APPLICATION FORM. 3. APPLICANTS INFORMATION (Refer Instruction No. 3A) KYC Status^ ^ Mandatory for any amount, If Yes, attach proof

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1 APPLICATION FORM (To be used / diributed with Key Information Memoraum) Please submit separate form for each scheme. Please read the Scheme Information Document / KIM of the scheme a inructions carefully. Application. All sections to be completed legibly in English in Black/Blue coloured ink a in BLOCK letters. 1. DISTRIBUTOR INFORMATION (Refer Inruction. 1) FOR OFFICE USE ONLY Diributor Code ARN - 2. TRANSACTION CHARGES (Please any one of the below) (Refer Inruction. 2) 3. APPLICANTS INFORMATION (Refer Inruction. 3A) Name of Sole/1 Applicant Mr. Ms. M/s. (Please ) Date of Birth D D M M Y Y Y Y (Please ) Proof of Date of Birth (Maatory in case of Minor) (Refer Inruction. 3B) F I R S T N A M E M I D D L E N A M E L A S T N A M E Name of 2 Applicant F F * Inveors providing id would maatorily receive only E-atement of account in lieu of physical atement of account. 4. BANK DETAILS (MANDATORY - IF LEFT BLANK, APPLICATION WILL BE REJECTED) (Refer Inruction. 5) Mention your Core Banking Account. (if applicable). Please check with your bank, if you do not have the same. Account. Account Type CA SB NRO NRE FCNR Others (Please specif y) Name of Bank Account Holder Branch I AM A FIRST TIME INVESTOR IN MUTUAL FUNDS MICR code I R S T N A M E M I D D L E N A M E L A S T N A M E Name of 3 Applicant (MICR code is the 9 digit code next to the cheque no.) Mr. Ms. M/s. (Please ) Date of Birth Mr. Ms. M/s. (Please ) Date of Birth IFSC code OR Bank Name City M A N D A T O R Y I AM AN EXISTING INVESTOR IN MUTUAL FUNDS (IFSC code is the 11 digit no. appearing on your cheque leaf) (Maatory for credit via NEFT/RTGS) D D M M Y Y Y Y D D M M Y Y Y Y I R S T N A M E M I D D L E N A M E L A S T N A M E Name of Guaian/Contact Person Mr. Ms. M/s. Relationship with Minor Proof of Relationship (Please ) (Refer Inruction. 3C) (Maatory in case of Minor Applicant) F I R S T N A M E M I D D L E N A M E L A S T N A M E 1 Applicant 2 Applicant 3 Applicant Guaian (In case 1 Applicant is a Minor) CONTACT INFORMATION Correspoence Address of Sole/Fir Applicant (P.O. Box address is not sufficient) (Refer Inruction. 4) City Overseas Address (Maatory for NRI/FII applicant) (P.O. Box address is not sufficient) City Sub Broker Code ARN - PAN* * Maatory with an atteed PAN Proof KYC Status^ ^ Maatory for any amount, If, attach proof Country Contact Details Tel.. STD Code Res. Off. Fax 1 Applicant Mobile. ID* 2 Applicant Mobile. ID* 3 Applicant Mobile. ID* Employee Code (E-UIN) Branch Serial Code Regirar Serial. Date/Time of Receipt Please incase the Employee Code (E-UIN) box has been left blank. I/We hereby confirm that where the EUIN space has been left blank by me/us, the transaction is an execution-only transaction. Upfront commission shall be paid directly by the inveor to the AMFI regiered Diributors based on the inveors assessment of various factors including services reered by the diributor. State Mode of Holding Single Anyone or Survivor Joint (Default Option) (Please any one) Status of Resident Iividual NRI PIO Tru FII Bank 1 Applicant Company/Body Corporate (Pvt. Ltd.) Partnership (Please any one) Company/Body Corporate (Public & Others Ltd.) NGO Minor AOP/BOI Club/Society Government Body HUF Others (Please specify) Occupation Private Sector Service Public Sector / Govt. Service (Please any one) Business Professional Agriculturi Student Retired Housewife Others (Please specify) PIN Code (Maatory) ZIP Code Maatory to submit a cancelled cheque leaf of the bank account mentioned here. ACKNOWLEDGEMENT SLIP (To be filled in by the inveor) Application. Received from Mr. / Ms. / M/s. an application for invement in Pramerica Mutual Fu - Option Growth Divide for (in figures) vide Inrument no. Bank Branch City All purchases are subject to realisation of cheque/dema draft a furnishing of maatory information/documents. Please retain this slip till you receive your Account Statement. Acknowledgement Stamp & Date

2 6. INVESTMENT / PAYMENT DETAILS Application. A. MENTION THE POWER SIP / MONTHLY SWITCH AMOUNT (Minimum Rs 1000/- per month a multiples of Rs 500/- thereafter) (Refer Inruction. 6) B. MODE OF INVESTMENT (Please any one option) Option 1: Lumpsum Option 2: Lumpsum with SIP Option 3: Lumpsum for Sequential Switch Transaction IMPORTANT Please fill Section 6C (I only) Please fill Section 6C (I & II) only Please fill Section 6D only C. SOURCE SCHEME DETAILS FOR OPTION 1 & 2 - LUMPSUM AND SIP INVESTMENT Divide Frequency Option Growth* Divide Thi party cheque / transfer will not be accepted for invement In case of exception to Thi party payment, please fill the Thi Party Dedaration Form. Divide Facility Payout Re-invement* (Refer Inruction. 6) I. LUMPSUM INVESTMENT DETAILS II. SIP INSTALMENT DETAILS 1 Cheque amount * = POWER SIP / Monthly switch Amount x 6 (e.g. 2,000 x 6 = 12,000) *The 1 cheque amount should be greater than or equal to 6 times of the SIP THROUGH AUTO DEBIT (ECS/Direct Debit) Please also fill a attach the SIP Auto Debit Facility Form OR Power SIP / Monthly Switch Amount SIP THROUGH POST-DATED CHEQUE Seco a subsequent Inalment cheque Details (Refer inruction no. 6-II-e) Mode of Payment Cheque DD Transfer Inruction / RTGS / NEFT Cheque s. From To (Please ) Dated From D D M M Y Y Y Y To D D M M Y Y Y Y Inrument. SIP Period : Till I/We inruct to discontinue the SIP Please mention Enrolment Period If option (B) is selected (A) From To Invement Amount (B). of inalments M M Y Y M M Y Y (Minimum SIP Inalments - 36 Months) Power SIP Date (Monthly) (Please ) 1 7th 10th 15th 25th All dates D. SOURCE SCHEME DETAILS FOR OPTION 3 - SEQUENTIAL SWITCH TRANSACTION (Minimum 2 schemes a Maximum 3 schemes) SOURCE SCHEME 1 Option Growth* Divide Divide Facility Payout Re-invement* Mode of Payment SOURCE SCHEME 2 SOURCE SCHEME 3 NRI / FII Inveors, Please iicate source of fus for your invement (Please ) NRE NRO FCNR Others (Please specify) Banker's certificate is a mu (please refer inruction no. 6b) 7. SWITCH DETAILS (Monthly) (MANDATORY) Target Scheme Pramerica Equity Fu - Growth Pramerica Dynamic Fu - Growth Switch Date Switch Period Mode of Payment Cheque 2 business day of every month. Divide Frequency DD Transfer Inruction / RTGS / NEFT Inrument. Option Growth* Divide Divide Facility Payout Re-invement* Mode of Payment Cheque a. In case of SIP, Switch Period will be similar to SIP Period mentioned above. b. In case of Sequential Switch maate, switch will continue till the unit balance is available in the Source Scheme(s). c. In case of lumpsum invement, please provide the switch period below:- Divide Frequency Invement Amount (Refer Inruction. 6d.2) From M M Y Y Y Y To M M Y Y Y Y (Minimum 6 inalments) (If to date is not specified switch will continue till balance is available in the source scheme) DD Transfer Inruction / RTGS / NEFT Inrument. Option Growth* Divide Divide Facility Payout Re-invement* Cheque Divide Frequency Invement Amount DD Transfer Inruction / RTGS / NEFT Inrument. Invement Amount Plan Regular Direct CHECK LIST (Please submit the following documents with your application (where applicable). All documents should be original/true copies Certified by a Director/ Truee/ Company / Secretary/ Authorised signatory/ tary Public.) Documents I Co. Soc. Partnership Invement Trus NRI Firms through POA PAN Ca (not required for Micro Inveors) KYC Acknowledgement Boa Resolution/ Authorisation to inve Li of authorised signatories with specimen signatures Memoraum & Articles of Association Tru Deed Bye-laws Partnership Deed tarised POA (signed by inveor a POA Holder) Proof of Address (for Micro Inveors) Proof of Identity (for Micro Inveors) For more information visit us at us at cuomercare@pramericamf.com Call us (Toll free) at

3 Application. 9. NOMINATION DETAILS (Please any one of the below mentioned Option. mination is not allowed in case Sole / Fir Applicant is minor) (Refer Inruction. 7) I / We do not wish to avail of nomination facility at present. (NOTE: SOLE INDIVIDUAL APPLICANTS ARE ADVISED TO COMPULSORILY NOMINATE). OR I/We do hereby nominate the uermentioned minee(s) to receive the Units allotted to my/our credit in my/our folio in the event of my/our death. I/We also uera that all payments a settlements made to such minee(s) a Signature of the minee(s) acknowledging receipt thereof, shall be a valid discharge by the AMC/Mutual Fu/Truees. Name & Address of minee(s) PAN Date of Name & Address of the Guaian Signature of minee / Guaian Proportion(%). Birth (where minee is a minor) (To be furnished in case the minee is a Minor) (OPTIONAL) should aggregate to 100% Default : Equal proportion DECLARATION AND SIGNATURES (MANDATORY - APPLICATION WITHOUT SIGNATURE(S) WILL BE REJECTED) (Refer Inruction. 8) I/We have read a uerood the contents of the Statement of Additional Information of Pramerica Mutual Fu a the Scheme Information Document(s)/Key Information Memoraum of the respective Scheme(s) a Addea thereo, issued from time to time a the Inructions overleaf. I / We, hereby apply to the Truee of Pramerica Mutual Fu for allotment of units of the respective Scheme(s) of Pramerica Mutual Fu, as iicated above a agree to abide by the terms, coitions, rules a regulations of the relevant Scheme(s). I / We have neither received nor been iuced by any rebate or gifts, directly or iirectly in making this invement. I / We declare that that I/We am are authorised to make this invement a the amount inveed in the Scheme is through legitimate sources only a is not designed for the purpose of contravention or evasion of any Act, Regulation, Rule, tification, Directions or any other applicable laws enacted by the Government of Iia or any Statutory Authority. 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 Fus from among which the Scheme(s) is/are being recommeed to me/us. I/We declare that the information given in this application form is correct, complete a truly ated. In the event of my/our not fulfiling the KYC process to the satisfaction of the AMC/Pramerica Mutual Fu, I/We hereby authorise the AMC/Pramerica Mutual Fu to redeem the units again the fus inveed by me/us at the applicable NAV as on the date of such redemption. I /We agree that Pramerica Mutual Fu can debit from my Folio Transaction Charges as applicable. For inveors inveing in Direct Plan: I/We hereby agree that the AMC has not recommeed or advised me/us regaing the suitability or appropriateness of the product/scheme/plan. Applicable to Micro Inveors (Delete if not applicable) : I/We hereby declare that I/We do not have any exiing Micro invements which together with the current application will result in aggregate invements exceeding 50,000 in a year. Applicable to NRIs: I/We confirm that I am/we are n-resident(s) of Iian Nationality / Origin a I/We hereby confirm that the fus for subscription have been remitted from abroad through normal banking channels or from fus in my / our n-resident External / Oinary Account/FCNR Account(s). SIGNATURE(S) (ALL APPLICANTS mu sign here) Date D D M M Y Y Y Y Sole/1 Applicant/Guaian/Authorised Signatory/POA 2 Applicant/Guaian/Authorised Signatory/POA 3 Applicant/Guaian/Authorised Signatory/POA If the invement is being made by a Conituted Attorney please furnish Name a PAN of Power of Attorney Holder (POA) in respect of each applicant below: Name POA Holder for 1 Applicant POA Holder for 2 Applicant POA Holder for 3 Applicant PAN K Y C Compliant* * (if, attach proof)

4 GENERAL GUIDELINES a) Please read the Scheme Information Document/Key Information Memoraum of the Schemes carefully before inveing. b) Please furnish all information marked as MANDATORY. In the absence of any maatory information, the application would be rejected. c) Applications on behalf of minors should be made by natural guaian (i.e. father or mother) or legal guaian (court appointed) a signed by them. The name of the Guaian should be filled in the relevant space provided in the Application Form. joint applicant/ joint holder is permitted with the minor beneficiary. d) Please rike off sections that are not applicable. e) Please note that Units issued uer Power SIP Facility cannot be held in demat form. INSTRUCTIONS 1. DISTRIBUTOR INFORMATION a. Upfront commission shall be paid directly by the inveor to the AMFI regiered Diributors based on the inveors assessment of various factors including the service reered by the diributor. b. Please mention DIRECT in case the application is not routed through any diributor. c. Pursuant to SEBI circular dated September 13, 2012, mutual fus have created a unique identity number of the employee/ relationship manager/ sales person of the diributor interacting with the inveor for the sale of mutual fu products, in addition to the AMFI Regiration Number (ARN) of the diributor. This Employee Unique Identification Number is referred as "EUIN". EUIN aims to assi in tackling the problem of mis-selling even if the employee/relationship manager/sales person leaves the employment of the diributor or his/her sub broker. Quoting of EUIN is maatory in case of advisory transactions. d. Diributors are advised to ensure that the sub broker affixes his/her ARN code in the column separately provided in addition to the current practice of affixing the internal code issued by the main ARN holder a the EUIN of the Sales Person (if any) in the EUIN space. e. Inveors are requeed to note that EUIN is applicable for transactions such as Purchases, Switches, Regirations of SIP / STP / Trigger STP / Divide Transfer Plan a EUIN is not applicable for transactions such as Inallments uer SIP/ STP / SWP / STP Triggers, Divide Reinvements, Bonus Units, Redemption, SWP Regiration, Zero Balance Folio creation a inallments uer Divide Transfer Plans. f. Inveors are requeed to note that EUIN is largely applicable to sales persons of non iividual ARN holders only (whether acting in the capacity of the main diributor or sub broker). Further, EUIN will not be applicable for overseas diributors who comply with the requirements as per AMFI circular CIR/ ARN-14/12-13 dated July 13, TRANSACTION CHARGES In terms of SEBI circular, Cir/ IMD/ DF/13/ 2011 dated Augu 22, 2011, the diributors of mutual fu products are allowed to be paid transaction charges for purchase 100/- per subscription of 10,000/- a above in respect of exiing unitholders; 150/- for subscription of 10,000/- a above in respect of a fir time inveor in mutual fus. In case of SIPs, the transaction charge if any, shall be applicable only if the total commitment through SIPs aggregates to 10,000/- a above a shall be recovered in 4 inallments. The transaction charge shall be deducted from the subscription amount a paid to the diributor; a the balance shall be inveed in the Scheme. The transaction charges a the net invement amount a the number of units allotted will be clearly mentioned in the Account Statement issued by the Mutual Fu. There shall be no transaction charges on (i) Direct invements; (ii) subscription below 10,000/- a (iii) switch (including STP) a redemption (including SWP) transactions. Diributors shall be able to choose to opt out of charging the transaction charge. However, the opt-out shall be at diributor level a not inveor level i.e. a diributor shall not charge one inveor a choose not to charge another inveor. 3. (A) APPLICANT'S INFORMATION a. Please furnish names of all applicants. The name of the Sole /Fir Applicant should be mentioned in the same manner in which it appears in the Income Tax PAN ca. Please note the following : In case the applicant is a n-iividual inveor, the Contact Person s name should be ated in the space provided (Name of Guaian / Contact Person) In case the applicant is a minor, the Guaian s name should be ated in the space provided (Name of Guaian / Contact Person). It is maatory to provide the minor s date of birth in the space provided. In case the application is being made on behalf of a minor, he / she shall be the Sole Holder/Beneficiary. There shall be no joint account with a minor unitholder. b. If there is more than one applicant but the mode of holding is not specified, the same would be treated as Joint. c. Please iicate the tax atus of the sole/1 applicant at the time of invement. The abbreviations used in this section are: NRI : n-resident Iian Iividual, PIO - Person of Iian Origin, FII - Foreign Initutional Inveor, NGO - n Government Organization, AOP - Association of Persons, BOI - Body of Iividuals, HUF - Hiu Uivided Family. d. Please mention your Occupation by ticking the appropriate option. (B) In case of a minor, it is maatory to submit photocopy of any one of the following towas proof of date of birth at the time of initial invement: Birth certificate of minor, or School leaving certificate / Mark sheet issued by Higher Secoary Boa of respective ates, ICSE, CBSE etc, containing the minor s date of birth, or. Passport of minor (C) In case of minor applicants, Guaian in the Folio should either be a natural guaian (i.e., father or mother) or a court appointed legal guaian. In both the cases, it is maatory to submit a document evidencing the relationship (in case of a natural guaian, if the same is not available as part of the documents submitted as per 4 (C) above) between the minor a the Guaian. (D) KYC/PROOF OF IDENTITY AND ADDRESS DETAILS Please furnish PAN & KYC details in this section for each applicant/unit holder, including the Guaian a/or Power Of Attorney (POA) holders as explained in (i) & (ii) below. i. PAN It is maatory for all inveors (including guaians, joint holders, NRIs a power of attorney holders) to provide their Income Tax Permanent Account Number (PAN) a also submit a photo copy of the PAN ca at the time of purchase of Units except for inveors who are exempted from PAN requirement, please refer to KYC Form for exemption of PAN requirement. ii. Know Your Cuomer (KYC) iii. KYC compliance is compulsory for all irrespective of the amount of invement. Micro Invement With effect from October 30, 2012, where the aggregate of the lump sum invement (fresh purchase & additional purchase) a Micro SIP inallments by an inveor in a financial year i.e. April to March does not exceed 50,000/- it shall be exempt from the requirement of PAN. However, requirements of Know Your Cuomer (KYC) shall be maatory. Accoingly, inveors seeking the above exemption for PAN ill need to submit the KYC Acknowledgement, irrespective of the amount of invement. This exemption will be available only to Micro invement made by the iividuals being Iian citizens (including NRIs, Joint holders, minors acting through guaian a sole proprietary firms). PIOs, HUFs, QFIs a other categories of inveors will not be eligible for this exemption. 4. CONTACT INFORMATION a. Please furnish the full poal address of the Sole/ Fir Applicant with PIN/Poal Code a complete contact details. (P.O. Box address is not sufficient). b. Please note that all communication i.e. Account atement, Annual Report, News Letters will be sent via , if the id of the inveor is provided in the application form. The Account atement will be encrypted with a passwo before seing the same to the regiered id. Should the unitholder face any difficulty in accessing/opening the Account Statements/documents sent via , the unitholder may call/write to the AMC/Regirar a ask for a physical copy. 5. BANK DETAILS a. Please furnish complete Bank Account Details of the Sole/Fir Applicant. This is a maatory requirement a applications not carrying bank account details shall be rejected. Bank details provided in the application form will be considered as the default Bank Maate for remitting redemption proceeds/divide amount. b. Please provide your complete Core Banking Account Number, (if applicable), in your Bank Maate in the Application Form. In case you are not aware of the Core Banking Account Number, kily check the same with your bankers. c. Please attach a original cancelled cheque leaf if your invement inrument is not from the same bank account mentioned in the Application form. d. Pramerica Mutual Fu will eeavour to remit the Redemption a Divide proceeds through electronic mode, wherever sufficient bank account details of the unit holder are available. 6. INVESTMENT/PAYMENT DETAILS Introduction of Direct Plan:- The AMC has introduced a separate plan for direct invements (i.e. invements not routed through an AMFI Regiration Number (ARN) Holder ( Diributor ) (hereinafter referred to as Direct Plan ) with effect from January 1, 2013 ( Effective Date ). Direct Plan is only for inveors who purchase /subscribe Units in a Scheme directly with the Fu a is not available for inveors who route their invements through a Diributor. Inveors may please note that the Direct Plan uer the Schemes is meant for inveors who uera the capital market, mutual fus a the risks associated therewith. The risks associated with the invements in the Schemes vary depeing upon the invement objective, asset allocation a invement rategy of the Schemes a the invements may not be suited for all categories of inveors. The AMC believes that inveors inveing uer the Direct Plan of the Schemes are aware of the invement objective, asset allocation, invement rategy, risks associated therewith a other features of the Schemes a has taken an informed invement decision. Please note that Scheme Information Document(s), Statement of Additional Information, Key Information Memoraum or any other advertisements a its contents are for information only a do not conitute any invement advice or solicitation or offer for sale of units of the Schemes from the AMC. All Options/Sub-Options offered uer the Schemes (hereinafter referred as Regular Plan ) will also be available for subscription uer the Direct Plan. Thus, from the Effective Date, there shall be 2 Plans available for subscription uer the Schemes viz., Regular Plan a Direct Plan. Inveors subscribing uer Direct Plan of the Schemes should iicate the Scheme/Plan name in the application form as Direct Plan form for e.g. Pramerica Equity Fu Direct Plan. Inveors should also iicate Direct in the ARN column of the application form. However, in case Diributor code is mentioned in the application form, but Direct Plan is iicated again the Scheme name, the Diributor code will be ignored a the application will be processed uer Direct Plan. Please note, where application is received for Regular Plan without Diributor code or Direct mentioned in the ARN Column, the application will be processed uer Direct Plan. Please note that thi party payments shall not be accepted. Thi Party Payment shall mean payment made through an inrument issued from an account other than that of the beneficiary inveor. In case of payment inruments issued from a joint bank account, the fir named applicant/inveor mu be one of the joint holders of the bank account from which the payment inrument is issued. Related person/s means such persons as may be specified by the AMC from time to time. Exceptions: The AMC/ Regirar of PMF will accept subscriptions to schemes of PMF accompanied by Thi-Party Payment Inruments only in the following exceptional cases: 1. Payment by Parents/Graparents/related persons on behalf of a minor in consideration of natural love a affection or as gift for a value not exceeding 50,000/- (each regular purchase or per SIP inallment); 2. Payment by employer on behalf of employee uer Syematic Invement Plan (SIP) facility through payroll deductions; 3. Cuodian on behalf of an FII or a Client The inveors making an application uer the above mentioned exceptional cases are required to comply with the following, without which their applications for subscriptions for units will be rejected / not processed. Maatory KYC compliance of the inveor a the person making the payment, in oer to determine the identity of the inveor a the person issuing the payment inrument. Submit a separate, prescribed, 'Thi Party Payment Declaration Form' from the beneficiary applicant/s (guaian in case of minor) a the person making the payment i.e., the Thi Party, giving details of the bank account from which the payment is made a the relationship of the Thi Party with the beneficiary. (The declaration form is available at Submit a cancelled cheque leaf or copy of bank atement / pass book page mentioning bank account number, account holders name a address or such other document as the AMC may require for verifying the source of fus to ascertain that fus have been remitted from the drawer s account only. For identifying Thi Party Payments, inveors are required to comply with the requirements specified below: a) Payment by Cheque: An inveor at the time of his/her purchase mu provide the details of pay-in bank account (i.e. account from which a subscription payment is made) a pay-out bank account (i.e. account into which redemption/divide proceeds are to be paid). Identification of thi party cheques by the AMC / Regirars will be on the basis of either matching of pay-in bank account details with regiered/pay-out bank account details or by matching the bank account number/name/signature of the fir named inveor with the name/account number/signature available on the cheque. If the name/bank account number is not pre-printed on the cheque a signature on the cheque does not match with signature on the application, then the fir named applicant/inveor should submit any one of the following documents: i. a copy of the bank passbook or a atement of bank account having the name a address of the account holder a account number; ii. a letter* (in original) from the bank on the bank s letterhead certifying that the inveor maintains an account with the bank, along with information like bank account number, bank branch, account type, the MICR code of the branch & IFSC Code (where available). *In respect of (ii) above, it should be certified by the bank manager with his/her full signature, name, employee code, bank seal a contact number. Inveors should note that where the bank account numbers have changed on account of the implementation of core banking syem at their banks, any related communication from the bank towas a change in bank account number should accompany the application form for subscription of units. b) Payment by Prefued Inrument: i. If the subscription is settled with pre-fued inruments such as Pay Oer, Dema Draft, Banker's cheque, etc., a certificate (in original) from the Issuing banker mu accompany the purchase application, ating the Account holder's name a the Account number which has been debited for issue of the inrument. The account number mentioned in the Certificate should be a regiered bank account or the fir named unitholder should be one of the account holders to the bank account debited for issue of such inruments.

5 INSTRUCTIONS (contd.) ii. A pre-fued inrument issued again cash shall not be accepted, except in case of payment made by Parents/Graparents/related persons on behalf of a minor in consideration of natural love a affection or as gift for a value not exceeding 50,000/-. This also should be accompanied by a certificate from the banker giving name, address a PAN of the person who has procured the payment inrument. The Certificate(s) mentioned in (i) a (ii) above should be duly certified by the bank manager with his/her full signature, name, employee code, bank seal a contact number. c) Payment by RTGS, NEFT, ECS, Bank transfer, etc: A copy of the inruction to the bank ating the account number debited mu accompany the purchase application. The account number mentioned on the transfer Inruction copy should be a regiered bank account or the fir named unitholder should be one of the account holders to the bank account. The above broadly covers the various modes of payment for mutual fu subscriptions. The above li is only iicative not exhauive li a any other mode of payment as introduced from time to time will also be covered accoingly. In case the application for subscription does not comply with the above provisions, the AMC / Regirars retains the sole a absolute discretion to reject/not process such application a refu the subscription money a shall not be liable for any such rejection. d. 1 PRAMERICA POWER SIP INVESTMENT Pramerica Power SIP is an invement plan that provides for subscriptions into all debt / liquid fus of Pramerica Mutual Fu as ameed from time to time (hereinafter referred to as the Source Scheme ) in any one of the following manner: 1. A Lumpsum invement along with monthly SIP in a single Source Scheme a subsequently switching the invement in to Pramerica Equity Fu (PEF) or Pramerica Dynamic Fu (PDF) (hereinafter referred to as the Target Scheme ). The monthly SIP inalments in the Source scheme would be uniform a the switch period would be similar to the SIP period as iicated by the inveor in the application form. 2. A Lumpsum invement in a single Source Scheme for subsequently switching the invement in to any one Target Scheme. The switch period would be as per the From a To date mentioned by the inveor in the application form. 3. A Lumpsum invement in multiple source schemes (i.e., minimum of 2 schemes a maximum of 3 Schemes) for subsequently switching it to any one Target Scheme by defining the sequence of the source schemes for switch out (hereinafter referred to as Sequential Switch Transaction ). The switch out will continue till unit balance is available in the source scheme(s). (If an additional purchase is given in any of the source scheme after hitting the zero value in that scheme, the additional invement will not qualify for the sequential switch transaction). To enroll for sequential switch transaction, please iicate the sequence of the Source Schemes by specifying the source scheme 1, 2 a/or 3 in section 7 of the application form. The switch out will begin from Source scheme 1 a would continue till the unit balance is available in the scheme, after which, the switch out will begin from the next source scheme as specified by the inveor in the application form. In all of the above methods, the amount of switches into the Target Scheme would be based on a value derived at the e of each month using a proprietary model developed by the AMC based on BSE Sensex PE Ratio (hereinafter referred to as Pramerica Multiplier ). The Pramerica Multiplier could range from 0 to 2; accoingly the switch amount into the Target Scheme each month could vary from nil to twice the switch amount. Please iicate the Scheme a Option uer which you wish to inve. Also iicate your choice of divide frequency along with the divide payout or reinvement facility. If any of the information is left blank, the default option will be applicable. Payment may be made only by Cheque or Bank Draft or Electronic Fu Transfer. Cheque/Draft should be drawn in favour of the "Scheme name", e.g. "PRAMERICA ULTRA SHORT TERM BOND FUND" a crossed "Account Payee only". I. LUMPSUM INVESTMENT/ FIRST INSTALMENT DETAILS Minimum initial (Lumpsum) invement in source scheme should be equal to or more than 6 times the monthly Power SIP Inalment / monthly Switch Amount. If you are from a city where there is no designated Inveor Service Centre of PMF, you may make a payment by a Dema Draft for the invement amount. Please enter the cheque or DD amount, (if applicable) a the invement amount. The AMC shall bear the incurred by an applicant as per dema draft charges prescribed by State Bank of Iia. The AMC shall, however, not refu any DD charges to the inveor uer any circumances. The fir SIP inalment or Lumpsum can be paid either through a Cheque, a Dema Draft (DD) / Pay Oer (PO). II. SECOND AND SUBSEQUENT INSTALMENT DETAIL An inveor needs to enroll for the SIP using a prescribed form uer any Debt / Liquid Fu of Pramerica Mutual Fu: a. SIP frequency - Only Monthly b. The following criteria should be met for a SIP invement: Minimum Power SIP inalment should be 1,000 per month a multiples of 500 thereafter. Minimum number of inalments should be 36 months If the SIP period is not specified by the inveor then the SIP enrolment will be deemed to be for perpetuity a processed accoingly. The SIP facility will be available on the following dates in a month as chosen by the inveor 1, 7th, 10th, 15th a 25th or all dates of every Month. If any of the said dates happen to be a holiday / non-transaction day, then the SIP transaction will be processed on the next business day. c. For your seco a subsequent SIP Inalments you may pay either through Auto Debit (ECS/Direct Debit) or by Po Dated Cheques. If you wish to opt for payments through Auto Debit, please iicate your preference for SIP through Auto Debit (ECS)' in the box provided for the purpose a fill in the attached AUTO DEBIT FACILITY FORM. If you wish to pay for your future SIPs through Po Dated Cheques (PDC), you should not fill in the AUTO DEBIT FACILITY FORM. Please mention the seco a subsequent Inalment cheque details in the space provided for the purpose. d. In case of payment of fir inalment through DD or PO, the Auto debit Bank details mentioned by you mu be atteed by the banker in Section 3 of Auto Debit Facility form. e. The fir inalment cheque should be dated with the date of submission of the Application Form. Please note the following: For SIPs through PDCs, the fir SIP cheque needs to be from the same bank account as the PDC s for your future SIP Inalments. The Seco SIP Inalment will be processed at lea 20 days in case of direct debit a 30 days in case of ECS after the date of the fir SIP Inalment. The fir Inalment cheque a the subsequent Inalments (either through PDCs or Auto Debit) should be for the same amount. f. In case of SIP through Auto Debit, the Auto Debit Authorisation needs to be filled in a signed by the Bank Account holders in the same oer a manner in which the Bank account is held by them. g. In case of any mismatch between the. of inalment a the SIP period, the SIP period will be considered as per the Auto Debit Facility Form. h. In case of any discrepancy between the SIP Power Application Form a the Auto Debit Facility Form, the SIP details provided in the latter will be considered for invement. d. 2 SWITCH DETAILS Uer the Power SIP Invement Plan, the invement would be switched into the Target Scheme on a recurrent basis on 2 business day of every month. Inveors are requeed to note that target scheme once chosen cannot be changed. For inveors who have enrolled through SIP, the switch period would be similar to the SIP period (minimum 36 months) as mentioned by the inveor. Inveors, who have enrolled by inveing a Lumpsum amount in a single source scheme for subsequent switch to a target scheme, mu iicate the switch period (minimum 6 months) by mentioning from a to date in the space provided in the application form. Inveors who have enrolled for sequential switch transaction, the switch will continue till unit balance is available in the source scheme(s). For all of the above methods, the minimum monthly switch amount should be 1,000 per month a multiples of 500 thereafter. The amount of switch into the target scheme would be based on a value derived at the e of each month using a Proprietary model developed by the AMC. Herein after referred to as "Pramerica Multiplier" (E.g. If the SIP inalment/ monthly switch amount is 1,500 a the Pramerica Multiplier value is 2 then the amount of switch would be 3,000) d. 3 For inveors who have enrolled through SIP: - Whenever the value of invement in source scheme falls to less than 3 SIP inalments, the inveor would have to replenish ("top up") the invement in the source scheme by making additional subscription equal to minimum 3 Power SIP inalments. If the unit in the source scheme gets exhaued the switch to the target scheme will not be executed a the same would be rearted in the next immediate business cycle (2 business day of the following month) the moment the source scheme is refilled through additional purchase. If the balance is less than applicable switch amount in the target scheme, the entire balance in the source scheme would be switch out to target scheme. NRI inveors NRIs a PIOs may purchase units of the scheme(s) on a repatriation a non-repatriation basis, while FIIs may purchase units only on a repatriation basis. They shall attach a copy of the cheque used for payment or a Foreign Inwa Remittance Certificate (FIRC) or an Account Debit Certificate from the bankers along with the application form to enable the AMC to ascertain the repatriation atus of the amount inveed. The account type shall be clearly ticked as NRE or NRO or FCNR, to enable the AMC determine the repatriation atus of the invement amount. The AMC a the Regirar may rely on the repatriation atus of the invement purely based on the details provided in the application form. Repatriation basis NRIs a PIOs may pay their subscription amounts by way of Iian Rupee drafts purchased abroad, cheques drawn on n-resident External (NRE) Accounts or Iian Rupee drafts payable at par at any of the centres where the AMC has a designated ISC a purchased out of fus held in NRE Accounts / FCNR Accounts. FIIs may pay their subscription amounts either by way of inwa remittance through normal banking channels or out of fus held in Foreign Currency Accounts or n Resident Rupee Accounts maintained with a designated branch of an authorised dealer with the approval of RBI. In case Iian Rupee drafts are purchased abroad or from FCNR/NRE accounts, an account debit certificate from the bank issuing the draft confirming the debit shall also be submitted with the application form. NRIs shall also be required to furnish such other documents as may be necessary a as requeed by the AMC/Mutual Fu/Regirar, in connection with the invement in the schemes. n-repatriation basis NRIs a PIOs may pay their subscription amounts by cheques/dema drafts drawn out of n-resident Oinary (NRO) accounts/ n-resident Special Rupee (NRSR) accounts a n Resident n-repatriable (NRNR) accounts payable at the city where the application form is accepted. 7. NOMINATION DETAILS You may nominate a maximum of 3 persons, to receive the Units/amounts aing to your credit payable in the event of death of the Unit Holder(s) in respect of invement uer a folio. The nomination may be made only by iividuals applying for/holding units on their own behalf, singly or jointly. n-iividuals including society, tru, body corporate, partnership firm, Karta of HUF, holder of POA or a parent/guaian applying on behalf of a minor beneficiary cannot nominate. A minor can be nominated a in that event, the name a address of the guaian of the minor nominee shall be provided in the application. mination can also be in favour of the Central Government, State Government, a a local authority, any person designated by virtue of his office or a religious or charitable tru. The minee shall not be a tru (other than a religious or charitable tru), society, body corporate, partnership firm, Karta of Hiu Uivided Family or a Power of Attorney holder. A n-resident Iian can be a minee subject to the exchange control regulations in force, from time to time. Transfer of units in favour of a minee shall be valid discharge by the AMC/Mutual Fu again the legal heir. The cancellation of nomination can be made only by the iividual(s) who hold units on their own behalf singly or jointly a who made the original nomination. On cancellation of the nomination, the nomination shall a rescied a the AMC shall not be uer any obligation to transfer the units in favour of the minee. In the event of the unit holders not iicating the percentage of allocation/share for each of the nominees, the AMC shall settle the claim equally among all the nominees It is recommeed for the nominee/guaian (in case the nominee is a minor) to provide the signature in the space provided. In case you do not wish to nominate, kily iicate by ticking in the space provided. 8. DECLARATION AND SIGNATURES 1. All signatures should be ha written in English or any Iian language. Thumb impressions should be from the left ha for males a the right ha for females a in both cases mu be atteed by a Judicial Magirate or a tary Public. 2. If the application form is signed by a Power of Attorney (PoA) holder, the form should be accompanied by a notarised photocopy of the PoA. Alternatively, the original PoA may be submitted, which will be returned after verification. If the PoA is not submitted with the application, the Application Form will be rejected. The POA should contain the signature of the inveor (POA Donor) a the POA holder. 3. In case of corporate or any non-iividual inveors, a li of authorised signatories should be submitted along with Application form or in case of any change in the authorised signatory li, the AMC / Regirar mu be notified within 7 days. 4. In case of application uer POA or by a n- Iividual (i.e. Company, tru, society, partnership firm etc.) the relevant POA or the resolution should specifically provide for/ authorize the POA holder/authorized signatory to make application/ inve moneys on behalf of the inveor.

6 AUTO DEBIT FACILITY REGISTRATION CUM MANDATE FORM INVESTORS SUBSCRIBING TO THE SCHEME THROUGH SIP AUTO DEBIT FACILITY TO COMPLETE THIS FORM ALONGWITH POWER SIP APPLICATION FORM (Refer General Guideline. 2A) All sections to be completed legibly in English in Black/Blue coloured ink a in BLOCK letters. 1. DISTRIBUTOR INFORMATION (Refer Inruction. 1) FOR OFFICE USE ONLY Diributor Code Sub Broker Code ARN - ARN - 2. APPLICANT INFORMATION (Refer Inruction. 2A) Name of Sole/1 Applicant 3. SIP DETAILS (Fir SIP cheque a subsequent via Auto Debit Facility in select cities only) (Refer Inruction. 3) Divide Facility Payout Re-invement* Divide Frequency Daily Divide* Weekly Divide Fortnighly Divide Monthly Divide 'Please read the Scheme Information Document of the respective scheme for minimum SIP inalment, minimum SIP period a aggregate amount of invement.' DECLARATION & SIGNATURE: I/We hereby declare that the particulars given above are correct a express my willingness to make payments referred above to debit my/our account directly or through participation in Auto Debit. If the transaction is delayed or not effected at all for reasons of incomplete or incorrect information, I/We would not hold the user initution responsible. I/We will also inform AMC, about any changes in my/our bank account. I/We have read a agreed to the terms a coitions mentioned overleaf. I/We confirm that 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 Fus from among which the Scheme is being recommeed to me/us. For inveors inveing in Direct Plan: I/We hereby agree that the AMC has not recommeed or advised me/us regaing the suitability or appropriateness of the product/scheme/plan. Applicable to Micro SIP Inveors (Delete if not applicable) : I/We hereby declare that I/we do not have any exiing Micro SIPs which together with the current application will result in aggregate invements exceeding 50,000 in a year. SIGNATURE (S) (Applicants mu sign as per Power SIP Form) 4. PARTICULARS OF BANK ACCOUNT (MANDATORY) Account Number Account Type Name of Sole / 1 Account Holder Name of 2 Account Holder Name of 3 Account Holder Name of Bank MICR Code (Maatory) IFSC Code (9 digit code next to the cheque no. MICR code arting a / or eing with 000 is not valid for ECS). (11 digit no. appearing on your cheque leaf) DECLARATION & SIGNATURE : - I/We hereby, authorise Pramerica Mutual Fu a its authorised service providers, to debit my/our above mentioned bank account directly or by ECS (debit clearing) for collection of SIP payments. SIGNATURE (S) (as in Bank recos) Sole/1 Applicant/Guaian/Authorised Signatory/POA CA SB NRO NRE FCNR Sole/1 Account Holder as in Bank Recos 5. BANKER S ATTESTATION (Maatory, if your Fir SIP inalment is through a Dema Draft/Pay Oer) Certified that the signature of account holder a the Details of Bank account are correct as per our recos Signature verification reque (To be retained by the Cuomer's Bank) 2 Applicant/Guaian/Authorised Signatory/POA 2 Account Holder as in Bank Recos Option Growth* Divide POWER SIP Date (Monthly) 1 7th 10th 15th 25th POWER SIP Amount = SIP Period : (please A or B) (A) Till I/We inruct to discontinue the SIP (B). of inalments (Minimum Power SIP inalments - 36 months) Employee Code (E-UIN) Branch Serial Code Regirar Serial. Date/Time of Receipt Please incase the Employee Code (E-UIN) box has been left blank. I/We hereby confirm that where the EUIN space has been left blank by me/us, the transaction is an execution-only transaction. Upfront commission shall be paid directly by the inveor to the AMFI regiered Diributors based on the inveors assessment of various factors including services reered by the diributor. POWER SIP Amount should be same as mentioned in the main application form All dates Please mention Enrolment Period If option (B) is selected From M M Y Y To M M Y Y 3 Applicant/Guaian/Authorised Signatory/POA Pin (Refer Inruction. 4) Mention your Core Banking Syem (CBS) Account Number (if applicable). Please check with your bank, if you do not have the same. Maatory to submit a cancelled cheque leaf of the bank account mentioned here. (Refer General Guideline 2B) 3 Account Holder as in Bank Recos Signature of Authorised Official from Bank (Bank amp a date) (Refer Inruction. 4(e)) Authorization of the Bank Account Holder The Branch Manager, This is to inform you that I/We have regiered for making payment towas my invements in Pramerica Mutual Fu by debit to my /our above account directly or through ECS (Debit Clearing). I/We hereby authorize to honour such payments a have signed a eorsed the Maate Form. Further, I authorize my representative (the bearer of this form) to get the above Maate verified & Executed. Maate verification charges, if any, may be charged to my/our account. Thanking you, SIGNATURE (S) (as in Bank recos) Sole/1 Account Holder as in Bank Recos 2 Account Holder as in Bank Recos 3 Account Holder as in Bank Recos

7 GENERAL GUIDELINES 1. This form should be used only for Regiration of SIP through Auto Debit (ECS/Direct Debit) facility. 2. A. Applicants need to fill in this form together with the Power SIP Form, for the purpose of availing the facility of Syematic Invements through Auto Debit (ECS/Direct Debit) facility. Exiing inveors to provide only the 'SIP Auto Debit Facility Regiration cum Maate Form'. B. Exiing inveors to provide cancelled cheque leaf only if the bank account details provided in Section 4 of the 'SIP Auto Debit Facility Regiration cum Maate Form' are different from the bank account details already regiered in the folio for remitting redemption proceeds/divide amount OR are different from the bank account from which auto debits are already happening for an SIP regiered in the pa. 3. Please read the terms a coitions for SIP in Key Information Memoraum. 4. Please furnish all information marked as MANDATORY in the form. In the absence of any maatory information, your application for invement would be rejected. 5. Please refer the INSTRUCTIONS below. This will help you fill in the necessary details in the form correctly a completely. 6. SIGNATURES: This form needs to be signed at three places marked X a XX. Please sign the forms as per inructions below. a. To be signed by Applicants for SIP invement in the same oer in which the Power SIP Form is signed. b. To be signed by Bank Account Holders in the oer in which the Bank Account is held a the manner in which their signatures appear in the Bank recos. 1. Diributor Information a. Please mention Direct in case the application is not routed through any diributor. b. Pursuant to SEBI circular dated September 13, 2012, mutual fus have created a unique identity number of the employee/ relationship manager/ sales person of the diributor interacting with the inveor for the sale of mutual fu products, in addition to the AMFI Regiration Number (ARN) of the diributor. This Employee Unique Identification Number is referred as "EUIN". EUIN aims to assi in tackling the problem of mis-selling even if the employee/relationship manager/sales person leaves the employment of the diributor or his/her sub broker. Quoting of EUIN is maatory in case of advisory transactions. c. Diributors are advised to ensure that the sub broker affixes his/her ARN code in the column separately provided in addition to the current practice of affixing the internal code issued by the main ARN holder a the EUIN of the Sales Person (if any) in the EUIN space. d. Inveors are requeed to note that EUIN is applicable for transactions such as Purchases, Switches, Regirations of SIP / STP / Trigger STP / Divide Transfer Plan a EUIN is not applicable for transactions such as Inallments uer SIP/ STP / SWP / STP Triggers, Divide Reinvements, Bonus Units, Redemption, SWP Regiration, Zero Balance Folio creation a inallments uer Divide Transfer Plans. e. Inveors are requeed to note that EUIN is largely applicable to sales persons of non iividual ARN holders only (whether acting in the capacity of the main diributor or sub broker). Further, EUIN will not be applicable for overseas diributors who comply with the requirements as per AMFI circular CIR/ ARN-14/12-13 dated July 13, Applicant Information Please mention the Power SIP Form number / exiing folio number a furnish the name of sole/ 1 applicant as it appears in the Power SIP Form. 3. SIP Details Please furnish the following details with respect to your syematic invement: a. Scheme Details -, Scheme Plan a Option. (If the Scheme details iicated in the Auto Debit Facility form materially vary from the Scheme details iicated in the Power SIP Form, the Scheme details mentioned in the Power SIP Form would be considered). b. SIP Frequency Only Monthly c. SIP Dates (Monthly) - 1, 7th, 10th,15th a 25th of every month. You also have a choice to have SIP inalments on all 5 dates by ticking the appropriate box provided for all 5 dates. d. SIP Inalment Requirement SIP minimum inalment amount : 1,000 & multiples of 500 thereafter TERMS AND CONDITIONS FOR AUTO DEBIT FACILITY 1. SIP Auto Debit is available through ECS or Direct Debit Facility. This Facility is offered to you using Reserve Bank of Iia's (RBI) Electronic Clearing Service (Debit Clearing Facility). By opting for this facility you agree to abide by the terms a coitions subject to which this facility is offered by RBI. 2. ECS The SIP ECS Facility is offered only to inveors having Bank Accounts in select cities lied below : Agra Ahmedabad Allahabad Amritsar Ana Asansol Aurangabad Bangalore Bahaman Baroda Belgaum Bhavnagar Bhilwara Bhopal Bhubaneshwar Bijapur Bikaner Calicut Chaigarh Chennai Cochin Coimbatore Cuttack Dargeeling Davangere Dehradun Delhi Dhanbad Durgapur Erode Gadag Gangtok Goa Gorakhpur Gulbarga Guwahati Gwalior Haldia Hubli Hyderabad Iore Jabalpur Jaipur Jalahar Jammu Jamnagar Jamshedpur Jodhpur Kakinada Kanpur Kolhapur Kolkata Kota Lucknow Ludhiana Madurai Maya Mangalore Mumbai Mysore Nagpur Nasik Nellore Patna Poicherry Pune Raichur Raipur Rajkot Ranchi Salem Shimla Shimoga Sholapur Siliguri Surat Thirupur Tirunelveli Tirupati Trichur Trichy Trivarum Tumkur Udaipur Udipi Varanasi Vijaywada Vizag The cities lied above may be modified/ removed at any time purely at the discretion of Pramerica Mutual Fu without assigning any reason or prior notice. Applications for SIP ECS Facility would be accepted only if the Bank Branch in the locations lied above in point 2 participates in local MICR/ECS Clearing. 3. Direct Debit Applications for SIP Direct Debit would be accepted for the following banks where the Core Banking Account number is provided. Direct Debit banks with Core Banking Account Number Length Bank of Baroda - 14 digits, Bank of Iia - 15 digits, Union Bank of Iia - 15 digits, IDBI Bank - 13 to 16 digits, IusI Bank - 13 to 16 digits, Kotak Mahira Bank - 15 digits, Citibank - 10 digits, State Bank of Iia - 11 digits arting with 1,2, 3, 5 a 6, Punjab National Bank - 16 digits, Axis Bank - 15 digits, Corporation Bank -t fixed but should accompany with copy of the bank passbook AUTO DEBIT FACILITY FORM - CHECKLIST Applicant s Information Application Form. Name of Sole/1 Applicant 4. In case your bank chooses to cross-verify the Auto Debit maate with you as the Bank's cuomer, you would need to promptly act on the same. Pramerica Mutual Fu (PMF) a its Regirar a other service providers will not be liable for any transaction failures due to rejection of the transaction by your bank/branch or its refusal to regier the SIP maate or any charges that may be levied by your Bank/Branch on you. 5. The inallment after the Common period should be dated after the date of declaration of fir NAV. Any payments inteed for the interim period will not be processed a will be treated void. While mentioning the SIP Auto Debit period (from) in this form, please consider the minimum gap requirement is at lea of 21 days for ECS setup & of at lea 15 days in case of Direct Debit a iicate the correct SIP Auto Debit commencement date. Please refer to point 3 in inructions. 6. For cancellation of the Auto Debit (ECS/Direct Debit) Facility, you need to give a notice 21 days in advance to the AMC or its Regirars. 7. You will not hold Pramerica Mutual Fu (PMF)/ Pramerica Asset Managers Private Limited (PAMPL) /Truees to the Fu, its Regirars a other service providers responsible if the transaction is not/incorrectly effected due to incomplete or incorrect inructions from the applicant. Besides, you will not hold either of the entities lied herein before responsible if the transaction is delayed or not effected or the applicant bank account is debited in advance or after the specific SIP date due to various clearing cycles of RBI s ECS/local holidays. 8. PMF/PAMPL reserves the right not to re-present any maate for Auto Debit facility, if the regiration could not be effected in time for reasons beyo its/their control. 9. PMF/PAMPL/Truees to the Fu, its Regirars a other service providers shall not be responsible a liable for any damages/compensation for any loss, damage, etc. incurred / suffered by you as a result of use of this facility. 10. As per the RBI circular DPSS (CO) EPPD. 191/ / , SIP- ECS inructions from January 01, 2010, has to be forwaed only with the Core Banking Syem (CBS) Account Numbers. In oer to enable smooth processing of the debits from your bank account towas purchase of SIP units, we reque you to mention the CBS account number, wherever applicable. Scheme Details Scheme Option Divide Facility Divide Frequency (if applicable) SIP Details SIP Inalment Amount Preferred SIP Date SIP Auto Debit Period Bank Account Details Name of Sole/1 Bank A/c Holder Bank A/c. (CBS A/c, wherever applicable) MICR code Banker s atteation in Section 5 where the payment for fir inalment is through a Dema Draft or Pay Oer. Thi Party Declaration Form, in case of thi party payment. Banker's certificate in case of fir inalment through a Dema draft. INSTRUCTIONS Cancelled Cheque leaf/copy of Cheque leaf is attached. e. SIP Auto Debit Enrollment Period - Minimum Number of inalment : 36 months. Please mention the Auto Debit Enrollment commencement art date a e date. In oer to save you from the hassle of seing us renewal inructions each time your SIP expires, Pramerica offers you two ways to inve. If you know how long you wish to inve for, specify the From Date a To Date. Alternatively, you can choose the open option -where you specify only the From Date - a can discontinue your SIP by writing to us. Please note if the SIP Dates, SIP Inalment Amount a the SIP Auto Debit Period iicated in the Auto Debit Regiration Form materially vary from the SIP Dates, SIP Inalment Amount a the SIP Auto Debit Period iicated in the Power SIP Form, the details contained in the Auto Debit Regiration Form would be considered for enrolment. f. This section needs to be signed by the applicants at the places marked O in the same oer a manner in which they have signed the Power SIP Form. 4. Particulars of Bank Account a. Please furnish your Bank Account details from which the Auto Debit is to be effected. Please note that the sole/fir applicant as mentioned in the "Applicants' Personal Details" section on this form need to be one of the a/c holders in the bank recos regiered for Auto Debit. If your bank is part of the Core Banking Syem (CBS), then the full CBS Account Number should be provided. Please refer to point 10 of Terms & Coitions for Auto Debit Facility Form. b. Please mention names of all bank account holders. If the mode of operation of your bank account is joint, all bank account holders would need to sign at the places marked OO in the same oer a manner in which their signatures appear on bank recos. c. Please iicate the Bank Account Type. d. It is maatory to furnish the 9 Digit MICR Code of your Bank in this section. This is the number appearing next to the cheque number on the MICR ba at the bottom of the cheque. In the absence of this information, your SIP Application would be rejected. Please note MICR code arting a / or eing with 000 is not valid for ECS. e. Please provide either a cancelled cheque leaf (or copy thereof) of the bank account from which the Auto Debit is to be effected or the Banker's atteation (in Section 5 of the Auto Debit Regiration Form in case the fir SIP Inalment is through a DD or a Pay Oer). This would help us cross-verify your bank details appearing in the cheque with the bank details furnished in this form a let you know of discrepancies, if any, for early corrective action. 5. The SIP enrolment will be discontinued if (a) 3 consecutive SIP inalments are not honoured. b) the Bank Account (for aing inruction) is closed a reque for change in bank account (for Staing Inruction) is not submitted at lea 21 days before the next SIP Auto Debit inalment due date or if written reque for cancellation is submitted by you at lea 21 days before the due date. All Bank Account Holders have signed the Form at the places marked in the same oer a manner in which their signatures appear on Bank Recos.