COMMON TRANSACTION SLIP (For existing Unitholders only)

BROKER CODE (ARN CODE) SUB-BROKER ARN CODE Employee Unique SUB-BROKER CODE
DIRECT Identification No. (EUIN) (As allotted by ARN holder)
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.
Declaration for "execution-only" transaction (only where EUIN box is left blank)
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.

Signature of Sole/First Holder Signature of Second Holder Signature of Third Holder

FOLIO NO. (Mandatory): 25830728 TAX STATUS: MODE OF HOLDING:

1st Holder
(Mandatory) RailTel Corporation of India Limited
2nd Holder

3rd Holder
# In case of direct application, please write as 'DIRECT' against broker code. * PAN & KYC are mandatory for all applicants including NRIs.

✔ Additional Purchase Request (Cheque/DD to be drawn in favour of “Name of the Scheme”). In case you do not mention Plan and/or Option units will
be allotted under default option as per respective scheme information documents.
Scheme Name ICICI PRUDENTIAL LIQUID FUND PLAN: DIRECT OPTION: GROWTH

Cheque / DD No. Drawn on Bank

Name & Branch
Amount of cheque/ DD charges, if any
Cheque / DD Date D D M M Y Y Y Y
DD in figures (Rs.) Rs. (in figures)
Bank Account Type Savings ✔ Current NRO NRE FCNR
A/c No. Others _____________________________ (Please specify)
160000000
We hereby confirm having initiated the Transfer / RTGS for transfer of INR ___________________________________ from our account no. _____________________________________ with

_________________________________________ (Bank) to your account no.______________________________________ with __________________________________________________ (Bank).

Documents attached to avoid Third Party Payment Rejection where applicable: In case, the additional purchase amount is `10,000 or above and distributor has opted to
Bank Certificate - for DD Third Party Declaration receive transaction charges, `100/- will be deducted from the Purchase amount and paid
to the distributor. Units shall be allotted for the balance amount only.
For third party investment/pre-funded instrument, please fill in a separate declaration form as available with AMC.

Switch Request (Please refer to the SID of the scheme you are switching from and to) I wish to switch: Rs. or Units
From To
(Scheme) Plan: (Scheme) Plan:

(Option) (Option)

Have you invested long enough ? Redemption Request

• Longer investment time period may allow your money the Benefit of
BEFORE YOU

Please
Compounding. Rs. or Units
REDEEM

Redeem
• We recommend you check your investment horizon against your financial
Scheme
goals and not to get swayed by short term market movements.
• Have you been invested long enough to avoid any short term capital gain Plan
tax and exit load charges ?
Option
Consult your financial advisor for the appropriate investment horizon!
If you have registered for multiple bank account facility in the above folio please specify the bank details in which you wish to receive the redemption proceeds. The bank account should be one of the registered
bank account in the folio else the payout will be released to the default bank account registered for the folio.
Bank Name Bank A/c No.

Contact details of First/Sole applicant

Mobile Number and/or Land Line Number

E-mail Address

YOUR CONFIRMATION/DECLARATION: I/We have read and understood the contents of the Scheme Information Document(s)/Key Infromation Memorandum(s) & Statement of Additional
Information(s) of the Scheme(s) and agree to abide by the terms, conditions, rules and regulations of the Scheme(s) as on the date of this transaction. I/We hereby declare that I am/we are not US Person(s).
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 hereby confirm that I/we have not been offered/communicated any indicative portfolio and/or any indicative yield for this investment.

Signature(s)
First Holder Second Holder Third Holder

RailTel Corporation of India Limited

25830728
Folio No. ............................................................................................................. ✔ Purchase Redeem Switch Date: .................................................
ICICI PRUDENTIAL LIQUID FUND
Scheme ....................................................................................................................................................................... Amount Rs. ............................................................... or Units .......................................

From Scheme (in case of switch) ........................................................................................................... To Scheme .........................................................................................................................................