y
Date of Birth
Mr. / Ms. / M/s.
Name
Enclosed (please 3)
KYC Compliance Proof
2
PAN/KRN
3
POA hOLDER DETAILS
(If the investment is being made by a Constituted Attorney please furnish the details of POA Holder)
Mr. / Ms. / M/s.
Name
Enclosed (please 3)
KYC Compliance Proof
2
PAN/KRN
3
Refer instruction no. 12 on page no. 18
2.
Demat Account Details
(Optional)
Please ( 3)
NSDL
CDSL
DP ID #
Beneficiary Account No.
DP Name
I
N
(# Not applicable in case of CDSL).
The details of the Bank Account linked with the Demat A/c as mentioned in the next page should be provided under section 4.
2
KYC Instructions (Please refer Instruction on page no. 22)
3
PAN Instructions (Please refer instruction on page no. 20)
4
For documentation please refer instruction on page no. 20.
Acknowledgement Slip
Application No :
(To be filled by the Applicant)
Received from
Mr. / Ms. / M/s.
an application for Units
Name of the Scheme
Date
D D
M M
Y Y Y Y
Option
Amount (Rs.)
Along with Cheque / DD No.
Dated
D D
M M
Y Y Y Y
Drawn on Bank / Branch
Signature, Stamp & Date
Please Note : All purchases are subject to realisation of cheques / demand drafts.
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