APPLICATION MONEY DETAILS (Cheque / DD to be drawn in the name of Tata Equity Management Fund)             ...
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  1. 1. BLUE PINK Key Information Memorandum & Application Form Sr. No. : TATA EQUITY MANAGEMENT FUND (A 18-months close ended equity fund with an automatic conversion into an open ended scheme on expiry of 18-months from the date of allotment) Existing Folio no. (if any): (A 18-months close ended equity fund with an automatic OFFER OF UNITS TO RESIDENTS AND NON RESIDENTS AT FACE VALUE OF RS. 10 EACH AT FACE VALUE conversion into an open ended scheme on expiry of 18-months from the date of allotment) Refer complete scheme details/instructions while filling in application form in English BLOCK LETTERS. Offer of units of face value of Rs. 10 each at Tick ( ) whichever is applicable. Strike out which is not required. face value BROKER/AGENT CODE SUB-BROKER CODE BANK/BRANCH SERIAL NO. New Fund Offer Opens On : 15th May, 2006 New Fund Offer Closes On : 9th June, 2006 ARN – 4724 ARN – 4724 Re-opens for Repurchase : Not later than CHOOSE THE OPTION FOR MAKING INVESTMENTS 7th July, 2006 Growth Dividend If Dividend, then please tick Payout Reinvestment Investment Manager: Default Option : Growth Default Option : Dividend Re-investment Tata Asset Management Ltd. Fort House, 221, D. N. Road, Fort, UNITHOLDER INFORMATION Mumbai 400 001. E-mail: Name of First Applicant Website: Date of Birth Please mention your name as it appears in your Bank Account This Key Information Memorandum (KIM) (DD/MM/YYYY) sets forth the information, which a PAN No. *(Mandatory for investments of Rs. 50000/- or more) Circle / Ward / District Enclosed Proof of PAN No. prospective investor ought to know before Form 60 / 61 investing. For further details of the scheme/ Mutual Fund, due diligence certificate by the Name of Guardian (in case AMC, Key Personnel, investors’ rights & first Applicant is Minor) services, risk factors, penalties & pending Circle / Ward / District Proof of PAN No. litigations, associate transactions etc. PAN No.* (Mandatory for investments of Rs. 50000/- or more) Enclosed investors should, before investment, refer Form 60 / 61 to the Offering Circular available free of cost Contact Person (in case of company) at any of the Investor Service Centres or distributors or from the website Mailing Address (PO Box Address is not sufficient) (Indian Addreass in case The Scheme particulars have been prepared of NRIs/FIIs) Pin Code in accordance with Securities and Exchange Board of India (Mutual Funds) Regulations City Country State 1996, as amended till date, and filed with Email ID of First Applicant________________________________________________________________________________________________ Securities and Exchange Board of India I/ We Wish to receive Account Statement / Annual Report / Other communication through Email in lieu of the physical copy of the same Yes No (SEBI). The units being offered for public subscription have not been approved or Contact Particulars Telephone : Office Fax disapproved by SEBI, nor has SEBI certified the accuracy or adequacy of this KIM. Residence Mobile No. Resident Individual NRI/NRO NRI/NRE AOP FII Body Corporate INSTRUCTIONS FOR FILLING THE Are you applying as Trust Partner Public Ltd. Co. On behalf of Minor HUF FOF APPLICATION FORM Proprietorship BOI Pvt. Ltd. Co. Societies Others_______________ (A) MINIMUM APPLICATION AMOUNT SHOULD BE: Rs. Overseas Address 5000/- and in multiples of Re. 1/- thereafter. (B) PAYMENT PROCEDURE (Mandatory for NRI/FII appilcations Pin Code 1. Payment may be made by MICR cheque/DD drawn in addition to mailing address) City Country on/made payable at all those places where the Investor Service Centres / Collection Centres Occupation Agriculture Business Service Professional Housewife Retired Student Other_________ are located. THE CHEQUE/DD MUST BE DRAWN IN FAVOUR OF “TATA EQUITY MANAGEMENT Mode of Holding Single Joint Anyone or Survivor Default Option: Joint. FUND” AND CROSSED ‘‘ACCOUNT PAYEE & NOT NEGOTIABLE’’. No outstation cheques will be Name of Second Applicant accepted. Demand Draft will be accepted only if they are payable at corresponding city of the Proof of PAN No. collection bank where the application is being given PAN No.* (Mandatory for investments of Rs. 50000/- or more) Circle / Ward / District Enclosed and the same is accompanied by a Banker’s Form 60 / 61 Certifcate. DD charges can be deducted to the corresponding SBI charges. Name of Third Applicant If there is no authorised Investor Service Centres / Collection Centres where the investor resides, he/ PAN No.* (Mandatory for investments of Rs. 50000/- or more) Circle / Ward / District Enclosed Proof of PAN No. she may send a Demand Draft from any other bank in favour of “TEMF - Tata Equity Management Fund” Form 60 / 61 payable at Mumbai, after deducting bank charges / commission (not exceeding rate prescribed by State Bank of India) from the amount of investment. If PROOF OF IDENTITY (Refer H) such bank charges / commission are not deducted by the applicant, then the same may not be Voter ID Card Driving License Passport reimbursed by the Trustee company. Such bank Voter ID No. Driving License No. Passport No. charges / commission will be treated as scheme expense. However in case of application along with Place of Issue Place of Issue Place of Issue local cheque or bank draft payable at Mumbai, at / from locations where TMF has its designated authorised Investor Service Centres / Collection Centres, Bank Draft charges/ commission may have BANK ACKNOWLEDGEMENT SLIP Mulla House, Ground Floor, 51, M.G. Road, to be borne by the applicant. In such cases the TATA EQUITY MANAGEMENT FUND Near Flora Fountain Mumbai - 400001. Sr. No. : Trustee Company is entitled, in its sole and absolute discretion, to reject or accept any application. Acknowledgement Stamp 2. Application forms duly completed in all respects Received from Mr. / Ms ......................................................................................................................................... an application for purchase may be submitted at : of units of Tata Equity Management Fund (Gross investment amount) Rs. .......................................... (Rupees in During the NFO: Only at Investor Service Centres and Collection Centers as mentioned in words......................................................................................................................................................................................................................... this Memorandum. 3. The applicants are requested to note the following ................................................................. ) Cheque / Demand Draft No. ...................................... dated....................................drawn on points before submitting the applications to any of the collection centres. .......................................Bank....................................... Branch for Rs. ................................(Cheques/Drafts are subject to realisation). i) Stockinvests, Post Dated Cheques, Money Orders and Postal Orders will not be accepted and such applications will not be considered for ACKNOWLEDGEMENT SLIP allotment. Mulla House, Ground Floor, 51, M.G. Road, ii) Cheques once returned in clearing will not be re- TATA EQUITY MANAGEMENT FUND Sr. No. : Near Flora Fountain Mumbai - 400001. presented and the accompanying applications may not be considered for allotment. Acknowledgement Stamp 4. Applications which are incomplete are liable to be Received from Mr. / Ms .............................................................................................................................................. an rejected and the Trustee Company of Tata Mutual Fund shall not be responsible for any consequences application for purchase of units of Tata Equity Management Fund(Gross investment amount) Rs. .............................. (Rupees in thereof. 5. Where an application is rejected in full or in part, words............................................................................................................................................................ application money will accordingly be refunded to WPPL Tel : 24939382 the applicant. No interest will be paid on the amount ............................................. ) C h e q u e / D e m a n d D r a f t N o . ........................ . . d a t e d ........................d r a w n o n so refunded. Letters of regret together with Refund Cheques/Orders if any, will be despatched by post. ..............................Bank................................ Branch for Rs. ............................(Cheques/Drafts are subject to realisation). Refund will be made by cheques or pay order drawn on the Bankers of Tata Mutual Fund. All communication may please be addressed to Computer Age Management Services Pvt Ltd., CAMS Unit: Tata Mutual Fund 178/10, 6. The right to accept or reject any application in whole or in part lies with the Trustee Company. Kodambakkam High Road, Nungambakkam, Chennai - 600 034 by quoting First applicant name, application Sr. No., Name of the scheme. (C) APPLICATION DETAILS 1. Please write the Applicant’s Name & Application Serial Number on the reverse of the Cheque/ or partnership deed and certificate of registration must be lodged at the office In case nature of Account is given as NRO or NRE, the status of Applicant Demand Draft. of the Registrar, quoting the serial number of application simultaneously with will be considered as NRI / NRO or NRI / NRE respectively. 2. Please mention the Pin Code Number in the the submission of the Application Form, failing which the application is liable For NRI/NRO, your bank account should be domestic bank /non - repatriable Address column. to be rejected. account. 3. All communication and/or payments will be made to 8. In case of application with more than one holder, if the ‘Mode of Holding/ For NRI/NRE, your bank account should be NRE. the sole/first applicant. Operation’ is not ticked, the default option would be Joint. Any application for subscription /request for redemption without Bank 4. Signatures should be in English or in any Indian D) PAN Number Details of the Investors account details will be rejected by the mutual fund. language, thumb impressions must be attested by As per SEBI Circular SEBI/MD/CIR. No6/ 4213/04 dated March 1, 2004 (G) BROKERS AND MARKETING ASSOCIATES. a Magistrate/Notary Public under his/her official Whenever an application is for total value of Rs 50000 or more, the 1. Tata Mutual Fund’s Marketing Associates, Agents & Brokers (who are holding seal. In case of HUF, the Karta should sign on applicant or in case of application is in joint names, each of the applicants, the AMFI Certificate) are eligible to mobilise subscriptions under the Fund and behalf of the HUF. In case of Partnership Firms, should mention his/her permanent account number (PAN) allotted under the earn brokerage based on the amounts subscribed. Brokerage will be paid only the Partner should sign on behalf of the Partnership Income Tax Act, 1961 to those Marketing Associates, Agents & Brokers whose stamp appears on the Firm. Similarly, for the Association of Persons As per Rule 114B of The Income Tata Rules 1962, every person shall quote application form. (AoP), Company etc. the application must be signed his permanent account number (PAN) in all documents pertaining to payment 2. Code numbers / ARN No. assigned by AMFI to the Marketing Associates/ by the Authorised Signatory/Signatories as of an amount of Rupees Fifty Thousand or more to a Mutual Fund for Agents must be used wherever applicable and their stamps should clearly applicable. purchase of its units. In case the person making the payment is a minor state their names and any other details as required, in English. 5. Individual(s) as Applicant/unit holder only can make who does not have any income chargeable to income tax, he shall quote 3. Agents are not permitted to accept CASH with Application Form. Tata Mutual nomination. Nominee must be an individual and not the permanent account number of his father or mother or guardian, as the Fund shall not be held responsible for any kind of wrong tenders. a trust, society, body corporate partnership firm, case may be. Any person who does not have a permanent account number 4. Brokerage will be paid to only Distributors empanelled with Tata Mutual Fund. Karta of Hindu Undivided Family or a power of and who enters into any transaction specified in this rule shall make a 5. Distributors / Agents should mention the ARN No. allotted by AMFI, on the Attorney Holder. Nomination stands rescinded upon declaration in Form No. 60/61 giving therein the particulars of such application form. transfer/Redemption/Switchover of Units transaction. (H) Proof of Identity: As per the Know-Your-Customer, please provide the 6. Where the units are held in the names of two or In case of a joint holding, PAN / Form No. 60 / 61 is required for all number and place of issue and a copy of your passport and/or driving three persons, such persons shall be deemed to the joint holders licence and/or voter’s ID card. hold the units on first holder basis. In case of HUF/ Any application for subscription of units of the total value of Rs. Anti Money Laundering Partnership Firm/AoP/Company, etc. no joint 50000/- or more without a valid PAN / Form No. 60/61 will be liable 1. The AMC, under powers delegated by the Trustees, shall have absolute holding will be considered. to be rejected by the Mutual Fund. discretion to reject any application, or prevent further transactions by a Unit 7. In case of applications under Power of Attorney or For validation purposes investors are required to submit photocopy Holder, if after due diligence, the investor / Unit Holder / a person making by a Limited Company or by a Corporate Body or of PAN Card or any other communication received from the Income Tax the payment on behalf of the investor does not fulfil the requirements of Eligible Institution or a Registered Society or a Trust department specifying name and PAN No of the investor. the “Know Your Customer” to the satisfaction of the AMC. In this behalf or a Fund the original Power of Attorney or the Note: Investors are urged to refer The Income Tax Rules, 1962 or consult the AMC reserves the right to reject any application and/or effect a certified copy thereof duly notarised and the their Tax Advisors for further details. mandatory Redemption of Units allotted at any time prior to the expiry of relevant resolution or authority to make the (F) BANK ACCOUNT DETAILS 30 Business Days from the date of the application. If the payment for application, as the case may be including authority It shall be mandatory for the Unitholders to mention their bank account Purchase of Units are made by a third party (e.g. a Power of Attorney granted in favour of the officials signing the numbers in their applications/requests for redemptions. Unitholders are Holder, a Financing agency, a relative, etc.), the Unit Holder may be application and their specimen signature etc., or requested to give the full particulars of their Bank Account i.e. nature of required to give such details of such transaction so as to satisfy the AMC duly certified copy thereof alongwith a certified account, Account Number, Nine digit Bank Code Number (For Electronic of the source and / or consideration underlying the transaction. copy of the Memorandum and Articles of Credit Facility), branch address of the bank at the appropriate space in the Association and/or bye-laws and/or trust deed and/ application form. BLUE PINK
  2. 2. BLUE PINK APPLICATION MONEY DETAILS (Cheque / DD to be drawn in the name of Tata Equity Management Fund) ICICI BANK NFO COLLECTION CENTRES * DD charges to be borne by AMC if investor doesn’t fall within ISCs. - Refer B Ahmedabad: Chirag Patel, JMC House, Opp. Parimal Gar- dens, Ambawadi, Ahmedabad-380006, Tel: (079) 55523700, Fax: Gross Amount in Rs. DD Charges Rs. (if any)* (079) 55523720, BM Tel.: (079) 55523716, Mobile No. 9879114830. Bangalore: Kalyana Chakravarthy, ICICI Bank Towers, 1, Commissariat Road, Ground Floor, Bangalore-560025. Tel: 080 Net Amount in Rs. - 51296007, Fax: 080 - 51124607, BM Tel.: 080 - 51296008. Cochin: Gibi George, Emgee Square, M.G.Road, Ernakulam, Gross Investment (Rs in Words) ________________________________________________________________________________________________ Kochi. Cochin-682035. Te.: 0484 - 2382026 / 27 /28, Fax: 0484 - 2372739, BM Tel.: 0484 - 2290163, Mobile No. 9349779825. Drawn on Bank __________________________________________________________________________ Branch __________________________ Coimbatore: Senthil Kumar R, Cheran Plaza,4292115, Fax: Road, Coimbatore-641018. Te.: 0422-4292102 - 1090, Trichy 0422 - 2300172, BM Tel.: 0422-4292101, Mobile No. 9994345670. A/c No. _____________________________ A/c Type _________________ Cheque/DD No. __________________ Dated _______/_______/ Hyderabad: Rahul Godse, 6-2-1012, TGV Mansions, Opp. In- _________ stitution of Engineers, Khairatabad, Hyderabad-500004. Tel: 040 - 23301534;55662345;23376844;55626660, Fax: 040 - NOMINATION 23321181, BM Tel.: 040 - 23394077, Mobile No. 98855 66088. Jamshedpur: Arnab Sensarma, Natraj Mansion, Main Road, Bistupur, Jamshedpur-831001. Tel.: 0657 - 2422509 / 10 / Nominee Name__________________________________________________Relationship_____________________ 2425907 / 12, Fax: 0657 - 2425865, BM Tel.: 0657 - 2425924, Mobile No. 09334042602, Kanpur: Barindra, J.S Towers ; 16/ Guardian details (if nominee is a minor) Name & Address_______________________________________________ 106 - The Mall. Kanpur-208001. Tel.:0512 - 2331041,42,43,44,45, Fax: 0512 - 2331042, BM Tel.: 0512 - 2331042, Mobile No. ______________________________________________________________________________________________________ Signature of Guardian 9839600345, 9839086665. Kolkata: Manoj Kumar Jaiswal, 22, R N Mukherjee Road, Kolkata-700001. Tel.:033 - 22428537 / 22100995. Fax: 033 - 22426696, BM Tel.: 033-22137601, Mobile YOUR BANK ACCOUNT DETAILS (Mandatory) please refer instruction F No. 9830088088. Lucknow: Saurab Pathak, 11, MG Road, Hazarat Gunj, Lucknow-226001. Tel.:0522 - 2214246 /2214247 All communication and payments will be made to the first applicant or to the Karta in case of HUF. / 2214254 Fax: 0522 - 2225232, BM Tel.: 0522 - 2201055, Mobile No. 9838513469. Mumbai: Capital Market Division, 30, Name of Your Bank Branch Mumbai Samachar marg, Fort, Mumbai 400 001 Nasik: Sandeep Your Account No. Gore, U-1, Crown Commercial Complex, Opp. Rajiv Gandhi Bhavan (NMC), Utility Centre, Sharanpur Road, Nashik-422002. Account No. (in words) Tel.:0253 - 5605600/ 5606032/ 5606033, Fax: 0253 - 2313475, BM Tel.: 0253 - 5605191 Mobile No. 9823330060. New Delhi: Bank Address Rahul Krishnatrey, 9A, Phelps Building, Inner Circle,Connaught City PIN MICR Place, New Delhi-110001. Tel.:011 -51517954-58, Fax: 011 - Code 23351092, BM Tel.: 011 - 51516142, Mobile No. +919811203153. Account Type Panji: Anant Narayan Samant, 65, Sindur Business Centre, Savings Current NRO NRNR NRE FCNR Swami Vivekanand Road, Panji-403001. Tel.:0832 - 2232180 / 2424217/ 2424225/ 2423444, Fax: 0832 - 2232390, BM Tel.: Example for filling Bank account details of First Unitholder 0832 - 2421639. Mobile No. 9823144162. Patna: Amit Ac. No. 0 0 9 7 4 6 1 5 2 is required without which the application Bhattacharjee, Shahi Bhawan Ground Floor Exihibition Road the Account number: In words Zero Zero Nine Seven Four Seven Six One Five Two would be rejected. Patna-800001. Tel.:0612 -2205398, 2205400, 2205400, Fax: 0612 - 2202968, BM Tel.: 0612 -2 202966, Mobile No. 9835030917. DIRECT CREDIT FACILITY FOR REDEMPTION / DIVIDEND Pune: Yatin Gupta, A-Wing, Shangrila Gardens, Bund Garden Road, Pune-411001. Tel.:020 - 26128248 , 26054345, Fax: 020 Tata Mutual Fund directly credits the Dividends /Redemption into the investor Bank Account in case the account is with ICICI Bank Ltd./HDFC Bank Ltd./UTI Bank /IDBI - 26128594, BM Tel.: 020 - 26111690, Mobile No. 9823330074. Bank/Standard Chartered Bank/Kotak Bank/HSBC Bank/Deutsche Bank. Vadodara: Hemant Gulabchand Baid, Landmark Building, Race I / We understand that the instruction to the bank for Direct Credit/ ECS will be given by the Mutual Fund and such instruction will be adequate discharge of Mutual Fund Course Circle, Alkapuri, Vadodara-390007. Tel.:0265 - 2339923 towards redemption/dividend proceeds. In case of bank not crediting my/our bank account with/without assigning any reason thereof or if the transaction is delayed or not / 2339924 / 2339925 / 2339927 / 2339928, Fax: 0265 - 2339926, BM Tel.: 0265 - 2325318, Mobile No. 9825047840 effected at all for reasons of incomplete or incorrect information, I/We would not hold Tata Mutual Fund responsible. I/We understand that in case account number furnished by me/us, if found incorrect, I/We would not hold Tata Mutual Fund responsible for the credit going to the wrong account. Further, the Mutual Fund reserves the right NRI Centres : Mumbai, Kolkata, Bangalore, Cochin, Ahmedabad and Vadodra to issue a demand draft/payable at par cheque in case it is not possible to make payment by DC/ECS. If however you wish to receive cheque payout, please tick here HDFC BANK NFO COLLECTION CENTRES Agra: Manoj Minocha/ Puneet Prakash, SHOP NO - 11, Block DOCUMENTS TO BE SUBMITTED (Please tick ( ) whichever is applicable) No-17/2/4, Friends Plaza, Sanjay Place, Agra-282 002. Tel.: (0562) 2524089. Ahmedabad: Kunal Kak/Mahyar Chhindiawala, 1) Memorandum & Articles of Association (Corporate) 2) Board Resolution (Corporate) 3) Authorised signatories list HDFC Bank House, Near Mithakali Six Roads, Navrangpura- 4) Trust Deed (in case of a trust) 5) Partnership Deed (for partnership firm) 6) Copy of the PAN card of all unitholders (for investment 380 009 Tel.: 079 -55217163 / 55217184. Ahmednagar: Anand of Rs. 50,000/- and above) Lele, Amber Plaza,Station Road, Opp ADCC Bank Sahakar Gruh, Ahmednagar-414 001. Tel.: 95241-2451962-63 / 2451194. Ajmer: Manish Vashistha, AMC NO - 13/10 & 14/10, Near DECLARATION AND SIGNATURES Signature(s) / Thumb Impression(s) Suchma Kendra, Adajcent to Swami Complex, Ajmer-305 001. The Trustee, Tata Mutual Fund Holder (Refer Instruction number C (4)) Tel.: 0145-5100123. Akola: Sachin Raje/Shrinivas Dhankar/ Having read and understood the contents of the Offer Document of the Scheme, I/ We Anand Karajgikar/Shukla, Sethi Heights, Opp To Collector Office, hereby apply for units of the scheme and agree to abide by the terms, conditions, rules Z P ROAD, Akola-444 001. Tel.: 0724-2432204 (D), 2441128 & and regulations governing the scheme. I/ We hereby declare that the amount invested in 2431446 (Ext 110). Allahabad: Abhishek Pathak, 54/1 S.P. the scheme is through legitimate sources only and does not involve and is not designed Marg Civil Lines, Allahabad-211 003. Tel.: 0532- 2260049. Alwar: 1st/ C. P. Jangir, Bhagat Singh Circle, Road No 2, Alwar-301 001. for the purpose of the contravention of any Act, Rules, Regulations, Notifications or Sole Directions of the provisions of the Income Tax Act, Anti Money Laundering Laws, Anti Tel.: 0144-5100880. Ambala: Balwinder Singh Sondhi, Shingar Corruption Laws or any other applicable laws enacted by the Government of India from Unitholder Palace Complex, Nicholson Road, Ambala Cantt 133 001 Tel.: time to time. I/ We have understood the details of the scheme and I/ We have not received 0171-2600044 (D), 0171-2600045. Amravati: Suryakant Sisodiya nor have been induced by any rebate or gifts, directly or indirectly in making this / Yatin Deshpande, C/o. Rasik Plaza, Jaistambh Chowk, Morshi Road, Amravati-444 601. Tel.: 0721- 2568432,05,06 Amritsar: investment. I/ We confirm that the funds invested in the Scheme, legally belong to me / Deepak Gohlan/Anoop Grover/Guneet Pal Singh/Rajpal Singh, us. In the event "Know Your Customer" process is not completed by me / us to the 39, The Mall Amritsar, Tel.: 0183-2564616. Anand: Ankit Shah, satisfaction of the AMC, I/ We hereby authorise the AMC, to redeem the funds invested 2nd 1St Floor , Sanket Towers, Opp Anand Arts College , Grid Road, in the Scheme, in favour of the applicant at the applicable NAV prevailing on the date of Unitholder Anand-388 001. Tel.: 02692- 573195. Ankleshwar: Mr. Tarak such redemption and undertaking such other action with such funds that may be required Gandhi,Mr Ritesh Shah, S A Motors Building, S A Motors Building, by the Law. Ankleshwar395 002. Tel.: (02646) 227704/227705. Asansol: For NRls only: I/ We confirm that I am / we are Non Residents of Indian Nationality / Amitabha, CMS Dept, P C Chatterjee Market, G.t Road, Origin and that I/ we have remitted funds from abroad through approved banking channels Rambhandu Tala, Asansol-713 303. Tel.: 0341-2214848. or from funds in my / our Non-Resident External / Non-Resident Ordinary / FCNR Aurangabad: Mr. Amol Bhale / Mr. Azeemuddine Shaikha / Mr account. 3rd Nitin Sawant / Madhu, Shivani Chambers, Manjeet Nagar , I/ We confirm that details provided by me / us are true and correct. Unitholder Jalna Road , Opp Akashwani, Aurangabad-431 001. Tel.: (0240) 2362042/47. Balasore: Subrat Mohanty, C/o Bharat Motors, Date: F.M Circle, Balasore-756 001. Tel.: 06782 - 263335. Bangalore: P Sugunan/ KT Bhanushree / Joseph Marian, NO 8 / 24 Salco Centre, Richmond Road, Bangalore-560 025. Tel.: 080- 41266865. Bardoli: Mr Jaideep SHekhawat (Manager) Daxesh CHECKLIST SHukla (TBG), Shree Ambika Niketan Temple, Shree Ambika Please ensure that your Application Form is complete in all respects & signed by all applicants : Name, Address and Contact Details are mentioned in full. Bank Account Niketan Temple, Bardoli-394 601. Tel.: 02622 223627, (02622) 223879. Barielly: Vinod Mishra, 154 , KRISHNA PALACE, Details are entered completely and correctly. Permanent Account Number (PAN) of all Applicants is mentioned if the investment amount is Rs. 50,000/- or more along with the CIVIL LINES, BAREILLY-243 001. Tel.: (0581) - 3099631. copy of the PAN card Copy of proof of identity Appropriate Option is selected. If the Dividend Option is chosen, Dividend Payout or Re-investment is indicated. If units Belgaum: Mr Vinay Balwally / Mr Ravi Kiran Ganti/ Girish , are applied for jointly, Mode of Operation of account is indicated Your Investment Cheque / DD is drawn in favour of “Tata Equity Management Fund”, dated and signed. 4830 / 28 A Opp District Hospital, Dr Ambedkar Road, Belgaum- Application Number is mentioned on the reverse of the cheque. Documents as listed below are submitted along with the Application Form (as applicable to your specific case). 590 002. Tel.: 2404411/15. Bharuch: Anuradha Gupta/Surya Prakash Patel, Near Octroi Naka Link Road, Near Octroi Naka Documents Companies Trusts Societies Partnership Firms Flls NRI Investments through Constituted Attorney , Link Road, Bharuch-392 001. Tel.: Direct No.222031 (02642), Board line -220108,222032 extn.23. Bhatinda: Sunil Seth, 3027 1. Resolution/Authorisation to invest - B Guru Kanshi Marg, Bhatinda-151 001. Tel.: 0164- 2. List of Authorised Signatories with Specimen Signature(s) 2240832,2240993-996. Bhavnagar: Manish Malkan, Gopi Arcade, Opp Takhteshwar Post Office, Bhavnagar. Tel.: (0278) 3. Memorandum & Articles of Association 5540340. Bhilwara: Rahul Atal / Tushar Mathur, 2-3-4, S.K 4. Trust Deed PLAZA COMPLEX, PUR ROAD, BHILWARA. Tel.: 01482- 5. Bye-Laws 512686. Bhopal: Tavinder Pal Singh, Sumeet Kapoor, Monu Mehra, E - 1/57 , Arera Colony, Bhopal-462 016. Tel.: 0755- 6. Partnership Deed 2461145 (Direct), Board-5281616,5276007,5276008. 7. Overseas Auditor’s Certificate Bhubaneshwar: Subir Roy / Subrat Mohanty, Junction of 8. Notarised Power of Attorney Janpath & Gandhi Marg, Hotal Jajati Complex , Kharvelanagar, Unit - III , Master Canteen Square, Bhubaneshwar-751 001. 9. Foreign Inward Remitiance Certificate, in case payment Tel.: 0674-2400986/95. Bhuj: Parth, 101 & 102 Sunrise Tower, is made by DD from NRE / FCNR a/c or where applicable 11 - Vijaynagar Society , Hospital Road, Bhuj -370 001.Tel.: All documents in 1 to 6 above should be originals / true copies certified by the Director / Trustee / Company Secretary / Authorised Signatory / Notary Public 02832-571466. Bokaro: Shamim Ahmed, B-9 City Centre, Sector IV, B - 9, City Center, Sector IV, Bokaro Steel City, Bokaro-827 004. Tel.: 06542-232786/87/88. Calicut: Ratheesh Vellora Vadakkeveettil, Malabar Palace, G.H Road, Calicut-673 001. Tel.: 0495-2727759. Chalakudy: Rajeev R, Police Station Road, Chalakudy-680 307. Tel.: 0480/2707754/55. Chandigarh: Hemant/Deepak, Sco 371/372, Sector 35 - B, 0172-2711285/5088303. Changanacherry: Gireesh G, Cms Dept, Golden Tower, Golden Tower , M C Road, Vezhakattiuchira, Changanacherry-686 101. Tel.: 0481 2425002/2425004. Chengannur: Mathew Jacob, Govt Hospital Junction, Chengannur 689 121 Tel.: 0479-2456215. Chennai: K L Lakshman / Sridhar Ramamurthy, 751 - B Anna Salai, Mariam Centre, Chennai-600 002. Tel.: 044-28420870 / 76 : Extn : 203 / 204. Cochin: R Bhagawatheeswaran, 2nd Floor , Elmar Square, M.g Road, M.g Road, Ravipuram, Cochin-682 016. Tel.: 0484-2359436./09349133907. Coimbatore: Mohan Kumar / Somaprakash, 1635 Classic Tower, Trichy Road, Coimbatore 641 018 Tel.: 0422-2302630/46/2303300. Cuttack: Ashim, Bajrakbati Road, Cuttack-753 001. Tel.: 0671-2332744/33/22/11, Davangere: Prashanth Ubrangala, No 621, Bhm Enclave, Binny Co Road, Mandipet, Davangere. Tel.: 08192-232781. Dehradun: Rupesh Nath, 56, Rajpur Road, Uttaranchal, Dehradun 248 001 Tel.: 0135-2745295. Dhanbad: Kamal Matwala, Sri Ram Plaza , 1st Floor, Bank More Dhanbad, Jharkhand 826 001 Tel.: (0326) 2308831. Durgapur: Nirmalya Banerjee / Snehamay De, A102 & 103, City Centre, Bengal Shristi Complex , City Center, Durgapur Road, Durgapur-713 216 Tel.: 0343- 2549962- 65. Erode: R Shri Krishnan, 456 Brough Road, Erode-638 001. Tel.: (95424) - 2261287 / 2268522 - Extn 0424. Gandhidham: Tejas Mankad, Plot No 1, Sector 8, Rabindranath Tagore Road , Near Gpo, Gandhidham-370 201 Tel.: (02836) - 573251. Gaya: Navneen, Near Ganta Ghar, K.p Road, Gaya-823 001. Tel.: (0631) -2220012. Gorakhpur: Prashant Kumar, Cms Dept, Prahlad Rai Trade Centre, Ayodhya Crossing, Bank Road, Gorakhpur-273 001 Tel.: (0551) -2342612. Guntur: Gupta K.s, 87-90 , Main Road, Lakshmipuram, Guntur-52 2007 Tel.: (0863) -2265648. Guwahati: Mr. Nayanjyoti Das, House No 126 , Opp Times Of India, Bhangagarh, Guwahati-781 005 Tel.: 0361-2461082 (D), 74/80/81. Gwalior: Suresh Asolia / Gopal Sharma, Block G1 , Plot No . 43, Anand Deep Building ,City Centre, Gwalior-474 011 Tel.: 0751 4015007. Himatnagar: Vandan Patel, G.F. Shop No 5-8 & First Floor 4 - 9, Kumar House, Durga Oil Mill Compound, Himmatnagar-383 001 Tel.: 02772-571156/9898592977 Hosur: C . N. Vinay, No. 24 & 25, Maruthi Nagar, Near Dharga, Sipcot Po, Hosur, 635 126 Tel.: 04344-500554 Hubli: Madhusudhan Radhakrishnan, T B Revankar Complex, Vivekanand Hospital Road, Hubli 580 029 Tel.: 0836-2217084 Hyderabad: Umesh Krishna / Krishna Phani Sharma Ammiraju / Shivaji, 6-1-73 3rd Floor Saeed Plaza, Lakadikapaul, Hyderabad 500 004 Tel.: 040-55666821/ 55630666 / 32347423/ 32347412 Indore: Mr.K.vinod Kumar / Raghunatha Reddy, 3 Rd Floor , 9/1A ,, South Tukonj, Indore 452 001. Tel.: 0731- 5201919/5077794 / 5077793 / 5200043 Irinjalakuda: Tito P J, Ushus Complex, Main Road West Tana Po, Irinjalaguda 680 121 Tel.: 0480 2829655 Jabalpur: Mr. Akhilesh Thakur, 1702, Naiper Town, Model Road, Jabalpur 482 002 Tel.: (0761) 5018773, 5063040 Or 41. Jaipur: Puneet Saxena / Ajay Rastogi, 1st Floor ,O - 10 , Ashok Marg, Ahimsa Circle, C Scheme, Jaipur 302 001 Tel.: 0141-5593966 Jalandhar: Raj Chaudhry, 911 , Near Narinder Cinema, G T Road, Jalandhar 144 001 Tel.: 0181-5071644. Jalgaon: Ashutosh Rana / Suresh Pawar, Plot No 134 / 135 , Dsp Chowk, Facing Mahal Road, Jalgaoan 4425 001 Tel.: 0257-2237642 / 2238948 / 2238958 / 223878 Extn - 104 /110. Jamnagar: Nilesh Dhruve, Plot No 6 , Park Colony, St Ann’s School, Bedi Bunder Road, Jamnagar3361 008 Tel.: 0288 - 2662035 , 0288-3112594. Jamshedpur: Sanjay Karmarkar / Babita Thakur / Arup / Arti, C/o Mithila Motors Ltd, Near Ram Mandir, Bistupur, Jamshedpur 831 001 Tel.: 0657-2756006 / 2756066. Jodhpur: Arun Verma / Anil Vyas, Plot No 57 / B, 9th Chopasani Road, Jodhpur 342 003 Tel.: 0291-5106400 / 5106100 / 5106200 / 51062300 Extn 108 / 110. Kadi: Amrish Jhala, Radhaswami Complex ,R.S. No 242, Nr. N.c. Desai Petrol Pump , Highway Char Rastha, Kadi-382 715Tel.: 02764 - 242027. Kanpur: Vasudha Khemka, Navin Market Branch, 15/46 Civil Lines, Kanpur 280 001 Tel.: 00512-3018052. Karad: Vishal Phadnis, Mr Pravin Shaligram,, Near Hotel Sangam, Pune Bangalore Highway, Karad 415 110 Tel.: 02164-229679. Karnal: Rohit Budhiraja, Sco 778-779, Opp Mahabir Dal Hospital, Kanjpura Road, Karnal Tel.: 00184-2202789. Kolhapur: Harshad Kulkarni / Amita Marathe, Jaju Arcade,TTarabai Park, Kolhapur 416 003 Tel. 0231-2651906, 2651908. Kolkata: Anish Gandhi / Debjyoti, Abhilasha Ii ,6, 1st Floor, 6 Royd Street, Kolkata 700 016 Tel.: 0033-22273760-65,2227 3761. Quilon: Harish Sivaram,Vgp Buildings , Door No XVI / 1539 (1320a), Vadakumbhagom Ward , Irumpupalam, Kollam6691 001 Tel.: 00474 2766171 / 74. Kota: Deepak Gupta, Neeraj Agarwal, Show Room No 13 - 14, Main Jhalawar Road,Kota3324 007 Tel.: 00744-2390485 (D), 9829 230 230. Kottayam: Manoj Kumar K.C, Unity Building , Opp Midc Centre, K K Road, Kottayam6686 002 Tel.: 00481-2302361 Latur: Pradeep D. Walunj, Shri Prabha Arcade , Shop No 3-6, M.G. Road, Near Nagar Parishad , Opp Town Hall, Latur 413 512 Tel.: 002382 - 255116. Lucknow: Nitish Srivastav / Anirudh Ramodarai / Amit Srivatava / Shivam Saxena, Pranay Tower,Darbari Lal Sharma Marg, Beside Pratibha Cinema, Lucknow 226 001Tel.: 0522-3019124-27 /3919811 / 3919813 /3019132/3019136 /3019140. Ludhiana: Mr Sanjeev Katare, Vishesh Sudhkaker, CMS Dept , 5th Floor,MMall Road, Ludhiana00 Tel.: 00161- 2422344 / 5021699. Madurai: Sridhar / Kannan Manikandan, 7 - A , West Veli Street, Opp Railway Station, Madurai6625 001 Tel.: 00452-2350707. Mangalore: Muralidhar Hande / Vishwanath Attar, M.N. Towers,KKadri,MMangalore5575 002 Tel.: 00824 - 2225405/2225410. Manjeri: Madhusoodanan P.V. / Shabeer, CMS Dept ,Kurikal Plaza, Bldg #20/1245 Kacheripady,Malapurram Road, Manjeri 676 121 Tel.: 0483 3094040/3091472. Mathura: Saurabh Pandya, CMS Dept, Ops Bsa College, Gaushala Raod, Mathura 281 001 Tel.: 0565-2463805 / 2463808. Meerut: Sumeet Talwar,3381 Western Kachery Road, Meerut2250 001 Tel.: 0121-2666080/2665799. Mehsana: Jigar Patel / Ketan Engineer, Prabhu Complex , Near Raj Kamal Petrol Pump,Abhu Highway, Mehsana 384 002 Tel.: 002762-243173, 02762 - 243 008. Moradabad: Manish B Saxena, Chaddha Shopping Complex,GGmd Road, Moradabad2244 001Tel.: 00591- 2310508 / 09. Mumbai: Deepak Rane / Tushar Gavankar / Sunil Kolencherry, Maneckjiwadia Building, Nanik Motwani Marg, Mumbai 4400 023Tel.: 022 - 56573657 / 56573669 / 22679947 / 22679961. Muzzafarpur: Pintu Kumar Singh, Above Maruti Showroom, Choti Saria Ganj, Muzzafarpur 842 001 Tel.: 0621-2241638 Mysore: Harsha, Nageetha Complex, Vishwamanawa Double Road, Saraswathi Puram, Mysore 570 009 Tel.: 0821-5255304. Nadiad: Rakesh Parmar, Shoot Out Building , Nadiad Ice Factory Compound, College Road,Nadiad 387 001 Tel.: 0268- 5540114. Nagpur: Chandramouli Bharadwaj/Pratima Sarangi, 303 & 304, 3rd Floor , Wardh Road,112, Milestone, Near Lokmat Square, Nagpur4440 010 Tel.: 0712- 2554405 / 2551746 Extn - 119 And 111 Nasik: Binoj Parameswaran / Prashant Pisolkar, Archit Centre, 3rd Floor, Chandak Circle Link Road,Opp Sandeep Hotel , Near Mahamarg Bus Stand, Nasik 422 002 Tel.: 0253-5647594 / 97 / 98. Navsari: Nirav Gandhi, Nandini Complex, Ground Floor, Station Road , Sandh Kuva,NNavsari 396 445 Tel.: 02637 280901 / 240702 / 247896 Nellore: T N Raj Kumar,G.T. Road, Nellore 524 001 Tel.: 00861-2327181 Delhi: Rahul Sikka / Chetan Sondhi / Bharat Chadha,, Figops , Ist Floor, Kailash Building , 26 K G Marg, New Delhi 110 001 Tel.: 011-41699406 / 41699406 Palanpur: Shauank Pandya, Parth Complex , Near Cozy Tower, Opp Joravar Palace,Palanpur3385 001 Tel.: 02742-571638,9327568081 Panipat: Harish Singla/Puneet Gupta/Gurpreet Singh/Ashu Gupta, 801 / 4 , G.T. Road, Panipat1132 103Tel.: 00180 - 5015268 (D) , 2648619-20 Ext 207 Panjim: Kamlakant Bhartu / Amar,Swami Vivekanand Road, 301 , Milroc Lar Menezes,Opp Gomantak Maratha Samaz, Panjim4403 001Tel.: 0832 - 5621250 / 5621251 / 2421952 Pathanamthitta: Prajish M, CMS Dept , Aban Arcade Ward # 9/1128, Pathanathitta-kumbazha Road, Pathanathitta 689 645 Tel.: 0468-2322378 Patiala: Jaswinder Singh/ Inder Pal Singh,SS.C.O. 70 - 73 , Leela Bhawan Market, Patiala1147 001Tel.: 00175 5002500 Patna: Rakesh Verma / Pintu Kumar, Rajendra Ram Plaza,Exhibition Road, Patna 800 001Tel.: 00612-2206161,2224332,3116348 Perinthalmanna: Prasanth P R, Calicut Road, Perinthalmanna , Malappura Dist, Perinthalmanna Tel.: 04933-395306 Phagwara: Gurpreet Singh, Kalra Road , Opp Hanuman Garhi Mandir,GG.t Road, Phagwara 144 401Tel.: 01824-221844-45 Pondicherry: R. Kumar,TTS No 6 , 100 Feet Road, Ellaipillaichavady, Pondhicherry 605 005Tel.: 00413-2200741 Pune: Mangesh Dhole/ Nitin Mandke, 5th Floor Millennium Tower, Bhandarkar Road, Shivaji Nagar ,Pune 411 004 Tel.: 020 -25651575 Extn 121 Raipur: Sunil Nagpal / Vaibhav Agarwal, Chawla Complex, Near Vanijya Bhawan, Sai Nagar, Devendra Nagar Road, Raipur4492 009Tel.: 0771 - 252 9110 (D), 0771 - 505 8901 /02 / 03 Ext. 201 / 202 Rajahmundry: Mr. Narayana Rao / Lakshminarayana, H.No : 46-17-20,MMain Road, Danavaipet,Rajahmundry 533 103Tel.: 0883-2442928 Rajkot: Rajiv S. Sheth / Bharat Pandya,Opp Alfred High School, 2nd Floor , Panchratna Bldg, Jawahar Road, Rajkot 360 001 Tel.: 0281-5595553 Ranchi: Sanjib Jha, Ranchi Club Shopping Complex,Apt No. 11 , Main Road,Ranchi 8834 001Tel.: 00651-2308148 Rohtak: Rajesh Gupta,,4401 -402, D Park, Model Town , Main Delhi Road, Rohtak 124 001 Tel.: 001262-210936, 01262-211064 Ext 211 & 212 Rourkela: Suvankar Pal,Bisra Road , Dwivedi Bhawan,Dwivedi Square, Rourkela 769 001Tel.: 00661- 2500666 ( D ) / 2511666 / 2522666 / 2514666 Rudrapur: Ankur Jain,Plot No1&2,Nanital Road, Plot No1&2,Nanital Road, Rudrapur 263 153 Tel.:05944-241747. Saharanpur: Alok Balodi, Mission Compound,Court Road, Adjoining Top Shop, Saharanpur 247 001 Tel.: 0132 - 2726467 Salem: Mr. Shanmugham,55 / 241 - F, Rathna Arcade, Omalur Main Road,Salem36636 004lTel.: 0427-2331604, 03A, Sangli: Prashant C, 640, Venkatesh Senate, Miraj Road,NSangli4414 416l Tel.: 0233-2327836H, Shimla: Ms. Anupama Srivastava, Jankidas Building, 3, The Mall , Shimla1171 001lTel.: 0177-2658541 / 26585412 / 26585413 Siliguri: Arupendu, 3 No , Ramkrishna Samity Building, Sevoke Road, Pani Tanki More,LSiliguri 734 401 Tel.: 0353-2640726., 0353 2642566 Extn. BLUE PINK