For Product Labelling & Suitability (Including Risk-o-Meter of Benchmark) and PRC

Matrix For Debt Schemes available on cover pages

Distributor / RIA / PMRN Name and ARN / Code

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.

(As per PAN) (Refer Instructions)

(As per PAN) (Refer Instructions)

NRI Investors should mention their Overseas address (Refer instructions).

Contact details belong to family due to investor being,

 Self  Spouse  Dependent Child  Dependent Parent  Dependent Sibling  Guardian In case of Minor

2nd Applicant Name

(As per PAN) (Refer Instructions)

3rd Applicant Name

(As per PAN) (Refer Instructions)
8. NOMINATION (PREFERABLE) OR OPT OUT (AVOIDABLE) Nominee Details or Opt-Out Declaration (by way of tick) is mandatory to process the application.
Nomination OPT-IN (All details in below table are mandatory)

Relationship If Nominee is a Minor*

Nominee Name/s & PAN with Allocation Nominee/Guardian
Date of (%) Signature
applicant Guardian Name & PAN Birth
1
2
3
Address *In case of each Minor as Nominee, please mention Guardian’s relationship with Minor Total 100%
as Mother/Father/Legal Guardian & Attach proof like Birth Certificate/School Leaving Certificate/Passport/Others.

OPT-OUT declaration: I / We hereby confirm that I / We do not wish to appoint any nominee(s) for my mutual fund units held in my / our mutual fund folio and understand the issues
involved in non appointment of nominee(s) and further are aware that in case of death of all the account holder(s), my / our legal heirs would need to submit all the requisite
documents issued by Court or other such competent authority, based on the value of assets held in the mutual fund folio.

Account Demat
Statement Mode
Mode
(Default)

Contact Center: 1800-208-4499 / 1800-200-4499

Name/s mentioned are as per PAN only
Address, Email ID/Mobile are correctly mentioned.
Debit Mandate Checklist: SIP Registration Checklist:
● Distributor code & details, if any, ● Distributor code & details, if any,
● Bank Account Number, Bank Name, IFSC or MICR Code ● Name, Folio No. / Application No.
● Amount in words AND in Figures, as you would in a cheque ● Scheme/s details
(your maximum limit) ● Date, Other details
● Your NAME and SIGNATURE as in your bank account ● Signature/s
Distributor / RIA / PMRN Name and ARN / Code Sub Broker ARN & Name Sub Broker/Branch/ EUIN (Refer note below) For Office use only
RM Internal Code

The following Mandate needs to be submitted only once for registration with or without SIP form. Once the mandate is registered, investor need not submit mandate again and can do lump sum investments,
start new SIP registrations, using Physical Forms, Call, SMS or Online.

OTM Debit Mandate Form NACH/DIRECT DEBIT

[Applicable for Lumpsum Additional Purchases as well as SIP Registrations]

UMRN Office use only Date D D M M Y Y Y Y

Utility Code Office use only Tick()  CREATE  MODIFY  CANCEL

Sponsor Bank Code Office use only I/We hereby authorize: DSP MUTUAL FUND Schemes
to debit (tick) SB / CA / CC / SB-NRE / SB-NRO / Other Bank A/c No.:

With Bank: Bank Name & Branch IFSC/MICR

an amount of Rupees In Words ` In Figures

Debit Type  Fixed Amount  Maximum Amount FREQUENCY  Mthly  Qtly  H. Yrly  Yrly  As & when presented
Reference 1 Folio No: Reference 2 Appln No:

I agree for the debit of mandate processing charges by the bank whom I am authorising to debit my account as per latest schedule of charges of the bank.This is to confirm that the declaration has been carefully
read, understood and made by me/us. I/We have understood that I/we are authorised to cancel/amend this mandate by appropriately communicating the cancellation/amendment request to the User entity or the
bank where I have authorised the debit and express my willingness and authorize to make payments through participation in NACH/Direct Debit/Standing Instructions. I/We hereby confirm adherence to the terms of
OTM Facility and as amended from time to time and of NACH/(Debits)/Direct Debits /Standing Instructions. Authorisation to Bank: This is to inform that I/We have registered for NACH (Debit Clearing) / Direct Debit
/ Standing instructions facility and that my/our payment towards my/our investment in DSP Mutual Fund shall be made from my/our above mentioned bank account with your Bank. I/We authorize the representatives
of DSP Mutual Fund carrying this mandate form to get it verified and executed.

PERIOD
From D D M M Y Y Y Y
to D D M M Y Y Y Y 1. 2. 3.
Signature of Account Holder Signature of Account Holder Signature of Account Holder
or  Until Cancelled
1. 2. 3.
Mobile
Name of Account Holder Name of Account Holder Name of Account Holder

SIP Registration/Renewal Form (for OTM registered investors only)

Please tick  as applicable:
Attention: No need to attach OTM Debit Mandate again, if already registered earlier.
 OTM Debit Mandate is already registered in the folio. [No need to submit again].  OTM Debit Mandate is attached and to be registered in the folio.
Distributor / RIA / PMRN Name and ARN / Code Sub Broker ARN & Name Sub Broker/Branch/RM Internal Code EUIN (Refer note below) For Office use only

I/We confirm that the EUIN box is intentionally left blank by me/us as this is an “execution-only”transaction without any interaction or advice by the distributor personnel concerned. Upfront Sole / FirstApplicant's
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. Signature Mandatory

Investor Name: Existing Investor

Folio No./Application No.

Sr. Scheme/Plan/Option/Sub-option SIP Installment SIP Date Start Month/Year Top-Up (Minimum ` 500 or in Percentage %)
Frequency
No. (Mention Cheque details, if attached) Amount (`) (1st* to 31st) End Month/Year# Amount (`) or Percentage %) Frequency
From M M Y Y Y Y
1. DSP - Monthly* ` OR % Yearly*
D D Quarterly For Perpetual 10 yrs 7 yrs 5 yrs Half-yearly

Or till M M Y Y Y Y Top-Up CAP*:

2. DSP - Monthly* From M M Y Y Y Y

` OR % Yearly*
D D Quarterly For Perpetual 10 yrs 7 yrs 5 yrs
Half-yearly

Or till M M Y Y Y Y Top-Up CAP*:

3. DSP - Monthly* From M M Y Y Y Y ` % Yearly*

D D Quarterly For Perpetual 10 yrs 7 yrs 5 yrs
OR
Half-yearly

Or till M Top-Up CAP*:

M Y Y Y Y

(*Default option/Date)
(#Default/Perpetual: 12/2099) Total
First SIP transactions via single cheque no. favouring ‘DSP Mutual Fund’ Dated D D M M Y Y Y Y

Debit Bank Details: Bank Name: A/C. No.:

Declaration: Having read, understood and agreed to the contents of OTM Facility, the Scheme Information Document, Statement of Additional Information, Key Information Memorandum, Instructions
and Addenda issued from time to time of the respective Scheme(s) of DSP Mutual Fund mentioned within, I hereby declare that the particulars given above are correct and express my willingness to
make payments towards SIP instalments referred above through participation in NACH/Direct Debit/Standing Instructions. The ARN holder, where applicable, 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 from amongst which the Scheme is being recommended to me/us.
Signatures [as per Mutual Fund Records/Application]
x First
Unit
Holder’s
Second
Unit
Holder’s
Third
Unit
Holder’s
Signature Signature Signature

Acknowledgement DSP Mutual Fund ISC Stamp

Investor Name: Folio No/Application No.
DEBIT MANADATE FORM SIP FORM
Website : www.dspim.com | E-mail : [email protected] | Contact Centre : 1800-208-4499 / 1800-200-4499