NFO APPLICATION FORM - ADITYA BIRLA SUN LIFE RETIREMENT FUND

Transcription

1 NFO APPLICATION F - AITA BIRLA SUN LIFE RETIREENT FUN (An open-end retirement solution oriented sceme aving a lock-in of 5 years or till retirement age (wicever is earlier)) Offer of units of ` 10/- eac during te New Fund Offer and Continuous Offer for Units at NAV based prices. New Fund Offer Opens: Tuesday, February 19, 2019 New Fund Offer Closes: Tuesday, arc 5, 2019 Sceme Re-opens for Continuous Sale And Repurcase: Witin 5 Business ays From Te ate Of Allotment Name of Sceme/ Investment Plan THIS PROUCT IS SUITABLE F INVESTS WHO ARE SEEKING* Fund Te 30s Plan Long term capital growt investments in equity and equity related securities Fund Te 40s Plan Long term capital growt and income investment predominantly in equity and equity related securities as well as bt and money market instruments Fund Te 50s Plan regular income wit capital growt over medium to long term investments in bt and money market instruments as well as equity and equity related securities o Hig rately orate LOW HIGH Low ely rat o Low Hig Investors unrstand tat teir principal will be at morately ig risk Capital appreciation & income over long term to acieve retirement goals investments in bt & money market instruments as well as equity and equity related securities o Hig rately orate ely rat ow o L Hig LOW HIGH Low Fund Te 50s Plus - ebt Plan RISKOETER Investors unrstand tat teir principal will be at morate risk *Investors sould consult teir financial advisers if in doubt weter te product is suitable for tem istributor Name & ARN/ RIA No. Sub Broker Name & ARN/ RIA No. ARN istributor obile No. Employee Unique I. No. (EUIN) Sub Broker Co Application No. istributor Id Applicable only for Scemes. Please note te istributor obile & Id will not be updated in te Broker aster and will be restricted to tis transaction only. EUIN is mandatory for Execution Only transactions. Ref. Instruction No. 9 I/we ereby confirm tat te EUIN box as been intentionally left blank my me/us as tis transaction is executed witout any interaction or advice by te employee/relationsip manager/sales person of te above distributor/sub broker or notwitstanding te advice of in-appropriateness, if any, provid by te employee/relationsip manager/sales person of te distributor/sub broker. First Applicant / Autorised Signatory Second Applicant Tird Applicant Transaction Carges for Applications routed troug istributors/agents only (Refer Instruction 1 (viii)) In case te subscription (lumpsum) amount is ` 10,000/- or more and your istributor as opted to receive Transaction Carges, ` 150/- (for first time mutual fund investor) or ` 100/- (for investor oter tan first time mutual fund investor) will be ducted from te subscription amount and paid to te distributor. Units will be issued against te balance amount invested. Existing Unitolr please fill in your Folio No., OB, Name & I and ten proceed to Section 4 (Individual investor aving completed 18 years of age is eligible to invest in te Sceme.) Existing Folio No. ate of Birt 1. FIRST / SOLE APPLICANT INFATION (ANAT) (Refer Instruction No. 2,3,5) Fres / New Investors fill in all te blocks. (1 to 9) (Individual investor aving completed 18 years of age is eligible to invest in te Sceme.) Name of First/Sole Applicant r. s. /s. PAN / PEKRN (andatory) CKC Number if any) Name of te Second Applicant ate of Birt 14 digit CKC Number r. s. /s. PAN / PEKRN (andatory) CKC Number if any) ate of Birt** (andatory) 14 digit CKC Number Acknowledgement Slip (To be filled in by te Investor) ** andatory #Te application is liable to get rejected if does not matc wit PAN card AITA BIRLA SUN LIFE RETIREENT FUN ate : / / Received from r./s. an application for allotment of Units of te Plan (as mentioned overleaf) of te ABSL Retirement Fund - along wit Ceque / emand raft / Payment Instrument as tailed overleaf. Please Note : All Purcases are subject to realisation of Ceques / emand rafts / Payment Instrument. Aditya Birla Sun Life AC Limited (Investment anager to Aditya Birla Sun Life utual Fund) (Formerly known as Birla Sun Life Asset anagement Company Limited) Regn. No.: 109. Regd Office: One Indiabulls Centre, Tower 1, 17t Floor, Jupiter ill Compound, 841, Senapati Bapat arg, Elpinstone Road, umbai care.mutualfunds@adityabirlacapital.com CIN: U65991H1994PLC Collection Centre / ABSLAC Stamp & Signature Contact Us: adityabirlacapital.com

2 1. FIRST / SOLE APPLICANT INFATION (ANAT) (Refer Instruction No. 2,3,5) Fres / New Investors fill in all te blocks. (1 to 9) (Individual investor aving completed 18 years of age is eligible to invest in te Sceme.) (Contd...) Name of te Tird Applicant r. s. /s. PAN / PEKRN (andatory) ate of Birt CKC Number if any) 14 digit CKC Number Name of te Poa Holr r. s. /s. PAN / PEKRN (andatory) Nationality #Te application is liable to get rejected if does not matc wit PAN card IS COE TEL: OFF. S T - TEL: RESI S T - Tax Status [Please tick (3)] (Applicable for First / Sole Applicant) Resint Individual NRI - NRO PIO/OCI NRI - NRE OE OF HOLING [Please tick (3)] (Please Refer Instruction No. 2(iii)) Joint Single Anyone or Survivor (efault option is Anyone or survivor) AILING ARESS OF FIRST / SOLE APPLICANT (P. O. Box Address is not sufficient. Please provi full address.) CIT STATE PINCOE OVERSEAS ARESS (andatory for NRI Applicant.) CIT COUNTR ZIP COE 2. GO GREEN [Please tick (3)] (Refer Instruction No. 11) SS Transact Online Access obile No Id I/ We would like to register for my/our SS Transact and/ or Online Access efault Communication mo is only, if you wis to receive following document(s) via pysical mo: [Please tick (3)] Account Statement Annual Report Oter Statutory Information Facebook Id Twitter Id 3. BANK ACCOUNT ETAILS (Please note tat as per SEBI Regulations it is mandatory for investors to provi teir bank account tails) Refer Instruction No. 3(A) Name of te Bank Branc Address Pin Co City Account No. Account Type [Please tick (3)] SAVINGS CURRENT NRE NRO FCNR OTHERS (Please Specify) 11 igit IFSC Co 9 igit ICR Co 4. TRIGGER FACILIT (10t of next mont after te birtday of First/ Sole Applicant) (Switc will result in termination of Trigger Facility) (Refer Instruction No. 4) Trigger Facility Opt-in es No Investors opting for tis facility will be able to automatically sift/switc teir investments from one plan to te oter based on te age of te investor. For example, if te investor as availed te trigger facility and is invested in Te 30s Plan at 36 years of age ten as e turns 40 is investments will automatically be switced in Te 40s Plan and subsequently as e turns 50 is investments will be switced from Te 40s Plan to Te 50s Plan. Tis switc witin plans based on trigger can also appen witin te lock-in period. Particulars Fund - Te 30s Plan Fund - Te 40s Plan Fund - Te 50s Plan Fund - Te 50s Plus - ebt Plan AITA BIRLA SUN LIFE RETIREENT FUN irect Plan Ceque / / Payment Instrument No. Ceque / / Payment Instrument ate Amount in Figures (`) rawn on (Name of Bank and Branc) irect Plan irect Plan irect Plan Currently, te Sceme offers Growt ivind Payout and Reinvestment Facility. In case of valid application received witout indicating coice between options unr te sceme, te same sall be consired as Growt Option and processed accordingly.... continued overleaf

3 5. INVESTENT ETAILS [Please tick (3)] (Refer Instruction No. 6, 9 & 10) (If tis section is left blank, only folio will be created) Single ceque/ mand draft must be issued for multiple investment drawn in favour of Fund and te instrument sould be crossed A/c Payee Only. Please write appropriate sceme name as well as te Plan/Option/Sub Option S. No. Ceque / Favouring Sceme Name* (refer Instruction 6) Plan Option Amount Invested (`) Ceque/ No./UTR No. (in case of NEFT/RTGS) Ceque ate Carges^ Net Amount Paid (`) 1. Fund - Te 30s Plan irect Growt ivind Payout ivind Reinvestment 2. Fund - Te 40s Plan irect Growt ivind Payout ivind Reinvestment 3. Fund - Te 50s Plan irect Growt ivind Payout ivind Reinvestment 4. Fund - Te 50s Plus - ebt Plan irect Growt ivind Payout ivind Reinvestment rawn on Bank/Branc: A/c no. In case of valid application received witout indicating coice between options unr te sceme, te same sall be consired as Growt Option and processed accordingly. # (Type of Account : Saving / Current / NRE / NRO / FCNR / NRSR) *All purcases are subject to realization of funds ^Refer to Instruction No. 6 KC ETAILS (andatory) OCCUPATION [Please tick (3)] FIRST APPLICANT SECON APPLICANT THIR APPLICANT GROSS ANNUAL INCOE [Please tick (3)] FIRST APPLICANT Below 1 Lac 1-5 Lacs 5-10 Lacs Lacs > 25 Lacs - 1 Crore > 1 Crore A/c Type: Forex ealer Oters... (please specify) Forex ealer Oters... (please specify) Forex ealer Oters... (please specify) Net wort Rs. as on [Not olr tan 1 year] SECON APPLICANT THIR APPLICANT For Individuals Below 1 Lac 1-5 Lacs 5-10 Lacs Lacs > 25 Lacs - 1 Crore > 1 Crore Net Wort Below 1 Lac 1-5 Lacs 5-10 Lacs Lacs > 25 Lacs - 1 Crore > 1 Crore Net Wort I am Politically Exposed Person I am Related to Politically Exposed Person Not Applicable Sole/First Applicant Second Applicant Tird Applicant 6. EAT ACCOUNT ETAILS (OPTIONAL) (Please ensure tat te sequence of names as mentioned in te application form matces wit tat of te A/c. eld wit te pository participant.) Refer Instruction No. 3(B) NSL: epository Participant Name: PI No.: I N Beneficiary A/c No. CSL: epository Participant Name: Beneficiary A/c No. Enclosed: Client aster Transaction/ Statement Copy/ IS Copy 7. NOINATION ETAILS (andatory) (Refer Instruction No. 8) I/We wis to nominate I/We O NOT wis to nominate and sign ere... 1st Applicant Signature (andatory) Nominee Name and Address Applicant s Relationsip Guardian Name (in case of inor) Allocation % Nominee/ Guardian Signature wit te Nominee Nominee 1 Nominee 2 Nominee 3

4 8. FATCA & CRS INFATION [Please tick (3)] For Individual Investors (Refer Instruction No. 14) Te below information is required for all applicant(s) Address Type: Resintial or Business Resintial Business Registered Office (for address mentioned in form/existing address appearing in Folio) Is te applicant(s) Country of Birt / Citizensip / Nationality / Tax Resincy oter tan India? If es, please provi te following information [mandatory] es No Please indicate all countries in wic you are resint for tax purposes and te associated Tax Reference Numbers below. Category First Applicant Second Applicant Tird Applicant Name of Applicant Place/ City of Birt Country of Birt Country of Tax Resincy# Tax Payer Ref. I No^ Intification Type [TIN or oter, please specify] Country of Tax Resincy 2 Tax Payer Ref. I No. 2 Intification Type [TIN or oter, please specify] Country of Tax Resincy 3 Tax Payer Ref. I No. 3 Intification Type [TIN or oter, please specify] #To also inclu USA, were te individual is a citizen/green card olr of USA. ^In case Tax Intification Number is not available, kindly provi its functional equivalent. 9. ECLARATION(S) & SIGNATURE(S) (Refer Instruction No. 1) To, Te Trustee, Aditya Birla Sun Life AC Ltd. ate Having read and unrstood te contents of te Statement of Additional Information / Sceme Information ocument of te Sceme, I/We ereby apply for units of te sceme and agree to abi by te terms, conditions, rules and regulations governing te sceme. I/We ereby clare tat te amount invested in te sceme is troug legitimate sources only and does not involve and is not signed for te purpose of te contravention of any Act, Rules, Regulations, Notifications or irections of te provisions of te Income Tax Act, Anti oney Launring Laws, Anti Corruption Laws or any oter applicable laws enacted by te government of India from time to time. I/We ave unrstood te tails of te sceme & I/we ave not received nor ave been induced by any rebate or gifts, directly or indirectly in making tis investment. For NRIs only: I/We confirm tat I am/we are Non Resints of Indian Nationality/igin and tat I/we ave remitted funds from abroad troug approved banking cannels or from funds in my/our Non-Resint External/Non-Resint dinary/fcnr account. (Refer Inst. No. 6) I/We confirm tat tails provid by me/us are true and correct.** I ave voluntarily subscribed to te on-line access for transacting troug te internet facility provid by Aditya Birla Sun Life AC Ltd. (Investment anager of Aditya Birla Sun Life utual Fund) and confirm of aving read, unrstood and agree to abi te terms and conditions for availing of te internet facility more particularly mentioned on te website and ereby unrtake to be bound by te same. I furter unrtake to discarge te obligations cast on me and sall not at any time ny or repudiate te on-line transactions effected by me and I sall be solely liable for all te costs and consequences tereof. Te ARN olr as disclosed to me/us all te commissions (in te form of trail commission or any oter mo), payable to im for te different competing Scemes of various utual Funds from amongst wic te Sceme is being recommend to me/us. "I / We acknowledge tat te RIA as entered into an agreement wit te AC / F for accepting transaction feeds unr te co. I / We ereby inmnify, fend and old armless te AC / F against any regulatory action, damage or liability tat tey may suffer, incur or become subject to in connection terewit or arising from saring, disclosing and transferring of te aforesaid information." I/We ereby provi my /our consent in accordance wit Aadaar Act, 2016 and regulations ma tereunr, for (i) collecting, storing and usage (ii) validating/autenticating and (ii) updating my/our Aadaar number(s) in accordance wit te Aadaar Act, 2016 (and regulations ma tereunr) and PLA. I/We ereby provi my/our consent for saring/disclosing of my Aadaar number(s) including mograpic information wit te asset management companies of SEBI registered mutual fund and teir Registrar and Transfer Agent (RTA) for te purpose of updating te same in my/our folios. FATCA & CRS eclaration: I/ We ave unrstood te information requirements of tis Form (read along wit FATCA & CRS Instructions) and ereby confirm tat te information provid by me/ us on tis Form is true, correct, and complete. I/ We also confirm tat I/ We ave read and unrstood te FATCA & CRS Terms and Conditions and ereby accept te same. (Refer Inst. No. 14) Signature of First Applicant / Autorised Signatory Signature of Second Applicant Signature of Tird Applicant CONFIRATION CLAUSE I/We ereby give consent to te Company or its Autorized Agents and tird party service provirs to use information/data provid by me to contact me troug any cannel of communication including but not limited to , telepone, sms, etc. and furter autorise te disclosure of te information contained erein to its affiliates/group companies or teir Autorized Agents or Tird Party Service Provirs in orr to provi information and updates to me on various financial and investment products and offering of oter services. I/We agree tat all personal or transactional related information collected/provid by me can be sared/transferred and disclosed wit te above mentioned parties including wit any regulatory, statutory or judicial autorities for compliance wit any law or regulation in accordance wit privacy policy as available at te website of te Company. es No VALUE A I/We am/are interested in knowing my/our credit score and am/are appy to receive elp in tis regard. I / We ereby provi my consent to :- 1. Aditya Birla Sun Life AC Limited and its group companies & associates to conduct ceck on my/our credit information wit any of te credit bureau. 2. Aditya Birla Sun Life AC Limited and its group companies & associates to conduct a background ceck eiter by teir employees or troug any tird party vendor. es No

5 our Investment for your Retirement istributor Name & ARN/ RIA No. Sub Broker Name & ARN/ RIA No. (PLEASE REA THE INSTRUCTIONS BEFE FILLING UP THE F.) Sub Broker Co Employee Unique I. No. (EUIN) EUIN is mandatory for Execution Only transactions. Ref. Instruction No. B-3 I/we ereby confirm tat te EUIN box as been intentionally left blank my me/us as tis transaction is executed witout any interaction or advice by te employee/relationsip manager/sales person of te above distributor/sub broker or notwitstanding te advice of in-appropriateness, if any, provid by te employee/relationsip manager/sales person of te distributor/sub broker First Applicant / Autorised Signatory Second Applicant Tird Applicant Transaction Carges for Applications routed troug istributors/agents only (Refer Instruction B-7) In case te subscription (lumpsum) amount is ` 10,000/- or more and your istributor as opted to receive Transaction Carges, ` 150/- (for first time mutual fund investor) or ` 100/- (for investor oter tan first time mutual fund investor) will be ducted from te subscription amount and paid to te distributor. Units will be issued against te balance amount invested. Existing Investor Folio No. FIRST / SOLE APPLICANT INFATION (ANAT) NAE OF FIRST / SOLE APPLICANT PLAN OPTION r. s. /s. ate of Birt* INVESTENT ETAILS (Refer Instruction A) Fund - SCHEE NAE Te 30s Plan Application No. ate SIP Frequency ontly SIP ate ontly SIP ate ontly SIP ate ontly SIP ate Tenure (Start date sould be on or after 11t April 2019) Fund - Te 40s Plan Fund - Te 50s Plan Fund - Te 50s Plus - ebt Plan Weekly Weekly Weekly Weekly onday to Friday) onday to Friday) onday to Friday) onday to Friday) (*ANAT) irect Plan irect Plan irect Plan irect Plan (*ANAT) SIP Installment Amount (OPTIONAL - and available only for SIP Investments troug NACH) First Installment Amount: 500/- 1000/- Amount: 500/- 1000/- Amount: 500/- 1000/- Amount: 500/- 1000/- Oter (In multiple of 500/-) Oter (In multiple of 500/-) Oter (In multiple of 500/-) Oter (In multiple of 500/-) Half early early Half early early Half early early Half early early * ax Amount: * ax Amount: * ax Amount: * ax Amount: Ceque ate Ceque No. Amount rawn on Bank and Branc Use existing One Time andate (To be filled in case of more tan one OT registration) Bank Name A/c No. Trigger Facility Opt-in es No In case of valid application received witout indicating coice between options unr te sceme, te same sall be consired as Growt Option and processed accordingly. 3. ECLARATION(S) & SIGNATURE(S) I/We ereby autorise Aditya Birla Sun Life utual Fund and teir autorised service provir to bit te above bank account by NACH/ Auto ebit Clearing for collection of SIP payments. I/We unrstand tat te information provid by me/us may be sared wit tird parties for facilitating transaction processing troug NACH/ Auto ebit Clearing or for compliance wit any legal or regulatory requirements. I/We ereby clare tat te particulars given above are correct and complete and express my/our willingness to make payments referred above troug participation in NACH/ Auto ebit. If te transaction is layed or not effected at all for reasons of incomplete or incorrect information, I/We will not old ABSLAC/F or teir appointed service provirs or representatives responsible. I/We will also inform, about any canges in my bank account immediately. I/We unrtake to keep sufficient funds in te funding account on te date of execution of standing instruction. I/We ave read and agreed to te terms and conditions mentioned overleaf. Te ARN olr as disclosed to me/us all te commissions (in te form of trail commission or any oter mo), payable to im for te different competing Scemes of various utual Funds from amongst wic te Sceme is being recommend to me/us. "I / We acknowledge tat te RIA as entered into an agreement wit te AC / F for accepting transaction feeds unr te co. I / We ereby inmnify, fend and old armless te AC / F against any regulatory action, damage or liability tat tey may suffer, incur or become subject to in connection terewit or arising from saring, disclosing and transferring of te aforesaid information." For icro SIP only: I ereby clare tat I do not ave any existing icro SIPs wic togeter wit te current application in rolling 12 mont period or in financial year i.e. April to arc will result in aggregate investments exceeding ` 50,000 in a year. (refer Instruction no: A-16). Signature(s) Name of First Unit Holr Name of Second Unit Holr Name of Tird Unit Holr First Applicant Second Applicant Tird Applicant (To be signed by All Applicants if mo of operation is Joint)