Application Fm (Except f HDFC Gold Exchange Traded Fund and HDFC Children s Gift Fund) Invests must read e Key Infmation Memandum, e instructions and Product Labeling on cover page befe completing is Fm. The Application Fm should be completed in English and in BLOCK LETTERS only. KEY PARTNER / AGENT INFORMATION (Invests applying under Direct Plan must mention Direct in column.) (Refer Instruction 1) FOR OFFICE USE ONLY (TIME STAMP) TRANSACTION CHARGES FOR APPLICATIONS THROUGH DISTRIBUTORS ONLY (Refer Instruction 2) In case e purchase/ subscription amount is Rs. 10,000 me and your Distribut has opted in to receive Transaction Charges, e same are deductible as applicable from e purchase/ subscription amount and payable to e Distribut. Units will be issued against e balance amount invested. Upfront commission shall be paid directly by e invest to e Holder (AMFI registered Distribut) based on e invests assessment of various facts including e service rendered by e Holder. 1. EXISTING UNIT HOLDER INFORMATION (IF YOU HAVE EXISTING FOLIO, PLEASE FILL IN SECTIONS viz. 1, 4, 6, 10 AND 13 ONLY. Refer instruction 3). Folio No. Name Sub Agent s Bank Branch Code Internal Code f Sub-Agent/ Unique Identification Number - 58603 E026768 EUIN Declaration (only where EUIN box is left blank) (Refer Instruction 1) I/We hereby confirm at e EUIN box has been intentionally left blank by me/us as is transaction is executed wiout any interaction advice by e employee/relationship manager/sales person of e above distribut/sub broker notwistanding e advice of in-appropriateness, if any, provided by e employee/relationship manager/sales person of e distribut/sub broker. The details in our recds under e folio number mentioned alongside will apply f is application. 2. MODE OF HOLDING [Please tick () Single Joint Anyone Surviv 3. UNIT HOLDER INFORMATION (Refer instruction 4) DATE OF BIRTH@ NAME OF FIRST / SOLE APPLICANT (In case of Min, ere shall be no joint holders) Mr. Ms. M/s. DD MM YYYY NAME OF GUARDIAN (in case of First / Sole Applicant is a Min) / NAME OF CONTACT PERSON DESIGNATION (in case of non-individual Invests) Mr. Ms. Designation Contact No. Proof of date of bir@ Please () Attached (Mandaty) (Mandaty) Relationship wi Min@ Please () Faer Moer Court appointed Legal Guardian Proof of relationship wi min@ Please () Attached @ Mandaty MAILING ADDRESS OF FIRST / SOLE APPLICANT (Mandaty) (Refer Instruction 4a) CITY STATE PIN CODE CONTACT DETAILS OF FIRST / SOLE APPLICANT Country Code STD Code Telephone : Off. Res. Fax ealerts Mobile 4. FIRST/ SOLE APPLICANT OTHER DETAILS (Mandaty) (Refer instruction 4) 4a. Status of First/ Sole Applicant Resident Individual Body Cpate NRI-Repatriation Individual NRI-Non Repatriation Partnership Trust HUF AOP PIO Company FIIs Min rough guardian BOI OCI LLP Society / Club Feign National Resident in India QFI FPI Sole Proprietship 4b. Occupation Details Service Private Sect Public Sect Government Service Retired Agriculture Proprietship edocs Email^ I/ We would like to register f my/our HDFCMF Personal Identification Number (HPIN) to transact online as per e terms & conditions displayed on website:www.hdfcfund.com (Email id mandaty). ^ On providing email-id invests shall receive scheme wise annual rept an abridged summary ereof/ account statements/ statuty and oer documents by email. (Refer Instruction 10 & 12) Non - Individual [Please attach FATCA, CRS & Ultimate Beneficial Ownership (UBO) Self Certification Fm] (Refer Instruction 4 & 19) (Mandaty) Oers (please specify) Non Profit Organisation Oers (please specify) Housewife 4c. Gross Annual Income (Rs.) Below 1 Lac 1-5 Lacs 5-10 Lacs 10-25 Lacs >25 Lacs - 1 Cre >1 Cre OR c. Net-w (Mandaty f Non-Individuals) Rs. as on (Not older an 1 year) DD MM YYYY 4d. Politically Exposed Person (PEP) Status (Also applicable f auised signaties/ Promoters/ Karta/ Trustee/ Whole time Directs) I am PEP I am Related to PEP Not Applicable Student Professional Business 4e. Non-Individual Invests involved/ providing any of e mentioned services Feign Exchange / Money Changer Services Money Lending / Pawning 5. JOINT APPLICANT DETAILS, If any (Refer instruction 4) (In case of Min, ere shall be no joint holders) 1. NAME OF SECOND APPLICANT Mr. Ms. M/s. a. Occupation Details Service Private Sect Public Sect Government Service Retired Agriculture Proprietship Oers (please specify) Student Gaming / Gambling / Lottery / Casino Services None of e above Professional (Mandaty) Housewife Business b. Gross Annual Income (Rs.) Below 1 Lac 1-5 Lacs 5-10 Lacs 10-25 Lacs >25 Lacs - 1 Cre >1 Cre OR Net w Rs. c. Politically Exposed Person (PEP) Status (Also applicable f auised signaties/ Promoters/ Karta/ Trustee/ Whole time Directs) # Please attach Proof. Refer instruction No 16 f PAN/PEKRN and No 18 f KYC. ACKNOWLEDGEMENT SLIP (To be flled in by e Invest) [F any queries please contact our nearest Invest Service Centre call us at our Customer Service Number 1800 3010 6767 / 1800 419 7676 (Toll Free)] Head Office : HDFC House, 2nd Flo, H.T. Parekh Marg, 165-166, Backbay Reclamation, Churchgate, Mumbai - 400 020. Received from Mr. / Ms. / M/s. an application f Purchase of Units of e Scheme(s) alongwi Cheque / DD / Payment Instrument as detailed overleaf. I am PEP I am Related to PEP Not Applicable Date :... continued overleaf
5. JOINT APPLICANT DETAILS, If any (contd...) (Refer instruction 4) (In case of Min, ere shall be no joint holders) 2. NAME OF THIRD APPLICANT Mr. Ms. M/s. a. Occupation Details Service Private Sect Public Sect Government Service Retired Agriculture Proprietship Oers (please specify) Student (Mandaty) Professional Housewife Business b. Gross Annual Income (Rs.) Below 1 Lac 1-5 Lacs 5-10 Lacs 10-25 Lacs >25 Lacs - 1 Cre >1 Cre OR Net w Rs. c. Politically Exposed Person (PEP) Status (Also applicable f auised signaties/ Promoters/ Karta/ Trustee/ Whole time Directs) 6. FATCA & CRS INFORMATION (f Individual including Sole Propriet) (Self Certification) (Refer instruction 4) # Please attach Proof. Refer instruction No 16 f PAN/PEKRN and No 18 f KYC. 8. BANK ACCOUNT DETAILS OF THE FIRST / SOLE APPLICANT (F redemption/ dividend if any) (refer instruction 5) (Mandaty to attach proof, in case e pay-out bank account is different from e bank account mentioned under Section 10 below.) F unit holders opting to hold units in demat fm, please ensure at e bank account linked wi e demat account is mentioned here. 9. MODE OF PAYMENT OF REDEMPTION / DIVIDEND PROCEEDS VIA NEFT / ECS / DIRECT CREDIT (refer instruction 11) Uniolders will receive redemption/ dividend proceeds directly into eir bank account (as furnished in Section 8) via Direct credit/ NEFT/ECS facility I/We want to receive e redemption / dividend proceeds (if any) by way of a demand draft instead of direct credit / credit rough NEFT system / credit rough ECS into my / our bank account 10. INVESTMENTS & PAYMENT DETAILS [Please ()] (refer instruction 6 & 7 f Scheme details and instruction 8 & 9 f Payment Details) The name of e first/ sole applicant must be pre-printed on e cheque. Scheme/Plan/Sub Option Payment Type [Please ()] Cheque/ DD/ Payment Instrument/ UTR No. Cheque/ DD/ Payment Instrument/ UTR Date Non-Third Party Payment F Default Plan (viz. Direct / Regular Plan) refer instruction 7. Amount of Cheque / DD / Payment Instrument / RTGS/ NEFT in figures (Rs.) Third Party Payment (Please attach Third Party Payment Declaration Fm ) DD Charges, if any Net Cheque/ DD Amount Drawn on Bank / Branch I am PEP I am Related to PEP Not Applicable The below infmation is required f all applicant(s)/ guardian Address Type: Residential Business Residential Business Registered Office (f address mentioned in fm/existing address appearing in Folio) Is e applicant(s)/ guardian's Country of Bir / Citizenship / / Tax Residency oer an India? Yes No If Yes, please provide e following infmation [mandaty] Please indicate all countries in which you are resident f tax purposes and e associated Tax Reference Numbers below. Categy Place/ City of Bir Country of Bir Country of Tax Residency# Tax Payer Ref. ID No^ Identification Type [TIN oer, please specify] Country of Tax Residency 2 Tax Payer Ref. ID No. 2 Identification Type [TIN oer, please specify] Country of Tax Residency 3 Tax Payer Ref. ID No. 3 Identification Type [TIN oer, please specify] 7. POWER OF ATTORNEY (PoA) HOLDER DETAILS Name of PoA Mr. Ms. M/s. First Applicant (including Min) Second Applicant/ Guardian Third Applicant #To also include USA, where e individual is a citizen/ green card holder of USA. ^In case Tax Identification Number is not available, kindly provide its functional equivalent. (Mandaty) Bank Name Branch Name Bank City Account Number MICR Code (The 9 digit code appears on your cheque next to e cheque number) Account Type (Please ) Savings Current NRO NRE FCNR Oers (please specify) *** Refer Instruction 5C (Mandaty f Credit via NEFT / RTGS) (11 Character code appearing on your IFSC Code*** cheque leaf. If you do not find is on your cheque leaf, please check f e same wi your bank) Regular Plan (Purchase/ Subscription routed rough Distribut) Mention valid in Key Partner/ Agent Infmation Direct Plan (Purchase/ Subscription made directly wi e Fund) Mention DIRECT in Key Partner/ Agent Infmation Pay-In Bank (F Cheque Only) Particulars Scheme Name / Plan / Option / Sub-option / Payout Option Cheque / DD / Payment Instrument / UTR No. / Date Drawn on (Name of Bank and Branch) Amount in figures (Rs.) Please Note: All Purchases are subject to realisation of cheques / demand drafts / Payment Instrument.
11. UNIT HOLDING OPTION DEMAT MODE* PHYSICAL MODE (Default) NSDL DP ID I N ( refer instruction 13) 12. NOMINATION (refer instruction 15) (Mandaty f new folios of Individuals where mode of holding is single) (F Units in Non-Demat Fm) [Please () and sign] I/We do not wish to Nominate First / Sole Applicant Second Applicant Third Applicant I/We wish to nominate as under: OR Name and Address of Nominee(s) Relationship wi Applicant Date of Bir Name and Address of Guardian (to be furnished in case e Nominee is a min) Signature of Nominee (Optional)/ Guardian of Nominee (Mandaty) Proption (%) in which e units will be shared by each Nominee (should aggregate to 100%) Nominee 1 Nominee 2 Nominee 3 13. DECLARATION & SIGNATURE/S (refer instruction 14) I/We am/are not prohibited from accessing capital markets under any der/ruling/judgment etc., of any regulation, including SEBI. I/We confirm at my application is in compliance wi applicable Indian and feign laws. I / We hereby confirm and declare as under:- (1) I / We have read, understood and hereby agree to comply wi e terms and conditions of e scheme related documents and apply f allotment of Units of e Scheme(s) of HDFC Mutual Fund ( Fund ) indicated above. (2) I/We am/are eligible Invest(s) as per e scheme related documents and am/are auised to make is investment as per e Constitutive documents/ auization(s). The amount invested in e Scheme(s) is rough legitimate sources only and is not f e purpose of contravention and/ evasion of any act, rules, regulations, notifications directions issued by any regulaty auity in India. (3) The infmation given in / wi is application fm is true and crect and furer agree to furnish such oer furer/additional infmation as may be required by e HDFC Asset Management Company Limited (AMC)/ Fund and undertake to infm e AMC / Fund/Registrars and Transfer Agent (RTA) in writing about any change in e infmation furnished from time to time. (4) That in e event, e above infmation and/ any part of it is/are found to be false/ untrue/ misleading, I/We will be liable f e consequences arising erefrom. (5) I/We hereby auize you to disclose, share, remit in any fm/manner/mode e above infmation and/ any part of it including e changes/updates at may be provided by me/us to e Mutual Fund, its Spons/s, Trustees, Asset Management Company, its employees, agents and ird party service providers, SEBI registered intermediaries f single updation/ submission, any Indian feign statuty, regulaty, judicial, quasi- judicial auities/agencies including but not limited to Financial Intelligence Unit-India (FIU-IND) etc wiout any intimation/advice to me/us. (6) I/We will indemnify e Fund, AMC, Trustee, RTA and oer intermediaries in case of any dispute regarding e eligibility, validity and auization of my/our transactions. (7) The holder (AMFI registered Distribut) has disclosed to me/us all e commissions (in e fm of trail commission any oer mode), payable to him/em f e different competing Schemes of various Mutual Funds from amongst which e Scheme is being recommended to me/us. (8) I/WE HEREBY CONFIRM THAT I/WE HAVE NOT BEEN OFFERED/ COMMUNICATED ANY INDICATIVE PORTFOLIO AND/ OR ANY INDICATIVE YIELD BY THE FUND/AMC/ITS DISTRIBUTOR FOR THIS INVESTMENT. F Feign Nationals Resident in India only: I/We will redeem my/our entire investment/s befe I/We change my/our Indian residency status. I/We shall be fully liable f all consequences (including taxation) arising out of e failure to redeem on account of change in residential status. F NRIs/ PIO/OCIs only: I/We confirm at my application is in compliance wi applicable Indian and feign laws. SIGNATURE(S) First / Sole Applicant / Guardian Second Applicant Third Applicant SIGN HERE (Please write Application Fm No. / Folio No. on e reverse of e Cheque / Demand Draft / Payment Instrument.) Please () Yes No If Yes, () Repatriation basis Non-repatriation basis VRIDHI 91-9551060808
(tick ) Bank A/c No.: Wi Bank: Please tick as applicable: The total of all installments in a day should be less an equal to e amount as mentioned in One Time Mandate already registered submitted, if not registered. KEY PARTNER / AGENT INFORMATION (Invests applying under Direct Plan must mention Direct in column.) FOR OFFICE USE ONLY (TIME STAMP) Name Sub-Agent s Bank Branch Code Internal Code Unique f Sub-Agent/ Identification Number - EUIN Declaration (only where EUIN box is left blank) I/We hereby confirm at e EUIN box has been intentionally left blank by me/us as is transaction is executed wiout any interaction advice by e employee/relationship manager/sales person of e above distribut/sub broker notwistanding e advice of in-appropriateness, if any, provided by e employee/relationship manager/sales person of e distribut/sub broker. Transaction Charges f Applications rough Distributs only (Please tick () any one) I confirm at I am a First time invest across Mutual Funds. (Rs. 150 deductible as Transaction Charge and payable to e Distribut) First Unit Holder s Signature Second Unit Holder s Signature Third Unit Holder s Signature SIP Registration/Renewal Fm (f OTM registered invests only) ACKNOWLEDGEMENT SLIP (To be filled in by e Distribut ( Holder) Head Office : HDFC House, 2nd Flo, H.T. Parekh Marg, 165-166, Backbay Reclamation, Churchgate, Mumbai Enrolment - 400 020. Date: D D M M Y Y Y Y I confirm at I am an existing invest in Mutual Funds. (Rs. 100 deductible as Transaction Charge and payable to e Distribut) If e total commitment of investment rough SIP (i.e. amount per SIP installment X no. of installments) amounts to Rs.10,000 me and your Distribut has opted to receive transaction Charges, e same are deductible as applicable from e installment amount and payable to e Distribut. In such cases Transaction Charge will be recoverable in 3-4 installments. Units will be issued against e balance of e installment amounts invested. Upfront commission shall be paid directly by e invest to e Holder (AMFI registered Distribut) based on e invests assessment of various facts including e service rendered by e Holder. Invest Name: Existing Invest Folio No. OR New Invest Application no. PAN/PEKRN & (Mandaty) Sole / First Applicant / Guardian Second Applicant Third Applicant # Please attach Proof. If PAN/PEKRN/KYC is already validated please don t attach any proof. Sr. No. 1. CREATE MODIFY CANCEL an amount of Rupees Reference 1 Folio No: OTM Debit Mandate is already registered in e folio. [No need to submit again]. SIP Auto debit can start in TEN Days i.e. f debit date 15, fm can be submitted till 4 of e mon. OTM Debit Mandate is attached and to be registered in e folio. SIP Auto debit will start after mandate registration which takes Ten to Thirty days depending on NACH ECS modalities. NSDL Scheme/Plan/Option/Sub-option SIP Top-up (Optional) (Refer Item No. 7 e) SIP Installment Amount (`) UNIT HOLDING OPTION DEMAT MODE* PHYSICAL MODE (Default) st* 1 15 SIP Date Frequency Start Mon/Year 5 20 10 25 Monly* Quarterly I/WE WOULD LIKE TO INVEST TO MEET MY/OUR FINANCIAL GOALS (choose anyone ( ) Marriage (Please to avail is facility) Top-up Amount (Rs.) DP ID Dream Home Dream Car Children s Education Children s Marriage Wld Tour Retirement Target Amount I N End Mon/Year (Default Dec 2032)* M M Y Y Y Y M M Y Y Y Y (The amount should be in multiples of Rs. 500 only) *Default SIP Top-up Frequency: Half-yearly Yearly (Quarterly SIP offers top-up frequency at yearly intervals only.) Maximum amount of debit (SIPTop-up) under direct debit facility f invests wi bank accounts wi State Bank of India shall not exceed Rs. 5,00,000/- per installment. (refer instruction 10) I / We hereby confirm and declare as under:- I/ We have read, understood and agree to comply wi e terms and conditions of OTM Facility, Scheme related documents of e Scheme and e terms & conditions of enrolment f Systematic Investment Plan (SIP). The holder has disclosed to me/us all e commissions (in e fm of trail commission any oer mode), payable to him/em f e different competing Schemes of various mutual Funds from amongst which e Scheme is being recommended to me/us. Date : Spons Bank Code Reference 2 Appln No: I/We hereby auize: Folio No. OTM DEBIT MANADATE FORM OTM Debit Mandate Fm NACH/ECS/DIRECT DEBIT/SI SIP FORM [Applicable f Lumpsum Additional Purchases as well as SIP Registrations] Received from: Utility Code Bank Name & Branch IFSC OR MICR Phone No: Email ID: Date D D M M Y Y Y Y to debit (tick ) SB / CA / CC / SB-NRE / SB-NRO / Oer FREQUENCY Monly Quarterly Half Yearly Yearly As & when presented DEBIT TYPE Fixed Amount Maximum Amount I agree f e debit of mandate processing charges by e bank whom I am auizing to debit my account as per latest schedule of charges of e bank. PERIOD From D D M M Y Y Y Y Signature of Primary Account Holder Signature of Account Holder Signature of Account Holder to 3 1 1 2 2 0 3 2 Until Cancelled 1. 2. 3. Name as in Bank Recds Name as in Bank Recds Name as in Bank Recds This is to confirm at e declaration has been carefully read, understood & made by me/us. I am auizing e User entity/ cpate to debit my account, based on e instructions as agreed and signed by me. I have understood at I am auized to cancel/ amend e mandate by appropriately communicating e cancellation/ amendment request to e User entity/ cpate e bank where I have auized e debit. UMRN HDFC0000060 HDFC Mutual Fund HDFC05834000028635 `
(tick ) Bank A/c No.: Wi Bank: Please tick as applicable: The total of all installments in a day should be less an equal to e amount as mentioned in One Time Mandate already registered submitted, if not registered. KEY PARTNER / AGENT INFORMATION (Invests applying under Direct Plan must mention Direct in column.) FOR OFFICE USE ONLY (TIME STAMP) Name Sub-Agent s Bank Branch Code Internal Code Unique f Sub-Agent/ Identification Number - EUIN Declaration (only where EUIN box is left blank) I/We hereby confirm at e EUIN box has been intentionally left blank by me/us as is transaction is executed wiout any interaction advice by e employee/relationship manager/sales person of e above distribut/sub broker notwistanding e advice of in-appropriateness, if any, provided by e employee/relationship manager/sales person of e distribut/sub broker. Transaction Charges f Applications rough Distributs only (Please tick () any one) I confirm at I am a First time invest across Mutual Funds. (Rs. 150 deductible as Transaction Charge and payable to e Distribut) First Unit Holder s Signature Second Unit Holder s Signature Third Unit Holder s Signature SIP Registration/Renewal Fm (f OTM registered invests only) ACKNOWLEDGEMENT SLIP (To be filled in by e Distribut ( Holder) Head Office : HDFC House, 2nd Flo, H.T. Parekh Marg, 165-166, Backbay Reclamation, Churchgate, Mumbai Enrolment - 400 020. Date: D D M M Y Y Y Y I confirm at I am an existing invest in Mutual Funds. (Rs. 100 deductible as Transaction Charge and payable to e Distribut) If e total commitment of investment rough SIP (i.e. amount per SIP installment X no. of installments) amounts to Rs.10,000 me and your Distribut has opted to receive transaction Charges, e same are deductible as applicable from e installment amount and payable to e Distribut. In such cases Transaction Charge will be recoverable in 3-4 installments. Units will be issued against e balance of e installment amounts invested. Upfront commission shall be paid directly by e invest to e Holder (AMFI registered Distribut) based on e invests assessment of various facts including e service rendered by e Holder. Invest Name: Existing Invest Folio No. OR New Invest Application no. PAN/PEKRN & (Mandaty) Sole / First Applicant / Guardian Second Applicant Third Applicant # Please attach Proof. If PAN/PEKRN/KYC is already validated please don t attach any proof. Sr. No. 1. CREATE MODIFY CANCEL an amount of Rupees Reference 1 Folio No: OTM Debit Mandate is already registered in e folio. [No need to submit again]. SIP Auto debit can start in TEN Days i.e. f debit date 15, fm can be submitted till 4 of e mon. OTM Debit Mandate is attached and to be registered in e folio. SIP Auto debit will start after mandate registration which takes Ten to Thirty days depending on NACH ECS modalities. NSDL Scheme/Plan/Option/Sub-option SIP Top-up (Optional) (Refer Item No. 7 e) SIP Installment Amount (`) UNIT HOLDING OPTION DEMAT MODE* PHYSICAL MODE (Default) st* 1 15 SIP Date Frequency Start Mon/Year 5 20 10 25 Monly* Quarterly I/WE WOULD LIKE TO INVEST TO MEET MY/OUR FINANCIAL GOALS (choose anyone ( ) Marriage (Please to avail is facility) Top-up Amount (Rs.) DP ID Dream Home Dream Car Children s Education Children s Marriage Wld Tour Retirement Target Amount I N End Mon/Year (Default Dec 2032)* M M Y Y Y Y M M Y Y Y Y (The amount should be in multiples of Rs. 500 only) *Default SIP Top-up Frequency: Half-yearly Yearly (Quarterly SIP offers top-up frequency at yearly intervals only.) Maximum amount of debit (SIPTop-up) under direct debit facility f invests wi bank accounts wi State Bank of India shall not exceed Rs. 5,00,000/- per installment. (refer instruction 10) I / We hereby confirm and declare as under:- I/ We have read, understood and agree to comply wi e terms and conditions of OTM Facility, Scheme related documents of e Scheme and e terms & conditions of enrolment f Systematic Investment Plan (SIP). The holder has disclosed to me/us all e commissions (in e fm of trail commission any oer mode), payable to him/em f e different competing Schemes of various mutual Funds from amongst which e Scheme is being recommended to me/us. Date : Spons Bank Code Reference 2 Appln No: I/We hereby auize: Folio No. OTM DEBIT MANADATE FORM OTM Debit Mandate Fm NACH/ECS/DIRECT DEBIT/SI SIP FORM [Applicable f Lumpsum Additional Purchases as well as SIP Registrations] Received from: Utility Code Bank Name & Branch IFSC OR MICR Phone No: Email ID: Date D D M M Y Y Y Y to debit (tick ) SB / CA / CC / SB-NRE / SB-NRO / Oer FREQUENCY Monly Quarterly Half Yearly Yearly As & when presented DEBIT TYPE Fixed Amount Maximum Amount I agree f e debit of mandate processing charges by e bank whom I am auizing to debit my account as per latest schedule of charges of e bank. PERIOD From D D M M Y Y Y Y Signature of Primary Account Holder Signature of Account Holder Signature of Account Holder to 3 1 1 2 2 0 3 2 Until Cancelled 1. 2. 3. Name as in Bank Recds Name as in Bank Recds Name as in Bank Recds This is to confirm at e declaration has been carefully read, understood & made by me/us. I am auizing e User entity/ cpate to debit my account, based on e instructions as agreed and signed by me. I have understood at I am auized to cancel/ amend e mandate by appropriately communicating e cancellation/ amendment request to e User entity/ cpate e bank where I have auized e debit. UMRN HDFC0000060 HDFC Mutual Fund HDFC05834000028635 `
Enrolment Fm f SIP/ Micro SIP [F Investments rough ECS (Debit Clearing) / Direct Debit Facility/Standing Instruction] (Please refer Product labeling available on cover page of e KIM and terms and conditions overleaf) Imptant: Please strike out e Section(s) at is/are not used by you to avoid any unauised use SIP/ Micro SIP via ECS (Debit Clearing) in select cities via Direct Debit/Standing Instruction in select banks / branches only. KEY PARTNER / AGENT INFORMATION (Invests applying under Direct Plan must mention Direct in column.) - Name Sub Agent s Bank Branch Code Internal Code f Sub-Agent/ Unique Identification Number FOR OFFICE USE ONLY (TIME STAMP) EUIN Declaration (only where EUIN box is left blank) (Refer Item No. 3a) I/We hereby confirm at e EUIN box has been intentionally left blank by me/us as is transaction is executed wiout any interaction advice by e employee/relationship manager/sales person of e above distribut/sub broker notwistanding e advice of in-appropriateness, if any, provided by e employee/relationship manager/sales person of e distribut/sub broker. Transaction Charges f Applications rough Distributs only (Refer Item No. 17 and please tick () any one) Date: D D M M Y Y Y Y I confirm at I am a First time invest across Mutual Funds. (Rs. 150 deductible as Transaction Charge and payable to e Distribut) If e total commitment of investment rough SIP (i.e. amount per SIP installment X no. of installments) amounts to Rs.10,000 me and your Distribut has opted to receive transaction Charges, e same are deductible as applicable from e installment amount and payable to e Distribut. In such cases Transaction Charge will be recoverable in 3-4 installments. Units will be issued against e balance of e installment amounts invested. Upfront commission shall be paid directly by e invest to e Holder (AMFI registered Distribut) based on e invests assessment of various facts including e service rendered by e Holder. Please () any one. In e absence of indication of e option e fm is liable to be rejected. NEW REGISTRATION CHANGE IN BANK ACCOUNT CANCELLATION (Refer Item No. 11) INVESTOR & INVESTMENT DETAILS Application No. (F new invest)/ Folio No. (F existing Uniolder) I confirm at I am an existing invest in Mutual Funds. (Rs. 100 deductible as Transaction Charge and payable to e Distribut) I / We hereby confirm and declare as under:- I/ We have read, understood and agree to comply wi e terms and conditions of e scheme related documents of e Scheme and e terms & conditions of enrolment f Systematic Investment Plan (SIP) and of ECS (Debit Clearing) / Direct Debit / Standing Instruction facilities. The holder has disclosed to me/us all e commissions (in e fm of trail commission any oer mode), payable to him/em f e different competing Schemes of various mutual Funds from amongst which e Scheme is being recommended to me/us. Sole/1st applicant SIGNATURE (Refer Item No. 3(c)) Name of Guardian (In case Applicant is min) Second Applicant Third Applicant (Mandaty) (Mandaty) (Mandaty) (Mandaty) # Please attach Proof. If PAN/PEKRN/KYC is already validated please don t attach any proof. Refer Item No. 15 and 16. Regular Plan (Purchase/ Subscription routed rough Distribut) Direct Plan (Purchase/ Subscription made directly wi e Fund) Mention valid in Key Partner/ Agent Infmation Mention DIRECT in Key Partner/ Agent Infmation F Default Plan (viz. Direct / Regular Plan) refer instruction 4. Scheme/Plan Option Lock-in Period (Applicable to HDFC Children s Gift Fund) Yes No (Default) Date: Application/ Folio No. Received from Mr./Ms./M/s. Scheme / Plan / Option instalment Amount (Rs.) ACKNOWLEDGEMENT SLIP (To be filled in by e Unit holder) Head Office : HDFC House, 2nd Flo, H.T. Parekh Marg,165-166, Backbay Reclamation, Churchgate, Mumbai - 400 020. SIP/ Micro SIP application f Please Note: All purchases are subject to realisation of cheques
I/WE WOULD LIKE TO INVEST TO MEET MY/OUR FINANCIAL GOALS (choose anyone ( ) (Refer Item No. 20) NSDL Marriage Target Amount Each SIP/ Micro SIP Amount (Rs.) SIP/ Micro SIP Date 1st 5 DP ID I I/we hereby auise HDFC Mutual Fund/HDFC Asset Management Company Limited and eir auised service providers, to debit my/our following bank account by ECS (Debit Clearing) / Direct Debit / Standing Instruction f collection of SIP/ Micro SIP payments. BANK DETAILS Bank Name 10 15 20 25 SIP/ Micro SIP Period Start From M M Y Y Y Y End On** M M Y Y Y Y OR Default Date (December 2032) First SIP/ Micro SIP Transaction via Cheque No. Mandaty Enclosure (if 1st Installment is not by cheque) The name of e first/ sole applicant must be pre-printed on e cheque. SIP Top-up (Optional) (Refer Item No. 7 e) Dream Home Dream Car Children s Education Children s Marriage Wld Tour Retirement SIP & DEBIT DETAILS (Please note at a minimum of 30 days is required to set up e ECS/ Direct Debit) (Please to avail is facility) Frequency Cheque Dated N D D M M Y Y Y Y Blank cancelled cheque Copy of cheque @The first cheque amount should be same as each SIP Amount. Top-up Amount (Rs.) Monly ( Default Date) [Refer Item No. 6(iv)] Quarterly ( Default Frequency) [Refer Item No. 6(iv)] Amount@ (Rs.) **Please refer Item No. 6(ii) and 7(b) (The amount should be in multiples of Rs. 500 only) SIP Top-up Frequency: Half-yearly Yearly (Quarterly SIP offers top-up frequency at yearly intervals only.) Maximum amount of debit (SIPTop-up) under direct debit facility f invests wi bank accounts wi State Bank of India shall not exceed Rs. 5,00,000/- per installment. (refer instruction 10) UNIT HOLDING OPTION DEMAT MODE* PHYSICAL MODE (Default) Branch Name Account Number Bank City 9 Digit MICR Code Account Type (Please ) Accounolder Name as in Bank Account Auisation of e Bank Account Holder (to be signed by e Invest)** ** To, The Branch Manager, (Name of e Bank) This is to infm at I/We have registered f e RBI s Electronic Clearing Service (Debit Clearing) / Direct Debit / Standing Instruction and at my/our payment towards my/our investment in e Scheme of HDFC Mutual Fund shall be made from my/our below mentioned bank account wi your bank. I/We hereby auise e representative carrying is ECS (Debit Clearing) / Direct Debit / Standing Instruction mandate Bank Account Number Fm to get it verified & executed. I/ We have read and agree to comply wi e terms and conditions mentioned overleaf and be bound by e same. I/We hereby declare at e particulars given above are true and crect and agree to make payments referred above rough participation in ECS (Debit Clearing) / Direct Debit / Standing Instruction.. I / We will also infm HDFC Mutual Fund/HDFC Asset Management Company Limited, about any changes in my bank account. Applicable to SIP Top-up facility (not available under Micro SIP): I/We hereby agree to avail e top-up facility f SIP and auize my bank to execute e ECS/Direct Debit/Standing Instruction f a furer increase in installment from my designated account. Please write Folio no. on e reverse of e cheque. (MANDATORY) 1st Account 2nd Account Holder s Holder s Signature Signature (As in Bank (As in Bank Recds) Recds) BANKER S ATTESTATION (FOR BANK USE ONLY) Certified at e signature of account holder and e details of Bank account and its MICR code are crect as per our recds F Office Use only (Not to be filled in by Invest) (Please enter e 9 digit number at appears after e cheque number) Savings Current NRO NRE FCNR Oers (please specify) 3rd Account Holder s Signature (As in Bank Recds) Signature of Auised Official from Bank (Bank Stamp and Date) Bank Account Number Recded on Recded by Scheme Code Credit Account Number