Non Transferable For the period 01 Jan 1900 to 12 Jan 2025 Statement Date : 12 Jan 2025

Account / Folio No : 407161948612 To serve you better, we have highlighted your profile / contact details. In case you find
any information /details to be incorrect, please reach us at 1860 266 0111 (Call charges
AMIT PARASHARAM CHAVAN apply) at the earliest.
Mode of Holding : SINGLE
S/O PARASHARAM CHAVAN,STREET ROAD LANE NARLI GALLI LANDMARK Status : INDIVIDUAL
KARVIR AREA LOCALITY SECTOR AMSHI
VILLAGE TOWN AMASHI Off. : NA Mobile : 9028056309
KOLHAPUR - 416204 Resi : NA
MAHARASHTRA,INDIA Email id : [email protected]
Nominee 1 : PA******** ****** ****AN
2nd Holder : NA
3rd Holder : NA
Note: In case there is any change in your KYC information please update the same by using the prescribed 'KYC Change Request form' and submit the same at the Point of Service of any KYC Registration Agency.

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# It is mandatory for all investors (new and existing) to provide information related to FATCA (Foreign Account Tax Compliance Act). These details can be updated online at https://mfs.kfintech.com/mfs/fatcahome.aspx or by submitting a duly
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Summary of Investments
Amount IDCW Earned * Current Value (`)
Scheme Details NAV(`) Balance Units
Invested (`) Paid (`) Re-invested (`)
NIPPON INDIA ELSS TAX SAVER FUND - GROWTH PLAN - GROWTH OPTION (TSGPG) 98,000.00 0.00 0.00 118.7378 1,508.639 1,79,132.48

Total: 98,000.00 0.00 0.00 1,79,132.48

*IDCW Paid includes total IDCW payout / sweep out amount. IDCW Reinvested includes amount only for balance units

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 Account No:407161948612 Statement Date : 12 Jan 2025
<font size="1.5" face="arial narrow"><b>NIPPON INDIA ELSS TAX SAVER FUND - GROWTH PLAN - GROWTH OPTION ( TSGPG) ISIN : INF204K01GK4 (NON-DEMAT)</b></font>

NIPPON INDIA ELSS TAX SAVER FUND - GROWTH PLAN - GROWTH OPTION ( TSGPG) ISIN : INF204K01GK4 (NON-DEMAT)
NAV Date Transaction Type Amount (`) Revised Cost* (`) NAV (`) Number of Units Balance Units
15/12/2016 Purchase 1,000.00 48.0883 20.795 20.795
Units under lock in till 15/12/2019
10/01/2017 Sys. Investment (1/Perpetual) 1,000.00 48.7657 20.506 41.301
Units under lock in till 10/01/2020
10/02/2017 Sys. Investment (2/Perpetual) 1,000.00 52.5691 19.023 60.324
Units under lock in till 10/02/2020
10/03/2017 Sys. Investment (3/Perpetual) 1,000.00 52.3445 19.104 79.428
Units under lock in till 10/03/2020
10/04/2017 Sys. Investment (4/Perpetual) 1,000.00 55.6592 17.966 97.394
Units under lock in till 10/04/2020
10/05/2017 Sys. Investment (5/Perpetual) 1,000.00 56.9214 17.568 114.962
Units under lock in till 10/05/2020
12/06/2017 Sys. Investment (6/Perpetual) 1,000.00 57.5656 17.371 132.333
Units under lock in till 12/06/2020
10/07/2017 Sys. Investment (7/Perpetual) 1,000.00 59.6011 16.778 149.111
Units under lock in till 10/07/2020
10/08/2017 Sys. Investment (8/Perpetual) 1,000.00 59.3819 16.840 165.951
Units under lock in till 10/08/2020
11/09/2017 Sys. Investment (9/Perpetual) 1,000.00 61.1134 16.363 182.314
Units under lock in till 11/09/2020
10/10/2017 Sys. Investment (10/Perpetual) 1,000.00 61.7775 16.187 198.501
Units under lock in till 10/10/2020
10/11/2017 Sys. Investment (11/Perpetual) 1,000.00 65.9563 15.162 213.663
Units under lock in till 10/11/2020
11/12/2017 Sys. Investment (12/Perpetual) 1,000.00 66.5193 15.033 228.696
Units under lock in till 11/12/2020
10/01/2018 Sys. Investment (13/Perpetual) 1,000.00 69.5279 14.383 243.079
Units under lock in till 10/01/2021
12/02/2018 Sys. Investment (14/Perpetual) 1,000.00 66.2421 15.096 258.175
Units under lock in till 12/02/2021
12/03/2018 Sys. Investment (15/Perpetual) 1,000.00 60.1882 16.615 274.790
Units under lock in till 12/03/2021
10/04/2018 Sys. Investment (16/Perpetual) 1,000.00 60.8091 16.445 291.235
Units under lock in till 10/04/2021
10/05/2018 Sys. Investment (17/Perpetual) 1,000.00 59.1861 16.896 308.131
Units under lock in till 10/05/2021
11/06/2018 Sys. Investment (18/Perpetual) 1,000.00 57.4637 17.402 325.533
Units under lock in till 11/06/2021
10/07/2018 Sys. Investment (19/Perpetual) 1,000.00 55.2575 18.097 343.630
Units under lock in till 10/07/2021
10/08/2018 Sys. Investment (20/Perpetual) 1,000.00 57.4689 17.401 361.031
Units under lock in till 10/08/2021
10/09/2018 Sys. Investment (21/Perpetual) 1,000.00 58.2318 17.173 378.204
Units under lock in till 10/09/2021
10/10/2018 Sys. Investment (22/Perpetual) 1,000.00 51.9036 19.266 397.470
Units under lock in till 10/10/2021
12/11/2018 Sys. Investment (23/Perpetual) 1,000.00 53.1887 18.801 416.271
Units under lock in till 12/11/2021
10/12/2018 Sys. Investment (24/Perpetual) 1,000.00 51.8301 19.294 435.565
Units under lock in till 10/12/2021
10/01/2019 Sys. Investment (25/Perpetual) 1,000.00 54.4533 18.364 453.929
Units under lock in till 10/01/2022
11/02/2019 Sys. Investment (26/Perpetual) 1,000.00 50.6398 19.747 473.676
Units under lock in till 11/02/2022
11/03/2019 Sys. Investment (27/Perpetual) 1,000.00 54.2927 18.419 492.095
Units under lock in till 11/03/2022
10/04/2019 Sys. Investment (28/Perpetual) 1,000.00 56.3941 17.732 509.827
Units under lock in till 10/04/2022
10/05/2019 Sys. Investment (29/Perpetual) 1,000.00 53.4804 18.698 528.525
Units under lock in till 10/05/2022
10/06/2019 Sys. Investment (30/Perpetual) 1,000.00 55.9843 17.862 546.387
Units under lock in till 10/06/2022
10/07/2019 Sys. Investment (31/Perpetual) 1,000.00 53.8177 18.581 564.968
Units under lock in till 10/07/2022
13/08/2019 Sys. Investment (32/Perpetual) 1,000.00 47.3784 21.107 586.075
Units under lock in till 13/08/2022
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 Account No:407161948612 Statement Date : 12 Jan 2025
<font size="1.5" face="arial narrow"><b>NIPPON INDIA ELSS TAX SAVER FUND - GROWTH PLAN - GROWTH OPTION ( TSGPG) ISIN : INF204K01GK4 (NON-DEMAT)</b></font>

NIPPON INDIA ELSS TAX SAVER FUND - GROWTH PLAN - GROWTH OPTION ( TSGPG) ISIN : INF204K01GK4 (NON-DEMAT)
NAV Date Transaction Type Amount (`) Revised Cost* (`) NAV (`) Number of Units Balance Units
Units under lock in till 13/08/2022
11/09/2019 Sys. Investment (33/Perpetual) 1,000.00 48.9261 20.439 606.514
Units under lock in till 11/09/2022
10/10/2019 Sys. Investment (34/Perpetual) 1,000.00 48.7980 20.493 627.007
Units under lock in till 10/10/2022
11/11/2019 Sys. Investment (35/Perpetual) 1,000.00 54.4529 18.364 645.371
Units under lock in till 11/11/2022
10/12/2019 Sys. Investment (36/Perpetual) 1,000.00 51.9458 19.251 664.622
Units under lock in till 10/12/2022
10/01/2020 Sys. Investment (37/Perpetual) 1,000.00 56.6422 17.655 682.277
Units under lock in till 10/01/2023
10/02/2020 Sys. Investment (38/Perpetual) 1,000.00 54.9788 18.189 700.466
Units under lock in till 10/02/2023
11/03/2020 Sys. Investment (39/Perpetual) 1,000.00 45.3471 22.052 722.518
Units under lock in till 11/03/2023
13/04/2020 Sys. Investment (40/Perpetual) 1,000.00 37.8567 26.415 748.933
Units under lock in till 13/04/2023
11/05/2020 Sys. Investment (41/Perpetual) 1,000.00 37.7381 26.498 775.431
Units under lock in till 11/05/2023
10/06/2020 Sys. Investment (42/Perpetual) 1,000.00 40.8615 24.473 799.904
Units under lock in till 10/06/2023
10/07/2020 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 42.8985 23.310 823.214
(43/Perpetual)
Units under lock in till 10/07/2023
10/08/2020 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 44.3866 22.528 845.742
(44/Perpetual)
Units under lock in till 10/08/2023
10/09/2020 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 45.3684 22.041 867.783
(45/Perpetual)
Units under lock in till 10/09/2023
12/10/2020 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 46.3269 21.585 889.368
(46/Perpetual)
Units under lock in till 12/10/2023
10/11/2020 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 49.6380 20.145 909.513
(47/Perpetual)
Units under lock in till 10/11/2023
10/12/2020 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 53.2928 18.763 928.276
(48/Perpetual)
Units under lock in till 10/12/2023
11/01/2021 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 57.8531 17.284 945.560
(49/Perpetual)
Units under lock in till 11/01/2024
10/02/2021 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 61.4444 16.274 961.834
(50/Perpetual)
Units under lock in till 10/02/2024
10/03/2021 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 63.9380 15.639 977.473
(51/Perpetual)
Units under lock in till 10/03/2024
12/04/2021 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 60.8900 16.422 993.895
(52/Perpetual)
Units under lock in till 12/04/2024
10/05/2021 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 64.5496 15.491 1,009.386
(53/Perpetual)
Units under lock in till 10/05/2024
10/06/2021 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 67.7427 14.761 1,024.147
(54/Perpetual)
Units under lock in till 10/06/2024
12/07/2021 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 68.4011 14.619 1,038.766
(55/Perpetual)
Units under lock in till 12/07/2024
11/08/2021 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 71.4233 14.000 1,052.766
(56/Perpetual)
Units under lock in till 11/08/2024
13/09/2021 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 75.9698 13.162 1,065.928
(57/Perpetual)
Units under lock in till 13/09/2024
11/10/2021 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 78.6688 12.711 1,078.639
(58/Perpetual)
Units under lock in till 11/10/2024
10/11/2021 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 80.4149 12.435 1,091.074
(59/Perpetual)
Units under lock in till 10/11/2024
10/12/2021 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 77.1382 12.963 1,104.037
(60/Perpetual)
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 Account No:407161948612 Statement Date : 12 Jan 2025
<font size="1.5" face="arial narrow"><b>NIPPON INDIA ELSS TAX SAVER FUND - GROWTH PLAN - GROWTH OPTION ( TSGPG) ISIN : INF204K01GK4 (NON-DEMAT)</b></font>

NIPPON INDIA ELSS TAX SAVER FUND - GROWTH PLAN - GROWTH OPTION ( TSGPG) ISIN : INF204K01GK4 (NON-DEMAT)
NAV Date Transaction Type Amount (`) Revised Cost* (`) NAV (`) Number of Units Balance Units
10/12/2021 (60/Perpetual) 999.95 77.1382 12.963 1,104.037
Units under lock in till 10/12/2024
10/01/2022 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 79.0944 12.642 1,116.679
(61/Perpetual)
Units under lock in till 10/01/2025
10/02/2022 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 78.3009 12.771 1,129.450
(62/Perpetual)
Units under lock in till 10/02/2025
10/03/2022 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 72.7948 13.737 1,143.187
(63/Perpetual)
Units under lock in till 10/03/2025
11/04/2022 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 78.9731 12.662 1,155.849
(64/Perpetual)
Units under lock in till 11/04/2025
10/05/2022 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 71.5556 13.974 1,169.823
(65/Perpetual)
Units under lock in till 10/05/2025
10/06/2022 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 71.1373 14.057 1,183.880
(66/Perpetual)
Units under lock in till 10/06/2025
11/07/2022 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 72.6370 13.766 1,197.646
(67/Perpetual)
Units under lock in till 11/07/2025
10/08/2022 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 77.9537 12.827 1,210.473
(68/Perpetual)
Units under lock in till 10/08/2025
12/09/2022 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 81.1709 12.319 1,222.792
(69/Perpetual)
Units under lock in till 12/09/2025
10/10/2022 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 77.9373 12.830 1,235.622
(70/Perpetual)
Units under lock in till 10/10/2025
10/11/2022 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 80.4256 12.433 1,248.055
(71/Perpetual)
Units under lock in till 10/11/2025
12/12/2022 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 83.3065 12.003 1,260.058
(72/Perpetual)
Units under lock in till 12/12/2025
10/01/2023 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 81.0069 12.344 1,272.402
(73/Perpetual)
Units under lock in till 10/01/2026
10/02/2023 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 79.7692 12.536 1,284.938
(74/Perpetual)
Units under lock in till 10/02/2026
13/03/2023 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 76.9437 12.996 1,297.934
(75/Perpetual)
Units under lock in till 13/03/2026
10/04/2023 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 78.3415 12.764 1,310.698
(76/Perpetual)
Units under lock in till 10/04/2026
10/05/2023 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 81.0504 12.337 1,323.035
(77/Perpetual)
Units under lock in till 10/05/2026
12/06/2023 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 83.6875 11.949 1,334.984
(78/Perpetual)
Units under lock in till 12/06/2026
10/07/2023 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 87.2072 11.466 1,346.450
(79/Perpetual)
Units under lock in till 10/07/2026
10/08/2023 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 90.2257 11.083 1,357.533
(80/Perpetual)
Units under lock in till 10/08/2026
11/09/2023 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 94.8604 10.541 1,368.074
(81/Perpetual)
Units under lock in till 11/09/2026
10/10/2023 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 92.8306 10.772 1,378.846
(82/Perpetual)
Units under lock in till 10/10/2026
10/11/2023 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 92.9074 10.763 1,389.609
(83/Perpetual)
Units under lock in till 10/11/2026
11/12/2023 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 101.4707 9.855 1,399.464
(84/Perpetual)
Units under lock in till 11/12/2026
10/01/2024 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 104.7536 9.546 1,409.010
(85/Perpetual)
Units under lock in till 10/01/2027
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 Account No:407161948612 Statement Date : 12 Jan 2025
<font size="1.5" face="arial narrow"><b>NIPPON INDIA ELSS TAX SAVER FUND - GROWTH PLAN - GROWTH OPTION ( TSGPG) ISIN : INF204K01GK4 (NON-DEMAT)</b></font>

NIPPON INDIA ELSS TAX SAVER FUND - GROWTH PLAN - GROWTH OPTION ( TSGPG) ISIN : INF204K01GK4 (NON-DEMAT)
NAV Date Transaction Type Amount (`) Revised Cost* (`) NAV (`) Number of Units Balance Units
12/02/2024 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 105.6284 9.467 1,418.477
(86/Perpetual)
Units under lock in till 12/02/2027
11/03/2024 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 109.9278 9.096 1,427.573
(87/Perpetual)
Units under lock in till 11/03/2027
10/04/2024 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 113.4501 8.814 1,436.387
(88/Perpetual)
Units under lock in till 10/04/2027
10/05/2024 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 112.6344 8.878 1,445.265
(89/Perpetual)
Units under lock in till 10/05/2027
10/06/2024 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 120.5013 8.298 1,453.563
(90/Perpetual)
Units under lock in till 10/06/2027
10/07/2024 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 128.0154 7.811 1,461.374
(91/Perpetual)
Units under lock in till 10/07/2027
12/08/2024 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 126.7642 7.888 1,469.262
(92/Perpetual)
Units under lock in till 12/08/2027
10/09/2024 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 131.0500 7.630 1,476.892
(93/Perpetual)
Units under lock in till 10/09/2027
10/10/2024 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 130.5920 7.657 1,484.549
(94/Perpetual)
Units under lock in till 10/10/2027
11/11/2024 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 125.7097 7.954 1,492.503
(95/Perpetual)
Units under lock in till 11/11/2027
10/12/2024 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 129.6153 7.715 1,500.218
(96/Perpetual)
Units under lock in till 10/12/2027
10/01/2025 Sys. Investment (Gross - Rs 1000.00 ,Stamp duty Rs 0.05 ) 999.95 118.7378 8.421 1,508.639
(97/Perpetual)
Units under lock in till 10/01/2028
Balance Units : 1508.639 Lock-in : 391.960, Free : 1116.679 Current Cost in (`) 98,000.00 Current value in (`) 1,79,132.48 NAV as on 10-Jan-2025 (`) 118.7378
NAV as on 31-Jan-2018 Rs. 67.8291 (For long term capital gains calculation)
Bank Name : ICICI BANK LIMITED
Bank Account No. : SAVINGS \ XXXXXXXX0719 IFSC : ICIC0006367 MICR No : 416229513 Mode of Payment : Electronic
Agent/Advisor Code & Name : ARN-9992 / Prudent Corporate Advisory Services Ltd Sub Broker ARN Code : ARN-93259 Sub Broker Code : 76502 EUIN : E096694
City Type : B30
Entry load - NIL; Exit load - NIL, Lock in period is 3 years from the date of subscription. The above investment in NIPPON INDIA ELSS TAX SAVER FUND is eligible for availing tax benefits under Section 80C of the Income-tax Act, 1961

OTBM REGISTRATION DETAILS

UMRN Number Registration Mode Bank Name Bank Account No Upper Limit Amount Validity Date Registration Status Rejection Reason (if Any)
NA OTMIC ICICI BANK LIMITED XXXXXXXX0719 1000.00 31/12/2099 Registered NA

*Form 15 : Not Registered

Inflows into Tax Saving scheme for the period from 01 Jan 1900 to 12 Jan 2025
Scheme Name Amount (INR)
NIPPON INDIA ELSS TAX SAVER FUND - GROWTH PLAN - GROWTH OPTION (TSGPG) 97997.25

SPECIAL PRODUCTS REGISTRATION DETAILS (For complete scheme name, refer transaction table.)

From Scheme To Scheme Start Date End Date Frequency Installment Amount Transaction Type Step-Up Frequency Step-Up Amount Insure status
NIMF Tax NA 10-Jan-2017 10-Dec-2099 Monthly Perpetual 1,000.00 SIP NA NA NA
Saver Fnd
For daily frequency options, units will be processed on business days only, excluding holidays, during the SIP and STP period. Accordingly, the start date and end date is provided to reflect the actual business
day processing schedule.
It is always good to keep your profile details updated with us. Hence, we request you to go through your Statement of Account and review important details such as Name(s), Bank details, PAN, Address etc. In case of any
discrepancy in the details mentioned in the Statement of Account (SOA), we request you to urgently (within 10 days of the receipt of SOA) get in touch with us as per modes / ways mentioned below for necessary correction. Call
us at 1860 266 0111 (Call charges apply) or write to us at [email protected] or write to the Registrar at KFin Technologies Limited (Formerly KFin Technologies Private Limited)., Selenium Tower, Plot No. 31 & 32,
Financial District, Nanakramguda, Serilingampally Mandal, Hyderabad 500032. Nippon India Mutual Fund (NIMF) ( mf.nipponindiaim.com), asset manager of NIMF or its Registrars shall NOT be liable for any discrepancy brought
to notice thereafter

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 PLEASE TEAR HERE
Agent/Advisor Code & Name: ARN-9992\ Prudent Corporate Advisory Services Ltd
Account / Folio No : 407161948612
Mode of Holding : SINGLE Sub-Broker ARN Code : ARN-93259 Sub Broker Code : 76502 EUIN : E096694
Scheme Please Mention the Scheme Name PAN / PEKRN KYC
First Holder AMIT PARASHARAM CHAVAN ATJPC0187A VERIFIED
Second Holder NA Not Provided NA
Third Holder NA Not Provided NA
Guardian Not Provided NA
Additional Purchase Request Payment Mode OTBM facility (one time bank mandate) Cheque DD
I / We would like to Purchase additional units in the above mentioned scheme. OTBM / Cheque / DD Net amount (`) | | | | | | | | | | | | | | dated | | | | |
DD Charges (`) | | | | | | Drawn on (bank) | | | | | | | | | | | | | | | | | | | | | | | | | Cheque/DD No | | | | | | | | | |
Branch | | | | | | | | | | | | | | City | | | | | | | | | |
Switch Request
I / We would like to Switch(`) | | | | | | | | | | | | | | | | | | | | | Units from the above mentioned Scheme / Plan to Nippon India
| | | | | | | | | | | | | | | Scheme | | | | | | | | | | | | | | | Plan | | | | | | | | | | | | | | | Option.
Redemption Request
Please redeem (`) (in fig.) | | | | | | | | | | or | | | | | | | | | | Units from the above mentioned Scheme / Plan.

Signature(s) Sole / First Unit holder Second Unit holder Third Unit holder

CA : DAPI-MFPFPRUDENTKCPL-12.01.2025 / LA: ARNSERVICE-12.01.25-12 : 609190340 Page 6 OF 6