A I A I R (To be used / diributed with Key Information Memoraum) Inveors mu read the Key Information Memoraum, Inructions a Product Labeling before completing this Form. Please read the inructions before filling up the Application Form. Tick ( ) whichever is applicable, rike out whichever is not required. DISTRIBUTOR INFORMATION ARN code ARN: 130706 Application No. Incase the EUIN box has been left blank, please refer the point related to EUIN in the Declaration & Signatures section overleaf. Upfront commission shall be paid directly by the inveor to the AMFI regiered diributor, based on the inveor's assessment of various factors, including the service reered by the diributor. TRANSACTION CHARGES FOR APPLICATIONS THROUGH DISTRIBUTORS ONLY (Please any one of the below) I confirm that I am a Fir time inveor in Mutual Fus. OR I confirm that I am an exiing inveor in Mutual Fus. EXISTING FOLIO NUMBER SOLE / FIRST APPLICANT'S DETAILS Mr Ms M/s RIA code ARN - Sub broker ARN code Sub broker code (as allotted by ARN holder) Employee Unique Identification Number (EUIN) The details in our recos uer the folio number mentioned alongside will apply for this application. Date of Birth (DOB) (Maatory for Minor) Proof of DOB of Minor enclosed (please ) Passport Birth Certificate Other please specify (if Sole/ Fir applicant is a Minor) / Contact Person (For Non Iividuals) Mr Ms M/s Mailing Address [P. O. Box Address is not sufficient] City Pincode (Maatory) State Country Phone (Off.) Fax No. Mobile No. Phone (Res) Overseas Address (Maatory in case of NRI/ FII applicant, in addition to mailing address) State Country Zip Code Status of the Fir Applicant (Maatory, please ) Resident Iividual NRI-Repatriation NRI-Non Repatriation Partnership Tru HUF AOP PIO Company FIIs Minor through guaian Body Corporate Society/Club Sole Proprietorship Non Profit Organisation Others (please specify) MODE OF HOLDING Single OR Anyone or Survivor OR Joint (Default option) SECOND APPLICANT'S DETAILS Mr Ms THIRD APPLICANT'S DETAILS Mr Ms POWER OF ATTORNEY (POA) HOLDER DETAILS (If invement is being made by a Conituted Attomey) Mr Ms Iividual client who has regiered uer Central Recos Regiry (CR) has to fill the 14 digit C Identification Number (CIN) FIRST APPLICANT'S BANK ACCOUNT DETAILS (Maatory) (Please attach copy of cancelled cheque) of the Bank Branch Account No. Account Type Savings Current NRO NRE Others Bank Address Pincode State City MICR Code (9 digits) *IFSC Code for NEFT / RTGS *This is an 11 Digit Number, kily obtain it from your Bank Branch. ACKNOWLEDGMENT SLIP (To be filled in by the inveor) An Application for scheme Along with Cheque / DD No. / UTR No. Dated Drawn on (Bank) DHFL PRAMERICA Amount ` Application No. Signature, Stamp & Date V5-10.06.16
Details (Maatory) Gross Annual Income [Please tick ( )] Others [Please tick ( )] Below 1 Lac 1-5 Lacs 5-10 Lacs 10-25 Lacs >25 Lacs-1 crore >1 crore OR Net worth (Maatory for Non-Iividuals) ` Below 1 Lac 1-5 Lacs 5-10 Lacs 10-25 Lacs >25 Lacs-1 crore >1 crore OR Net worth ` Below 1 Lac 1-5 Lacs 5-10 Lacs 10-25 Lacs >25 Lacs-1 crore >1 crore OR Net worth ` INVESTMENT & PAYMENT DETAILS The name of the fir/ sole applicant mu be pre-printed on the cheque. (Inveors applying uer Direct Plan mu mention "Direct" again the Scheme name.) Scheme DHFL PRAMERICA Option Growth* Divide *Default Option Divide Facility Payout Re-Invement Divide Sweep Facility (DSF) Divide Frequency: To Scheme DHFL PRAMERICA ( Please refer to SID / addeum thereof for schemes available for DSF) Mode of Invement Lump Sum Only SIP Only (Fir invement cheque is optional) Lump Sum with SIP Micro Invement Payment Type [Please ] Non-Thi Party Payment Thi Party Payment (Please attach Thi Party Payment Declaration Form ) Amount of Cheque / DD / Payment Inrument / RTGS/ NEFT in figures (`) Occupation [Please tick ( )] DD Charges, if any Net Cheque/ DD Amount as on Professional Agriculturi Retired Professional Agriculturi Retired Professional Agriculturi Retired Cheque / DD / Payment Inrument No. & Date (Not older than 1 year) For Iividuals [Please tick ( )]: I am Politically Exposed Person (PEP)^ I am Related to Politically Exposed Person (RPEP) Not applicable For Non-Iividuals [Please tick ( )] (Please attach maatory Ultimate Beneficial Ownership (UBO) declaration form - Refer Inruction No. 4 (F)): (i) Foreign Exchange / Money Changer Services YES NO; (ii) Gaming / Gambling / Lottery / Casino Services YES NO; (iii) Money Leing / Pawning - YES NO I am Politically Exposed Person (PEP)^ I am Related to Politically Exposed Person (RPEP) Not applicable I am Politically Exposed Person (PEP)^ I am Related to Politically Exposed Person (RPEP) Not applicable ^ PEP are defined as iividuals who are or have been entrued with prominent public functions in a foreign country, e.g., Heads of States or of Governments, senior politicians, senior Government/judicial/ military officers, senior executives of ate owned corporations, important political party officials, etc. Drawn on Bank / Branch SIP Invement (Please any one) Monthly Quarterly SIP THROUGH AUTO DEBIT (ECS/Direct Debit/NACH) Please also fill a attach the SIP Auto Debit Facility Form OR SIP THROUGH POST-DATED CHEQUE Seco & subsequent Inalment cheque Details Cheque Nos. From To Dated From MMYYYY To DDMMYYYY DEMAT ACCOUNT DETAILS Depository Participant DP ID No. National Securities Depository Limited Mr / Ms / M/s Beneficiary A/c No. Seco & Subsequent Inalment Details: (All subsequent inalment amounts should be same as the fir inalment.) Inalment Amount ` SIP Date (Please ): 1 7th 10th 15th 21 25th 28th All 7 dates SIP Period (Please ): Till I/We inruct to discontinue the SIP No. of inalments Please mention Enrolment Period: From MMYY Y Y To YYY Y Depository Participant Target ID No. Central Depository Services (Iia) Limited Mr / Ms / M/s NOMINATION DETAILS (To be filled in by iividuals singly or jointly. Maatory only for Inveors who opt to hold units in Non-Demat Form) I/We do not wish to nominate OR I/We do hereby nominate the uermentioned Nominee(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 payment a settlements made to such Nominee(s) a Signature of the Nominee(s) acknowledging receipt thereof, shall be a valid discharge by the AMC/Mutual Fu/Truees. a Address of the Nominess(s) Nominee 1 Nominee 2 Nominee 3 DECLARATION AND SIGNATURES Date of Birth & Address of (to be furnished in case the nominee is minor) Signature of / Nominee I / We hereby confirm a declare as uer :- I/We have read a uerood the contents of the Statement of Additional Information of DHFL Pramerica Mutual Fu a the Scheme Information Document(s)/Key Information memoraum of the respective Scheme(s) a Addea thereto, issued from time to time a the Inructions. I/We, hereby apply to the Truee of DHFL Pramerica Mutual Fu for allotment of units of the respective Scheme(s) of DHFL 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 I am/we 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, Notification, 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 process to the satisfaction of the AMC/DHFL Pramerica Mutual Fu, I/We hereby authorise the AMC/DHFL 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 DHFL Pramerica Mutual Fu can debit from my Folio Transaction Charges as applicable. I/We agree tonotifydhflpramerica Asset ManagersPrivate Limited (erwhilepramerica Asset Managers Private Limited)immediately inthe event the information inthe self-certificationchanges. 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: 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 NRls: I/We confirm that I am/we are Non-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 Non-Resident External/Oinary Account/FCNR Account(s). FATCA a CRS Declaration: I/We hereby acknowledge a confirm that the information provided in this form is true a correct to the be of my/our knowledge a belief. In case any of the above specified information is fou to be false or untrue or misleading or misrepresenting, I/We shall be liable for it. I/We also uertake to keep you informed in writing about any changes/modification to the above information in future a also uertake to provide any other additional information as may be required at your e. I/We hereby authorise you to disclose, share, remit in any form, mode or manner, all/any of the information provided by me/us, including all changes, updates to such information as a when provided by me/us to Mutual Fu, its Sponsor, Asset Management Company, truees, their employees ('the Authorised Parties') orany Iianorforeign governmentaloratutory orjudicialauthorities/agenciesincluding but not limited tothe Financial IntelligenceUnit-Iia(FIU-IND),the tax /revenueauthorities a other inveigation agencieswithout any obligationofadvisingme/us ofthe same. Please if the EUIN space is left blank: I/We hereby confirm that the EUIN box has been intentionally left blank by me/us as this is an execution-only transaction without any interaction or advice by the employee/relationship manager/sales person of the above diributor or notwithaing the advice of in-appropriateness, if any, provided by the employee/relationship manager/sales person of the diributor a the diributor has not charged any advisory fees on this transaction. Please I/We would not like to regier for INVEST NOW to transact online as per the terms & coitions for this facility. By providing Email Id, I/We agree to receive the IPIN for INVEST NOW regiration on the same. Proportion (%) by which the units will be shared by each nominee (% to aggregate to 100%) 1 Applicant Signature / Signature / POA Signature / Thumb Impression Signature / POA Signature / Thumb Impression 3 Applicant Signature / POA Signature / Thumb Impression DHFL Pramerica Asset Managers Private Limited (erwhile Pramerica Asset Managers Private Limited) Nirlon House, 2 floor, Dr. Annie Besant Road, Worli, Mumbai 400030 Tel. +91-22-61593000 Fax +91-22-61593100 www.dhflpramericamf.com CIN : U74900MH2008FTC187029
SIP AUTO DEBIT FACILITY REGISTRATION CUANDATE FORM Please read the Scheme information Document of the respective scheme for minimum SIP inalment, minimum SIP period a aggregate amount of invement. 1. DISTRIBUTOR INFORMATION ARN code RIA code ARN: 130706 Sub broker ARN code ARN - Sub broker code (as allotted by ARN holder) Employee Unique Identification Number (EUIN) Incase the Employee Unique Identification Number (EUIN) box has been left blank please refer point 3 related to EUIN. 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. 2. APPLICANT INFORMATION Application No. / Exiing Folio No. of Sole/ 1 Applicant 3. SIP DETAILS (Fir SIP cheque a subsequent via Auto Debit Facility) Scheme DHFL PRAMERICA *Option Growth Divide *Divide Facility Payout Re-Invement Divide Sweep Facility (DSF) *Divide Frequency SIP Frequency (Please any one) Monthly Quarterly SIP Date : 1 7th 10th 15th 21 25th 28th All 7 dates Inalment Amount (In figures) ` * Please refer SID for default option Please refer to SID / addeum thereof for schemes available for DSF SIP Period (Please A or B) Till I/We inruct to discontinue the SIP (A) No. of Inalments (B) Please mention Enrolment Period: From YYY Y To YY Y Y DECLARATION & SIGNATURE: l/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 inauto Debit. If the transaction his delayed or not effected at all for reasons of incomplete or incorrect information. l/we would not hold the user initution responsible. l/we will also inform AMC, about any changes in my/our bank account. l/we have read a agreed to the terms a coitions mentioned. l/we confirm that thearn Holder has disclosed to me/us all the commissions (in the form of trail commission or any Other mode), payable to him for different competing Schemes of various Mutual Fus from among which the Scheme is recommeed to me/us. For inveors inveing in Direct Plan: l/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): l/we hereby declare that l/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. Please if the EUIN space is left blank: I/We hereby confirm that the EUIN box has been intentionally left blank by me/us as this is an execution-only transaction without any interaction or advice by the employee/relationship manager/sales person of the above diributor or notwithaing the advice of in-appropriateness, if any, provided by the employee/relationship manager/sales person of the diributor a the diributor has not charged any advisory fees on this transaction. Authorisation to Bank: This is to inform that l/we have regiered for ECS / NACH (Debit Clearing) / Direct Debit / Staing inructions facility a that my/ourpayment towas my/our invement in DHFL Pramerica Mutual Fu shall be made from my/our below mentioned bank account with your Bank. l/we authorize the representatives of DHFL Pramerica Mutual Fu carrying this maate form to get it verified a executed. l/we authorize the bank to debit my account for any charges towas maate verification, regiration, transactions, returns, etc. as applicable. SIGNATURE (S) (Applicants mu sign as per Common Application Form) Sole/1 Applicant//Authorised Signatory/POA //Authorised Signatory/POA 3 Applicant//Authorised Signatory/POA 4. BANKER S ATTESTATION (Maatory, if an original cancelled cheque leaf of SIP maate is not provided) 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) Signature of Authorised Official from Bank (Bank amp a date) CREATE MODIFY CANCEL UMRN Sponsor Bank Code I/We hereby authorize Bank a/c number* MANDATE INSTRUCTION FORM (Please read Inruction no. 4 overleaf) (*Maatory field) Utility Code With Bank* of cuomers bank IFSC* MICR* an amount of Rupees* SIP inalment amount in wos ` In Figures FREQUENCY* Mthly Qtly H-Yrly As & When presented DEBIT TYPE* Fixed Amount Maximum Amount Reference - 1 Application no. / Folio number Date* DHFL PRAMERICA MUTUAL FUND to debit (Please ) SB / CA / CC / SB-NRE / SB-NRO / Other Phone No Reference - 2 I agree for the debit of maate processing charges by the bank whom I am authorizing to debit my account as per late schedule of charges of the bank. PERIOD* From Signature of fir account holder Signature of seco account holder Signature of thi account holder To OR Until Cancelled of fir account holder* of seco account holder* of thi account holder* This is to confirm that the declaration has been carefully read, uerood & made by me/us. I am authorizing the User entity/ Corporate to debit my account. I have uerood that I am authorized to cancel/ame this maate by appropriately communicating the cancellation / amement reque to the User entity/ corporate or the bank were I have authorized the debit.
C & KRA Form Know Your Client Application Form (For Iividuals only) (Please fill the form in English a in BLOCK Letters) Fields marked with * are maatory fields Application Type* New Update Number* Type* Normal ( is maatory) Exempt Inveors (Refer inruction K) 1. Identity Details (Please refer inruction A at the e) Please enclose a duly atteed copy of your Ca Prefix Fir Middle La * (same as ID proof) Maiden (If any*) Father / Spouse * Mother * Date of Birth* Photo Geer* M- Male F- Female T-Transgeer Marital Status* Married Unmarried Others Citizenship* IN- Iian Others Country Country Code Residential Status* Resident Iividual Non Resident Iian Foreign National Person of Iian Origin Occupation Type* S-Service Private Sector Public Sector Government Sector O-Others Professional Self Employed Retired B- X-Not Categorised Signature/ Thumb Impression 2. Proof of Identity (PoI)* (for exempt Inveor or if ca copy not provided) (Please refer inruction C & K at the e) (Certified copy of any one of the following Proof of Identity [PoI] needs to be submitted) A- Passport Number Passport Expiry Date B- Voter ID Ca D- Driving Licence Driving Licence Expiry Date E- Aadhaar Ca F- NREGA Job Ca Z- Others (any document notified by the central government) Identification Number 3. Proof of Address (PoA)* 3.1 Current / Permanent / Overseas Address Details (Please see inruction D at the e) Address Dirict* Zip / Po Code* State/UT Code as per Iian Motor Vehicle Act, 1988 State/UT* Country* Country Code as per ISO 3166 Address Type* Residential / Residential Regiered Office Unspecified (Certified copy of any one of the following Proof of Address [PoA] needs to be submitted) Proof of Address* Passport Number Passport Expiry Date Voter ID Ca Driving Licence Driving Licence Expiry Date Aadhaar Ca NREGA Job Ca Others (any document notified by the central government) Identification Number 3.2 Correspoence / Local Address Details* (Please see inruction E at the e) Same as Current / Permanent / Overseas Address details (In case of multiple correspoence / local addresses, please Annexure A1, Submit relevant documentary proof) Dirict* Zip / Po Code* State/UT Code as per Iian Motor Vehicle Act, 1988 State/UT* Country* Country Code as per ISO 3166 Version 1.6 Page 1
4. Contact Details (All communications will be sent on provided Mobile no. / Email-ID) (Please refer inruction F at the e) Mobile Tel. (Off) Tel. (Res) 5. FATCA/CRS Information (Tick if Applicable) Residence for Tax Purposes in Jurisdiction(s) Outside Iia (Please refer inruction B at the e) Additional Details Required* (Maatory only if above option (5) is ticked) Country of Jurisdiction of Residence* Country Code of Jurisdiction of Residence Tax Identification Number or equivalent (If issued by jurisdiction)* as per ISO 3166 Place / City of Birth* Country of Birth* Country Code as per ISO 3166 Address Dirict* Zip / Po Code* State/UT Code as per Iian Motor Vehicle Act, 1988 State/UT* Country* Country Code as per ISO 3166 6. Details of Related Person (Optional) (please refer inruction G at the e) (in case of additional related persons, please fill Annexure B1 ) Related Person Deletion of Related Person Number of Related Person (if available*) Related Person Type* of Minor Assignee Authorized Representative Prefix Fir Middle * (If number a name are provided, below details of section 6 are optional) Proof of Identity [PoI] of Related Person* (Please see inruction (H) at the e) (Certified copy of any one of the following Proof of Identity[PoI] needs to be submitted) A- Passport Number Passport Expiry Date B- Voter ID Ca C- Ca D- Driving Licence Driving Licence Expiry Date E- Aadhaar Ca F- NREGA Job Ca Z- Others (any document notified by the central government) Identification Number 7. Remarks (If any) La 8. Applicant Declaration I hereby declare that the details furnished above are true a correct to the be of my knowledge a belief a I uertake to inform you of any changes therein, immediately. In case any of the above information is fou to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it. I hereby declare that I am not making this application for the purpose of contravention of any Act, Rules, Regulations or any atute of legislation or any notifications/directions issued by any governmental or atutory authority from time to time. I hereby consent to receiving information from Central Regiry through SMS/Email on the above regiered number/email address. Date: Place : 9. Atteation / For Office Use Only Documents Received Date Emp. Emp. Code Emp. Designation Certified Copies Verification Carried Out by (Refer Inruction I) Code Emp. Branch Initution Details [Signature / Thumb Impression] Signature / Thumb Impression of Applicant [Employee Signature] [Initution Stamp] In-Person Verification (IPV) Carried Out by (Refer Inruction J) Date Emp. Emp. Code Emp. Designation Code Emp. Branch Initution Details [Employee Signature] [Initution Stamp] Version 1.6 Page 2