Free Door-Step Service Save Tax… Get Rich !! Give a Missed Call: 94 8300 8300 or SMS: <Your Name> to 94 8300 8300 or Send Email: SaveTaxGetRich @ gmail.com Save Tax…Under Section 80C, Indian Government allows every Individual to invest Rs. 1 Lakh and save on tax. Get Rich!! One can invest Rs. 1 Lakh p.a. in a monthly fashion (Rs. 8,333/- p.m.) and compounding the investment at a healthy rate and create wonderful fortune in life and get super rich!! Returns Rate 10 Years 15 Years 20 Years 25 Years 30 Years 12% 19.65 Lacs 41.75 Lacs 80.69 Lacs 1.49 Crore 2.70 Crore 15% 23.34 Lacs 54.71 Lacs 1.78 Crore 2.44 Crore 4.999 Crore Get in touch with us…. We can do more…. Free Door-Step Service
Save Tax! Missed Call: Free Door-Step ServiceGet Rich… 94 8300 8300About ELSS Mutual Funds:There are various options available to you, to save tax under section 80C of Income tax Act, likePublic Provident Fund (PPF), National Savings Certificate (NSC), 5-Year FD, Insurance Policy.When compared to these traditional tax savings instruments, an Equity Linked Savings SchemeMutual Fund (ELSS MF) is more opportunistic for you, as it provides a shorter lock-in period ofthree years and potential for higher returns, which are exempt from taxes. ELSS MFs provideopportunities aimed at harnessing the benefits of investing in equity and also providing taxbenefits. Your Salary Income Tax By investing in ELSS MF, You can Slab Save Up to Rs. 2,00,000/- 0% - 2,00,001 – 5,00,000/- 10% Rs. 10,000/- 5,00,001 – 20% Rs. 20,000/- 10,00,000/- Above 10,00,000/- 30% Rs. 30,000/-Comparison of various Tax Saving Instruments: ELSS PF / PPF 5-Year FD Insurance NSC ELSS Mutual Instrument (LIC, ULIP) Fund Lock-In Period 15 Years 5 Years More than 5 Years 5 Years / 3 Years 10 Years (Shortest) Returns History 8.8% Around 8% Varies, but there 8.6% / 9% - 12.9% (at end of lock- are a lot of 8.9% for the top in period) deductions and performing charges. funds Any Hidden No No Yes No No Charges Do you have to No No Varies between Yes No pay Tax on schemes Profit / Returns Earned? Preference for 2 3 5 4 1* Investment* What should you choose? You should choose ELSS Mutual Fund for saving tax since it is thebest option considering the above.Save Tax! Missed Call: Free Door-Step ServiceGet Rich… 94 8300 8300
Save Tax! Missed Call: Free Door-Step ServiceGet Rich… 94 8300 8300Our Recommendation:Based on comparison of some of the Top Performing Mutual Funds, Invest in any of the ELSSFunds below. DSP-BR Tax Saver Fund ICICI Pru Tax Plan Reliance Tax Saver Returns History Returns History Returns History 1 Year 3 Years 5 Years 1 Year 3 Years 5 Years 1 Year 3 Years 5 Years 14.1% 26.2% 16.8% 11.8% 38.6% 37.4% 18.0% 44.1% 28.7% ₹10,000/- invested has become Rs.10,000/- invested has become Rs.10,000/- invested has become ₹11,410 ₹12,620 ₹11,680 ₹11,180 ₹13,860 ₹13,740 ₹11,800 ₹14,410 ₹12,870Mutual Fund investments are subject to market risks, read all scheme related documentscarefully.Instructions For Filling up the forms: 1. Depending on the funds of your choice, write an A/C Payee Crossed Cheque favoring: I. “DSP BlackRock Tax Saver Fund” II. “ICICI Prudential Tax Plan” III. “Reliance Tax Saver Fund” 2. In the attached Application Forms, fill your: I. Name, Address, Email Id, Phone Number II. PAN Number III. Nominee Details IV. Cheque and Bank Details V. Your Signature in the space provided for “Sole/First Applicant” 3. Give us a Missed Call at 94 8300 8300 to pick up the application/for any guidance.We will provide Free Service / Assistance within 24 hours.Save Tax! Missed Call: Free Door-Step ServiceGet Rich… 94 8300 8300
Save Tax! Missed Call: Free Door-Step ServiceGet Rich… 94 8300 8300We provide various financial services including: 1. Tax Planning and Saving. 2. Retirement Planning using Mutual Funds. 3. Life Insurance Planning (We have insured more than 100 people for an amount of Rupees 1 Crore each at a cost of less than Rs. 40/- per day). We recommend The Best “Term Insurance Plans” only. 4. Children’s Donation and Recurring Education Fees Planning. 5. Financial Planning for Buying Your Own House/Apartment/Site. 6. Full-fledged Financial Planning for All Your Life’s Goals. 7. Mutual Fund Recommendations. 8. Child Insurance Plans with Triple Benefits.We would love to provide our services to you, and your Friends, Colleagues and Relatives.Kindly provide their contact details so that we can help them also:Sl. Name Contact Number (Mobile) Email Id. (if Where do theyNo. available) work?Save Tax! Missed Call: Free Door-Step ServiceGet Rich… 94 8300 8300
APPLICATION FORM Please read instructions before filling this Form01-08-2012 V2.2012 Application No.: Distributor Name and ARN Sub Broker Code Branch / RM Code For Office use only Raghavendra Prasad Raghavendra Prasad ARN - 74461 Distributor Contact No:ARN - 74461 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. 1. TRANSACTION CHARGES (Please refer instructions and tick any one) Applicable for transactions routed through a distributor who has ‘opted in’ for transaction charges. I am a First Time Investor in Mutual Fund Industry. I am an Existing Investor in Mutual Fund Industry. (Rs 150 will be deducted.) (Rs 100 will be deducted.) 2. FIRST APPLICANT’S DETAILS Name of First Applicant (Should match with PAN Card) Gender Male Female Title Mr. Ms. M/s Existing Folio Number For Investments “On behalf of Minor” (* Attach Mandatory Documents as per instructions). Date of Birth Proof of DoB Birth Certificate School Certificate / Mark sheet (Mandatory for minor) attached * Passport Any other …………….….......................……. PAN (1st Applicant / Guardian) Guardian named below is : Father Mother Court Appointed* Enclose KYC Acknowledgement PoA PAN* Name of Guardian if minor / Contact Person for non-individuals / PoA Holder name: KYC* Correspondence Address *PoA PAN & KYC is mandatory Landmark City Pin Code State (Mandatory) Status of Sole/1st Applicant (Please tick ) Resident Individual On Behalf Of Minor HUF Sole Proprietorship NRI (Repatriable) NRI (Non-Repatriable) LLP Partnership Firm Company AOP/BOI Body Corporate Trust Society FII FOF - MF schemes Provident Fund Superannuation / Pension Fund Gratuity Fund Bank / FI Government Body Insurance Companies Others (Please specify) DSPBR eServices Email ID (in capital) Mobile +91 Fax DSPBR eSMS STD Code Tel. (Off) Tel. (Resi.) DSPBR Online Yes, I wish to have a PIN for internet / telephone transactions and agree to terms and conditions of PIN Issuance NEW PIN (Please tick ) and Usage as available in SID/SAI and www.dspblackrock.com Email ID, Date of Birth, Mobile Number, PAN are mandatory details for issuance of PIN and Online Facility. 3. JOINT APPLICANTS’ DETAILS Mode of Holding (Please tick ) Joint (Default) Anyone or Survivor Single Name of Second Applicant (Should match with PAN Card) Title Mr. Ms. M/s PAN (2nd applicant ) Enclose KYC Acknowledgement Name of Third Applicant (Should match with PAN Card) Title Mr. Ms. M/s PAN (3rd applicant ) Enclose KYC Acknowledgement ACKNOWLEDGEMENT SLIP (To be filled in by the investor) DSP BLACKROCK MUTUAL FUND Received, subject to realisation, verification and conditions, an application for purchase of Units as mentioned in the application form. Application No. From Cheque no. Date Amount Scheme
4. BANK ACCOUNT DETAILS (Refer Instruction 4 and avail Multiple Bank Registration Facility) Bank Name Bank A/C No. A/C Type Savings Current NRE NRO FCNR Others Branch Address City Pin IFSC code: (11 digit) MICR code (9 digit) (This is a 9 digit number next to your cheque number) 5. INVESTMENT AND PAYMENT DETAILS (Refer Instruction 5) (Cheque DD should be in favour of “Scheme Name”) Scheme/Plan /Option/Sub Option DSP BlackRock - TAX SAVER FUND - Growth Option Scheme Plan Option/Sub Option (Default plan/option/sub option will be applied incase of no information, ambiguity or discrepancy) One time Lump sum Investment: Please fill the details hereunder. Do not submit SIP Auto Debit Form. Payment Mode: Cheque DD RTGS NEFT Funds transfer Cheque/RTGS/ NEFT/DD DateLUMPSUM Cheque/DD/RTGS/NEFT No. Payment from Pay In A/c No. Amount (Rs.) (i) Bank A/c No. DD charges, (Rs.)(ii) Bank Name Total Amount (Rs.) (i) + (ii) In figures Branch In Words Account Type Savings Current NRE NRO FCNR Documents Attached to avoid Third Party Payment Rejection, where applicable: Bank Certificate, for DD Third Party Declarations SIP: Systematic Investment Plan. Please fill up SIP Auto Debit form and attach with this form . First SIP Cheque Details: (Mention Amount in SIP Auto Debit Form) (Refer instruction 4(i) on Third Party Payments)SIP Cheque / DD No. Drawn on Bank A/c No. Pay In A/c No. Cheque/DD Date Bank & Branch 6. NOMINATION DETAILS (Refer Instruction 6) Individuals (single or joint applicants) are advised to avail Nomination facility. I/We wish to nominate. I/We DO NOT wish to nominate and sign here 1st Applicant Signature (Mandatory) Nominee Name Guardian Name (In case of Minor) Allocation % Nominee/ Guardian Signature Nominee 1 Nominee 2 Nominee 3 Address Total = 100% 7. UNIT HOLDING OPTION: (It is mandatory to tick any one option or ‘Account Statement Mode’ option will be considered) Refer Instruction 7). In Account Statement Mode In Demat mode, in demat account provided below: (Switch not allowed. Redemption through SE platforms/ DPs only) (default): Depository Participant (DP) ID (NSDL only) Beneficiary Account Number (NSDL only) (Switch/Redemption through NSDL: I N Fund/RTA offices only.) CDSL: Enclose for demat option: Client Master List Transaction/Holding Statement DIS Copy 8. DECLARATION & SIGNATURES Having read and understood the contents of the Scheme Information Document and Statement of Additional Information, Key Information Memorandum, Instructions and addenda issued by DSP BlackRock Mutual Fund, I / We, hereby apply to the Trustee of DSP BlackRock Mutual Fund for Units of the relevant Scheme and agree to abide by the terms and conditions, rules and regulations of the Scheme. I / We have neither received nor been induced by any rebate or gifts, directly or indirectly in making this investment. I / We hereby nominate the above nominee to receive all the amounts to my/our credits in the event of my/our death and have read the instructions for nomination. Signature of the nominee acknowledging receipts of my/our credit will constitute full discharge of liabilities of DSP BlackRock Mutual Fund. I / We declare that the amount invested in the Scheme is through legitimate sources only and is not designed for the purpose of contravention or evasion of any Act, Regulation, Rule, Notification, Directions or any other applicable laws enacted by the Government of India or any Statutory Authority. The ARN holder has disclosed to me/us all the commissions (in the form of trail commission or any other mode), payable to him for the different competing Schemes of various Mutual Funds from amongst which the Scheme is being recommended to me/us. Applicable to NRIs only: I/We confirm that I am/We are Non-Resident(s) of Indian Nationality / Origin and I/We hereby confirm that the funds for subscription have been remitted from abroad through normal banking channels or from funds in my / our Non-Resident External / Ordinary Account/FCNR Account(s). Sole / First Applicant / Guardian Second Applicant Third Applicant Email: firstname.lastname@example.org Contact Centre: 1800 200 4499 Website: www.dspblackrock.com Quick Name, Address are correctly mentioned Full scheme name, plan, option is mentioned Additional documents provided if investor name is Checklist not pre-printed on payment cheque or if Email ID / Mobile number are mentioned Pay-In bank details and supportings are attached PAN / KYC requirements are enclosed Nomination facility opted Demand Draft is used. Additional documents provided in case Complete Bank details provided Form is signed by all applicants of specific exceptional Third Party Payments.
COMMON APPLICATION FORM Application No. FOR LUMPSUM INVESTMENTS Please read INSTRUCTIONS (Page 24-26) carefully. All sections to be completed in ENGLISH in BLACK / BLUE COLOURED INK and in BLOCK LETTERS.ARN-74461 CODEARN - ARN-74461 BROKER SUB-BROKER CODE FOR OFFICIAL USE ONLY 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. SERIAL NUMBER, DATE & TIME OF RECEIPT 1 EXISTING UNITHOLDERS INFORMATION If you have an existing folio no. with PAN & KYC validation, please mention your name & folio No. and proceed to Step 4 Name Mr. Ms. M/s FIRST MIDDLE LAST Folio No. 2 APPLICANT(S) DETAILS (Please Refer to Instruction No. II (b) ) Mandatory information – If left blank the application is liable to be rejected. 1st Applicant Mr. Ms. M/s FIRST MIDDLE LAST Date of Birth* D D M M Y Y Y Y PAN* Enclosed (Please )§ Attested PAN Card KYC Acknowledgement Letter Name of * # Mr. Ms. GUARDIAN IN CASE FIRST APPLICANT IS A MINOR OR CONTACT PERSON IN CASE OF NON-INDIVIDUAL APPLICANTS PAN* Relationship with Natural guardian Enclosed (Please )§ Attested PAN Card Minor applicant Court appointed guardian KYC Acknowledgement Letter 2nd Applicant Mr. Ms. FIRST MIDDLE LAST Date of Birth D D M M Y Y Y YPAN* Enclosed (Please )§ Attested PAN Card KYC Acknowledgement Letter 3rd Applicant Mr. Ms. FIRST MIDDLE LAST Date of Birth D D M M Y Y Y YPAN* Enclosed (Please )§ Attested PAN Card KYC Acknowledgement Letter§ For PAN KYC requirements, please refer to the instruction Nos. II b(4), V(I) X # Name of Guardian/Contact Person is Mandatory in case of Minor/Non-Individual Investor. For documents to be submitted on behalf of minor folio refer instruction IIb(2) Mode of holding [Please tick ()] Status of First Applicant [Please tick ()] Others PLEASE SPECIFY Single Joint Anyone or Survivor Minor NRI/PIO Resident Individual HUF Sole Proprietorship Partnership Firm (Default option: Anyone or Survivor) Trust Bank/FI AOP/BoI Club/Society Company FII Correspondence Address (Please provide full address)* Overseas Address (Mandatory for NRI / FII Applicants) HOUSE / FLAT NO. HOUSE / FLAT NO. STREET ADDRESS STREET ADDRESS STREET ADDRESS STREET ADDRESS CITY / TOWN STATE CITY / TOWN STATE COUNTRY PIN CODE COUNTRY PIN CODE Tel. (Off.) Tel. (Res.) Fax Email MobileOccupation [Please tick ()] Professional Business Retired Housewife Service Student Others (Please specify) Please 9 if you wish to receive Account statement / Annual Report/ Other statutory information via Post instead of Email Please 9 any of the frequencies to receive Account Statement through e-mail £ : Daily Weekly Monthly Quarterly Half Yearly Annually* Mandatory information – If left blank the application is liable to be rejected. £ Please refer to instruction no.IX 3 BANK ACCOUNT DETAILS OF FIRST APPLICANT (Please Refer to Instruction No. III) Mandatory information – If left blank the application is liable to be rejected. Account Type Current Savings NRO NRE FCNR Account NumberMANDATORY Name of Bank Branch Details BRANCH NAME BRANCH CITY 9 Digit MICR code 11 Digit IFSC Code 4 DEMAT ACCOUNT DETAILS OF FIRST APPLICANT (Please refer Instruction No. XI) NSDL OR CDSL Depository Participant (DP) ID (NSDL only) Beneficiary Account Number (NSDL only) Depository Participant (DP) ID (CDSL only) £ £ FOR ANY ASSISTANCE OR FURTHER INFORMATION PLEASE CONTACT US Application No. ICICI Prudential Asset Management Company Limited 3rd Floor, Hallmark Business Plaza, Sant Dyaneshwar Marg, Bandra (East), Mumbai - 400 051. India SIGNATURE STAMP DATE SIGNATURE STAMP DATE SIGNATURE STAMP DATE TOLL FREE NUMBER 1800 222 999 (MTNL/BSNL) 1800 200 6666 (OTHERS) EMAIL email@example.com WEBSITE www.icicipruamc.com Note: All future communications in connection with this application should be addressed to the nearest ICICI Prudential Mutual Fund Customer Service Centre, quoting full name of 3 the first applicant, the application serial number, the name of the scheme, the amount invested, date and the place of the Customer Service Centre where application was lodged.
5 INVESTMENT PAYMENT DETAILS (Refer Instruction No. IV) For Plans Sub-options please see key features for scheme specific details 1 Name of scheme ICICI PRUDENTIAL TAX PLAN Option Sub option (Please 9 the appropriate boxes only if applicable to the scheme in which you plan to invest) Retail Option Growth OR Dividend – Reinvestment or Payout OR AEP^ – Regular* or Appreciation Institutional Option * Cumulative – AEP Regular Option: Encashment of units is subject to declaration of dividend in the respective Scheme(s). Please refer to Instruction no. IV(c) Dividend Frequencies Daily Weekly Fortnightly Monthly Quarterly Half Yearly AEP Frequencies Monthly Quarterly Half Yearly Payment Details for Scheme 1 Mode of Payment Cheque DD Funds Transfer NEFT RTGS Amount Paid DD Charges Amount ` ` A ` B Invested A+B (if applicable) Cheque / Y Y Date D D M M BANK / BRANCH DD Number BANK ACCOUNT DETAILS (For Payment Details of Scheme 1 ) Mandatory information – If left blank the application is liable to be rejected. Account Type Current Savings NRO NRE FCNR Account Number Bank Details NAME OF BANK BRANCH NAME / CITY Applications with Third Party Cheques, prefunded instruments etc. and in circumstances as detailed in AMFI Circular No.135/BP/16/10-11 shall be processed in accordance with the said circular. For Third Party Payment Declaration form and instructions please refer to pages 19-20 and 25 respectively. 2 Name of scheme ICICI PRUDENTIAL Option Sub option (Please 9 the appropriate boxes only if applicable to the scheme in which you plan to invest) Retail Option Growth OR Dividend – Reinvestment or Payout OR AEP^ – Regular* or Appreciation Institutional Option * Cumulative – AEP Regular Option: Encashment of units is subject to declaration of dividend in the respective Scheme(s). Please refer to Instruction no. IV(c) Dividend Frequencies Daily Weekly Fortnightly Monthly Quarterly Half Yearly AEP Frequencies Monthly Quarterly Half Yearly Payment Details for Scheme 2 Mode of Payment Cheque DD Funds Transfer NEFT RTGS Amount Paid DD Charges Amount ` ` A ` B Invested A+B (if applicable) Cheque / Y Y Date D D M M BANK / BRANCH DD Number BANK ACCOUNT DETAILS (For Payment Details of Scheme 2 ) Mandatory information – If left blank the application is liable to be rejected. Account Type Current Savings NRO NRE FCNR Account Number Bank Details NAME OF BANK BRANCH NAME / CITY For Third Party Payment Declaration form and instructions please refer to pages 19-20 and 25 respectively and refer instruction VI(e). Please ensure that the Bank Account details are mentioned separately, for Cheque and Demand Draft (DD) payments for Investments in Scheme 1 and in Scheme 2. ^AEP - Automatic encashment plan 6 NOMINATION DETAILS (Refer instruction VII) • For Multiple nominations, please use the form on page 23. • Nomination is mandatory if the mode of holding is SINGLE. I/We do not wish to nominate [Please tick () sign] SIGNATURE OF FIRST APPLICANT SIGNATURE OF SECOND APPLICANT SIGNATURE OF THIRD APPLICANT I/We hereby nominate the under-mentioned nominee to receive the amount to my/our credit in the event of my/our death and confirm that I/we have read and understood the nomination clause under instruction no. VII. Date of Birth is MANDATORY in case Nominee is a minor Nominee Date of Birth D D M M Y Y NAME OF NOMINEE Relationship with Natural guardian Guardian MANDATORY, IF NOMINEE IS A MINOR Minor applicant () Court appointed guardian Nominee’s HOUSE / FLAT NO STREET ADDRESS Address CITY / TOWN PIN CODE SIGNATURE OF NOMINEE / GUARDIAN, IF 7 INVESTOR(S) DECLARATION SIGNATURE(S) NOMINEE IS A MINOR The Trustee, ICICI Prudential Mutual Fund, I/We have read and understood the Scheme Information Document/Key Information Memorandum of the Scheme(s). I/We apply for the units of the Fund and agree to abide by the terms, conditions, rules and regulations of the scheme and other statutory requirements of SEBI, AMFI, Prevention of Money Laundering Act, 2002 and such other regulations as may be applicable from time to time.I/We confirm to have understood the investment objectives, investment pattern, and risk factors applicable to Plans/Options under the Scheme(s). I/we have not received nor been induced by any rebate or gifts, directly or indirectly, in making this investment. I/We declare that the amount invested in the Scheme is through legitimate sources only and is not designed for the purpose of contravention or evasion of any Act, Regulations or any other applicable laws enacted by the Government of India or any Statutory Authority. I/We agree that in case my/our investment in the Scheme is equal to or more than 25% of the corpus of the plan, then ICICI Prudential Asset Management Co. Ltd.(the AMC), has full right to refund the excess to me/us to bring my/our investment below 25%. I/We hereby declare that I am/we are not US Person(s). I/We hereby declare that I/we do not have any existing Micro SIPs which together with the current application will result in a total investments exceeding Rs.50,000 in a year. The ARN holder has disclosed to me/us all the commissions (in the form of trail commission or any other mode), payable to him for the different competing Schemes of various Mutual Funds from amongst which the Scheme is being recommended to me/us. I/We interested in receiving promotional material from the AMC via mail, SMS, telecall, etc. If you do not wish to receive, please call on tollfree no. 1800 222 999 (MTNL/BSNL) or 1800 200 6666 (Others). D D M M Y Y SIGNATURE OF FIRST APPLICANT SIGNATURE OF SECOND APPLICANT SIGNATURE OF THIRD APPLICANT £ £ ACKNOWLEDGEMENT SLIP Please Retain this Slip To be filled in by the Investor. Subject to realization of cheque and furnishing of Mandatory Information. 1 Scheme ICICI PRUDENTIAL TAX PLANSCHEME ANDOption - Growth OPTION ` AMOUNT CHEQUE / DD No. D D M M Y Y 2 Scheme ICICI PRUDENTIAL SCHEME AND OPTION ` AMOUNT CHEQUE / DD No. D D M M Y Y 1 DRAWN ON BANK BRANCH 2 DRAWN ON BANK BRANCH EXISTING FOLIO NO.4
Reliance Capital Asset Management Limited A Reliance Capital Company APP No.: WE-00012343 COMMON APPLICATION FORM All Columns marked * are mandatory. TO BE FILLED IN CAPITAL LETTERS IN BLUE/BLACK INK ONLY.1. DISTRIBUTOR / BROKER INFORMATION (Refer Instruction No. I.9) 2. EXISTING UNIT HOLDER INFORMATIONName Broker Code / ARN Sub Broker / Sub Agent Code For existing investors please fill in your Folio number,ARN-74461 FOLIO NO.Upfront commission shall be paid directly by the investor to the AMFI registered Distributors based on the investors assessment of various factorsincluding the service rendered by the distributor. 3. APPLICANT INFORMATION (Refer Instruction No. II) APPLICATION FOR Zero Balance Folio Invest Now MODE OF HOLDING Single Joint Any One or Survivor(s) (Default Joint) OCCUPATION Business Professional Service Retired Student Current/Former MP/MLA/MLC/Head of State Retired Civil Servant Politician Forex Dealer House wife Senior Executive of State owned corporation Political Party Official Others _________________STATUS 1st Applicant Resident Indian NRI STATUS NON- FIIs Society Banks Trust HUFINDIVIDUAL 2nd Applicant Resident Indian NRI INDIVIDUAL Minor Fls AOP/BOI Partnership firm 3rd Applicant Resident Indian NRI Company/Body Corporate Others _________________Name of First / Sole applicant Mr. Ms. M/s.1st holder PAN PAN Proof Enclosed Date of Birth** KYC Acknowledgement Copy #Document Category No. (Refer Instruction No. IX.4) D D M M Y Y Y Y M a n d a t o r y (**Date of birth mandatory if the applicant is minor)Name of Guardian (In case of Minor)/(Contact Person Name - In case of non-individual Investors) Mr. Ms. Relation with Minor / Designation M a n d a t o r yGuardian’s PAN PAN Proof Enclosed KYC Acknowledgement Copy #Document Category No. M a n d a t o r y (Refer Instruction No. IX.4)Name of Second applicant Mr. Ms. PAN Proof Enclosed KYC Acknowledgement Copy #Document Category No.2nd holder PAN M a n d a t o r y (Refer Instruction No. IX.4)Name of Third applicant Mr. Ms.3rd holder PAN PAN Proof Enclosed KYC Acknowledgement Copy #Document Category No. M a n d a t o r y (Refer Instruction No. IX.4)#Mandatory for MICRO SIP Investors (Refer Instruction No. IX)Mailing AddressAdd 1Add 2 DistrictAdd 3 CityState Country PINOverseas Address (Mandatory for NRI / FII Applicant) (Please provide your complete address. P.O. Box alone is not adequate)Add 1Add 2City Country PINCONTACT DETAILS OF SOLE/FIRST APPLICANT (For Receiving SMS Alert)Tel. No. STD Code __________ Office ____________________ Residence _____________________ Mobile no. ______________________________________Email ID (For Receiving Email Alert)Investors providing Email Id would mandatorily receive only E - Statement of Accounts in lieu of physical Statement of Accounts. (Refer Instruction No. VI) I WISH TO APPLY FOR TRANSACT ONLINE I WISH TO APPLY FOR RELIANCE ANY TIME MONEY CARD (Please refer to ATM Instruction) I have read understood the Terms Conditions attached Name as you would like to appear on Any Time Money Card (Max. 19 characters) M a n d a t o r y Mother’s maiden name in full M a n d a t o r yPlease collect your time stamped acknowledged slip for future referencesReceived from ___________________________________________________________________________an application for allotment of TAX SAVER FUNDUnits under Reliance ________________________________________________________as per details below. APP No.: WE-00012343 Growth Option Bonus Option Dividend Reinvestment Dividend PayoutCheque / DD No. ____________________________ Dated ______________Rs. _______________________ Time Stamp Datedrawn on ________________________________________________________________________________ of receiving office
4 . BANK ACCOUNT DETAILS (Refer Instruction No.III) MANDATORY for Redemption/Dividend/Refunds, if anyA/c. Type SB Current NRO NRE FCNR Account No. M a n d a t o r yBank M a n d a t o r y BranchBranch CityPIN IFSC Code For Credit via NEFT 9 Digit MICR Code* F o r C r e d i t v i a E C SPlease ensure the name in this application form and in your bank account are the same 5. INVESTMENT PAYMENT DETAILS (Separate Application Form is required for investment in each Plan/Option (Refer instruction no. IV) PAYMENT BY CASH IS NOT PERMITTED. Scheme Plan Option DD Charge Net Cheque / Cheque / DD No. Bank / Branch Rs. DD Amount Rs. Date Growth OptionRELIANCE Growth Plan Bonus OptionTAX SAVER FUND Dividend Plan Reinvestment PayoutSIP ENROLLMENT DETAILS PDC Auto Debit / ECS (Refer Instruction No. I-12)Frequency (Please ) Monthly Quarterly SIP Date: 2 10 18 28 REGULAR PERPETUAL (Default) (Not applicable for PDCs) Amount per Instalment:Enrollment Period: From: M M Y Y To: Enrollment Period: From: M M Y Y To: 1 2 9 9 Rs. _______________________ M M Y Y 6. DOCUMENTS ENCLOSED (Please ) (MANDATORY) (Refer to Instruction No.I-9) For Corporate For Systematic Transactions For Additional Document Memorandum Articles of Association SIP Enrollment Form (Cheque or Auto Debit and ECS) Cheques Power of Attorney Trust Deed Bye-Laws Partnership Deed Systematic Transfer Plan Dividend Transfer Plan Enrollment Form Resolution / Authorization to invest Systematic Withdrawal Plan Enrollment Form Reliance SMART Others ________________ List of Authorised Signatories with Specimen Signature(s) STEP Enrollment Form Trigger Form Reliance SIP Insure Form 7. NOMINATION (Refer to Instruction No.V) (Mandatory if mode of holding is single)I/ We _______________________________________, __________________________________and__________________________________________* (Unit holder 1) (Unit holder 2) (Unit holder 3)do hereby nominate the person(s) more particularly described hereunder/ and*/cancel the nomination made by me/ us on the ________ day of________________ in respect of the Units under Folio No.___________________ (* strike out which is not applicable) Date of Proportion (%) by which the Signature of Signature of Name and Address of Nominee(s) Name and Address of Guardian Birth (Minor) units will be shared by each Nominee Guardian Nominee (should aggregate to 100%) (to be fur nished in case the Nominee is a minor) Nominee 1 Nominee 2 Nominee 3I/ We _______________________________________, _____________________________________and__________________________________________ (Unit holder 1) (Unit holder 2) (Unit holder 3)do hereby declare that we do not wish to nominate any person/person(s) in the folio/account. Sole / 1st applicant/ 2nd applicant/ 3rd applicant/ Authorised Signatory Authorised Signatory Authorised Signatory 8. DECLARATIONI/We would like to invest in Reliance_____________________________ subject to terms of the Statement of Additional Information (SAI), Scheme Information Document (SID), Key InformationMemorandum (KIM) and subsequent amendments thereto. I/We have read, understood (before filling application form) and is/are bound by the details of the SAI, SID KIM including details relating tovarious services including but not limited to ATM/ Debit Card. I/We have not received nor been induced by any rebate or gifts, directly or indirectly, in making this investment. I / We declare that the amountinvested in the Scheme is through legitimate sources only and is not designed for the purpose of contravention or evasion of any Act / Regulations / Rules / Notifications / Directions or any other ApplicableLaws enacted by the Government of India or any Statutory Authority. I accept and agree to be bound by the said Terms and Conditions including those excluding/ limiting the Reliance Capital AssetManagement Limited (RCAM) liability. I understand that the RCAM may, at its absolute discretion, discontinue any of the services completely or partially without any prior notice to me. I agree RCAM candebit from my folio for the service charges as applicable from time to time. The ARN holder has disclosed to me/us all the commissions (in the form of trail commission or any other mode), payable to him forthe different competing Schemes of various Mutual Funds from amongst which the Scheme is being recommended to me/us. I hereby declare that the above information is given by the undersigned andparticulars given by me/us are correct and complete. Applicable for NRI Investors: I confirm that I am resident of India. I/We confirm that I am/We are Non-Resident of Indian Nationality/Origin andI/We hereby confirm that the funds for subscription have been remitted from abroad through normal banking channels or from funds in my/our Non-Resident External / Ordinary Account/FCNR Account.I/We undertake that all additional purchases made under this folio will also be from funds received from abroad through approved banking channels or from funds in my/ our NRE/FCNR Account. S i g n a t u Sole / 1st applicant/Guardian/ 2nd applicant/ 3rd applicant/ r e Authorised Signatory Authorised Signatory Authorised SignatoryACKNOWLEDGMENT SLIP (To be filled in by the Applicant)One Indiabulls Centre, Tower 1, 11th 12th Floor,Jupiter Mill Compound, 841, Senapati Bapat MargElphinstone Road, Mumbai-400 013Call : 30301111 | Toll free: 1800-300-11111www.reliancemutual.com
Save Tax! Missed Call: Free Door-Step ServiceGet Rich… 94 8300 8300 Financial Planning Contingency Planning Risk Planning Investment Planning Tax Planning Wealth Planning Estate Planning Give a Missed Call: 94 8300 8300 or SMS: Your Name to 94 8300 8300 or Send Email: PrajnaCapital @ gmail.comSave Tax! Missed Call: Free Door-Step ServiceGet Rich… 94 8300 8300