An Integrated Wealth

SIP/STP/SWP REGISTRATION FORM Management Group

ICR/OCR FORM
Application No.

Investor must read key Scheme Features and Instructions before completing this form. All sections to be completed in ENGLISH in BLACK / BLUE COLOURED INK and in BLOCK LETTERS.
BROKER CODE (ARN CODE) SUB-BROKER ARN CODE SUB-BROKER CODE Employee Unique
(As allotted by ARN holder) Identication No. (EUIN)
ARN-9992 ARN- E

Declaration for “execution-only” transaction (only where EUIN box is left blank). - I/We hereby conrm 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.

SIGNATURE OF SOLE / FIRST APPLICANT SIGNATURE OF SECOND APPLICANT SIGNATURE OF THIRD APPLICANT

TRANSACTION CHARGES FOR APPLICANTS THROUGH DISTRIBUTORS ONLY

In case the subscription (lumpsum) amount Rs 10,000/- or more and your Distributor has opted to receive transactions charges, Rs 150/- (for rst time mutual fund investor) or Rs 100/- (for investor other than rst time
mutual fund investor) will be deducted from the subscription amount and paid the distributor. Units will be issued against the balance amount invested.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 FUND NAME

FUND Name
Sole/ First
Applicant Name

FOLIO No. /

Scheme Name

(Please P the appropriate boxes only if applicable to the scheme in which you plan to invest)
OPTION: Growth/Cumulative Dividend SUB-OPTION: Dividend Reinvestment Dividend Payout OR AEP- Regular @ OR Appreciation

2 Systematic Investment Plan (SIP) Registration:

First Installment My existing CAMS OTM registered to be used for initial & subsequent
through cheque/DD SIP Installments (mention CAMS OTM No. in the boxes)

First cheque/DD No: Initial SIP Installment

Dated
Amount Rs.

Bank Name Branch City

V E R 0 4

Each SIP Amount Rs. SIP Frequency: Daily Weekly Monthly Quarterly (Default SIP frequency is Monthly)

SIP Date: 1
st
5
th
7
th
10
th SIP Start Month/Year M M Y Y Y Y
th th th
15 20 25 Others (As Per AMC)_________ SIP END Month /Year M M Y Y Y Y OR 1 2 2 0 9 9 Default end date is Dec 2099

SIP TOP UP (Optional)

Percentage: TOP UP Amount: (* TOP UP amount has to be in multiples of Rs.500 only).
(Tick to avail this facility)

TOP UP Frequency: Half Yearly Yearly SIP TOP UP CAP: Amount OR Month-Year # : M M Y Y Y Y

(Investor has to choose only one option – either CAP Amount or CAP Month-Year)

3 Systematic Transfer Plan (STP)

STP IN SCHEME
Scheme/Plan/Option
Option & Sub option (Please P the appropriate boxes only if applicable to the scheme in which you plan to invest)
OPTION: Growth/Cumulative Dividend SUB-OPTION: Dividend Reinvestment Dividend Payout OR AEP- Regular @ OR Appreciation

st th th th th th th
Daily 1 5 7 10 15 20 25 Others (As Per AMC)_________

STP Start Month/Year M M Y Y Y Y STP END Month /Year M M Y Y Y Y

4 Systematic Withdrawal Plan (SWP)

st th th th th th th
SWP Frequencies Monthly Quarterly SWP Date: 1 5 7 10 15 20 25 Others (As Per AMC)_________

SWP AMOUNT: SWP Start Month/Year M M Y Y Y Y SWP END Month /Year M M Y Y Y Y

I/We hereby conrm that the information/documents provided by me/us in this form are true, correct and complete in all respect. / I/We hereby agree and corm to inform AMC promptly in case of any changes.
SIGNATURE OF SOLE / FIRST APPLICANT SIGNATURE OF SECOND APPLICANT SIGNATURE OF THIRD APPLICANT

SIP STP SWP