FORM 1 - FOR LUMP SUM / SIP INVESTMENTS Application No.

(PLEASE READ THE INSTRUCTIONS BEFORE FILLING UP THE FORM. All sections to be completed in ENGLISH in BLACK / BLUE COLOURED INK and in BLOCK LETTERS.)
Distributor ARN Sub-Distributor ARN Internal Sub-Broker / Sol ID Employee Code EUIN RIA CODE^ Serial No., Date & Time Stamp

ARN 78821 ARN E E065713

Upfront commission shall be paid directly by the investor to the AMFI registered distributor based on the investor's assessment of various factors including the service rendered by the distributor.
^I/We, have invested in the scheme(s) of Axis Mutual Fund under Direct Plan. I/We hereby give my/our consent to share/provide the transactions data feed/ portfolio holdings/ NAV etc. in respect of my/our investments under Direct Plan(s) of all
the below mentioned scheme(s) of Axis Mutual Fund, to the above mentioned SEBI Registered Investment Adviser.
“I/We hereby confirm that the EUIN box has been intentionally left blank by me/us as this
transaction is executed without any interaction or advice by the employee/relationship First / Sole Applicant /
manager/sales person of the above distributor/sub broker or notwithstanding the advice of in- Second Applicant Third Applicant Power of Attorney Holder
appropriateness, if any, provided by the employee/relationship manager/sales person of the Guardian
distributor/sub broker.”

TRANSACTION CHARGES FOR APPLICATIONS ROUTED THROUGH DISTRIBUTORS/AGENTS ONLY (Refer Instruction No. 20)

I confirm that I am a first time investor across Mutual Funds. OR I confirm that I am an existing investor in Mutual Funds.
In case the subscription (lumpsum) amount is ` 10,000/- or more and your Distributor has opted to receive Transaction Charges, ` 150/- (for first time mutual fund investor) or ` 100/- (for investor other than first
time mutual fund investor) will be deducted from the subscription amount and paid to the distributor. Units will be issued against the balance amount invested.
EXISTING INVESTOR'S FOLIO NUMBER INVESTMENT TYPE MODE OF HOLDING
(Please tick any one) (Applicable details and Mode of holding will be as per the existing Folio No.)
(If you have an existing folio with KYC validated, (in case of Demat Purchase Mode of Holding should be same as in Demat Account)
please mention here and skip to section 6/7.) LUMP SUM LUMP SUM WITH SIP
LUMP SUM WITH STP SINGLE CHEQUE MULTIPLE SCHEMES Single Joint (Default) Anyone or Survivor

1 APPLICANT INFORMATION (MANDATORY) (In case of investment "On behalf of Minor", Please Refer Instruction no. 11.)

FIRST / SOLE APPLICANT Mr. Ms. M/s.

PAN (Mandatory) Date of Birth D D M M Y Y Y Y CKYC No. 14 digit CKYC Number

Aadhaar No. Optional Mobile No.

Address

State City Pin Code

Email ID

SECOND APPLICANT Mr. Ms. M/s.

PAN (Mandatory) Date of Birth D D M M Y Y Y Y CKYC No. 14 digit CKYC Number

Aadhaar No. Optional

THIRD APPLICANT Mr. Ms. M/s.

PAN (Mandatory) Date of Birth D D M M Y Y Y Y CKYC No. 14 digit CKYC Number

Aadhaar No. Optional

GUARDIAN DETAILS (In case First / Sole Applicant is minor) / CONTACT PERSON - DESIGNATION / PoA HOLDER (In case of Non-individual Investors)
Mr. Ms. M/s.

PAN (Mandatory) Date of Birth D D M M Y Y Y Y CKYC No. 14 digit CKYC Number

Aadhaar No. Optional Mobile No.

Relationship Of Guardian (Refer Instruction No. 11) Email ID

Proof of the Relationship with Minor Birth Certificate School Certificate Passport Other Specify
TAX STATUS (Applicable for First / Sole Applicant)
Resident Individual FIIs NRI - NRO HUF Club / Society PIO Body Corporate Minor Government Body Trust NRI - NRE Bank & FI
Sole Proprietor Partnership Firm QFI Provident Fund Others Specify

6 DEBIT MANDATE (For Axis Bank A/c only.) To be processed in CMS software under client code “AXISMF” TO BE DETACHED BY KARVY & PRESENTED TO AXIS BANK CMS Application No.
I/ We Name of the account holder(s) authorise you to debit my/our account no. Date D D M M Y Y

Account type Savings NRO NRE Current FCNR Others Specify to pay for the purchase of
Axis Bluechip Fund, Axis Long Term Equity Fund, Axis Regular Saver Fund, Axis Triple Advantage Fund, Axis Midcap Fund, Axis Focused 25 Fund, Axis Arbitrage Fund,
Axis Equity Saver Fund, Axis Multicap Fund, Axis Dynamic Equity Fund Axis Equity Hybrid Fund Axis Small Cap Fund Axis Growth Opportunities Fund OR Axis MF Multiple Schemes
Amount (figures) (words)

Signature of First Account Holder Signature of Second Account Holder Signature of Third Account Holder

ACKNOWLEDGMENT SLIP 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

Stamp & Signature
 2 KYC DETAILS (Refer Instruction No. 8. In case of investment "On behalf of Minor", Please Refer Instruction No. 11)

OCCUPATION [Please tick (P)]

Private Sector Service Public Sector Service Government Service Business Professional Agriculturist Retired Housewife
FIRST APPLICANT
Student Forex Dealer Others
Private Sector Service Public Sector Service Government Service Business Professional Agriculturist Retired Housewife
SECOND APPLICANT
Student Forex Dealer Others
Private Sector Service Public Sector Service Government Service Business Professional Agriculturist Retired Housewife
THIRD APPLICANT
Student Forex Dealer Others

GROSS ANNUAL INCOME [Please tick (P)]

Below 1 Lac 1-5 Lacs 5-10 Lacs 10-25 Lacs > 25 Lacs - 1 Crore > 1 Crore
FIRST APPLICANT
Net worth (Mandatory for Non - Individuals Rs. as on D D M M Y Y Y Y [Not older than 1 year]

SECOND APPLICANT Below 1 Lac 1-5 Lacs 5-10 Lacs 10-25 Lacs > 25 Lacs - 1 Crore > 1 Crore OR Net Worth

THIRD APPLICANT Below 1 Lac 1-5 Lacs 5-10 Lacs 10-25 Lacs > 25 Lacs - 1 Crore > 1 Crore OR Net Worth

For Individuals For Non-Individual Investors (Companies, Trust, Partnership etc.)

I am Politically Exposed Person Is the company a Listed Company or Subsidiary of Listed Company or Controlled by a Listed Company: Yes No
(If No, please attach mandatory UBO Declaration)
I am Related to Politically Exposed Person Foreign Exchange / Money Charger Services Yes No
Gaming / Gambling / Lottery / Casino Services Yes No
I am not related to Politically Exposed Person
Money Lending / Pawning Yes No

3 FATCA AND CRS DETAILS FOR INDIVIDUALS (Including Sole Proprietor. Refer Instruction No. 23)

The below information is required for all applicants/guardian

Place/City of Birth Country of Birth Country of Citizenship / Nationality

First Applicant / Guardian Indian U.S. Others

Second applicant Indian U.S. Others

Third applicant Indian U.S. Others

Are you a tax resident (i.e., are you assessed for Tax) in any other country outside India? Yes No [Please tick]
If ‘YES’ please fill for ALL countries (other than India) in which you are a Resident for tax purpose i.e. where you are a Citizen/Resident / Green Card Holder / Tax Resident in the respective countries.

Country of Tax Residency Tax Identification Number or Identification Type Address Type
Functional Equivalent (TIN or other please specify)
First Applicant / Guardian Residential Registered Office Business

Second applicant Residential Registered Office Business

Third applicant Residential Registered Office Business

'FATCA and CRS Self Certification form' is available on the website of AMC i.e. www.axismf.com or at the Investor Service Centres (ISCs) of Axis Mutual Fund

4 DEMAT ACCOUNT DETAILS (OPTIONAL) (Please ensure that the sequence of names as mentioned in the application form matches with that of the A/c. held with the depository participant.) Refer Instruction No. 19

NSDL: Depository Participant Name DPID No. I N Beneficiary A/c No.

CDSL: Depository Participant Name Beneficiary A/c No.

Enclosed Client Master Transaction/ Statement Copy/ DIS Copy

QUICK CHECKLIST
KYC acknowledgement letter (Compulsory for MICRO Investments) SIP Registration Mandate - NACH for SIP investments
Multiple Bank Accounts Registration form (if you want to register multiple bank accounts so that future payments can be made
Self attested PAN card copy from any of the accounts)
Email id and mobile number provided for online transaction facility Relationship proof between Guardian and Minor (if application is in the name of a Minor) attached
Additional documents attached for Third Party payments. Refer instruction No. 7.
Plan / Option / Sub Option name mentioned in addition to scheme name
FATCA Declaration.
 5 NOMINATION DETAILS (Mandatory) (Refer Instruction No. 18)

Sr. Nominee Name PAN Allocation Relationship with Guardian Name Guardian Signature
No. (%) Investor (in case of Minor)

3
I/We DO NOT wish to nominate and sign here

First / Sole Applicant Second Applicant Third Applicant

7A PAYMENT TYPE
Non-Third Party Payment Third Party Payment (Refer instruction no. 7 and attach 'Third Party Payment Declaration Form')

7B INVESTMENT DETAILS Refer Instruction No. 22)

Sr. No. Scheme Plan Option Amount
1.
2.
3.
4.
Total In words In figures

7C PAYMENT DETAILS
Mode Cheque DD Axis Bank Debit Mandate (Please fill section 6.) Cheque / DD no. Dated D D M M Y Y
Amount (figures) (words)

Pay-in A/c no. Drawn on bank /

branch name &
Account type Savings NRO NRE Current FCNR Others Specify address

IFSC Code (11 Digit) MICR Code (9 Digit)

8 BANK ACCOUNT DETAILS FOR PAYOUT (Please note that as per SEBI Regulations it is mandatory for investors to provide their bank account details. Refer Instruction No. 6)

Tick here and don't fill the section below, if the Bank account details for Pay-Out should be same as the bank account details mentioned in section 7C.
Name of the Bank
Branch Address
City Pin Code
Account No. Account Type Savings Current NRE NRO FCNR Others

IFSC Code (11 Digit) MICR Code (9 Digit)

9 DECLARATION AND SIGNATURE

Having read and understood the content of the SID / KIM of the scheme and SAI of the Axis Mutual Fund (The Fund), I/we hereby apply for units of the scheme. I have read and understood the terms, conditions, details, rules and
regulations governing the scheme. I/We hereby declare that the amount invested in the scheme is through legitimate source only and does not involve designed for the purpose of the contravention of any Act, Rules, Regulations,
Notifications or Directives of the provisions of the Income Tax Act, Anti Money Laundering Laws, Anti Corruption Laws or any other applicable laws enacted by the Government of India from time to time. I/we have not received
nor have been induced by any rebate or gifts, directly or indirectly in making this investment. I/We confirm that the funds invested in the Scheme, legally belongs to me/us. In event “Know Your Customer” process is not
completed by me/us to the satisfaction of the Mutual Fund, (I/we hereby authorize the Mutual Fund, to redeem the funds invested in the Scheme, in favour of the applicant, at the applicable NAV prevailing on the date of such
redemption and undertake such other action with such funds that may be required by the law.) The ARN holder has disclosed to me/us all the commissions (trail commission or any other mode), payable to him for the different
competing Schemes of various Mutual Funds amongst which the Scheme is being recommended to me/ us. I / we give my / our consent to collect personal data or information as prescribed in the privacy policy which is available
on the website of the AMC / Fund. I /We give my consent to AMC and its agents to contact me over phone, SMS, email or any other mode to address my investment related queries and/or receive communication pertaining to
transactions/ non-commercial transactions/ promotions/ potential investments and other communication/ material irrespective of my blocking preferences with the Customer Preference Registration Facility .
I/We confirm that I/We do not have any existing Micro SIP/Lumpsum investments which together with the current application will result in aggregate investments exceeding ` 50,000 in a year (Applicable for Micro investment
only.) with your fund house. For NRIs only - I / We confirm that I am/ we are Non Residents of Indian nationality/origin and that I/We have remitted funds from abroad through approved banking channels or from funds in my/ our
Non Resident External / Non Resident Ordinary / FCNR account. I/We confirm that details provided by me/us are true and correct.
CERTIFICATION: I / We have understood the information requirements of this Form (read along with the FATCA & CRS Instructions) and hereby confirm that the information provided by me/us on this Form is true, correct, and
complete. I / We also confirm that I / We have read and understood the FATCA & CRS Terms and Conditions below and hereby accept the same.
AADHAAR DECLARATION: I/ We hereby provide my/our consent in accordance with Aadhaar Act, 2016 and regulations made thereunder, for (i) collecting, storing and usage (ii) validating/authenticating and (ii) updating my/
our Aadhaar number(s) in accordance with the Aadhaar Act, 2016 (and regulations made thereunder) and PMLA. I/ We hereby provide my/our consent for sharing/disclosing of the Aadhaar number(s) including demographic
information with the asset management companies of SEBI registered mutual fund (s)and their Registrar and Transfer Agent (RTA) for the purpose of updating the same in my/our folios with my PAN.

First / Sole Applicant /

Second Applicant Third Applicant Power of Attorney Holder
Guardian

Date : D D M M Y Y Place :