ARN/RIA Code ARN-131351 Application Form (Except for ETFs, HDFC Retirement Savings fu a HDFC Children s Gift Fu) Inveors mu read the Key Information Memoraum, the inructions a Product Labeling on cover page before completing this Form. The Application Form should be completed in English a in BLOCK LETTERS only. KEY PARTNER / AGENT INFORMATION (Inveors applying uer Direct Plan mu mention Direct in ARN column.) (Refer Inruction 1) ARN/RIA Name Sub Agent s ARN Bank Branch Code Internal Code for Sub-Agent/ Employee Employee Unique Identification Number (EUIN) FOR (TIME STAMP) EUIN Declaration (only where EUIN box is left blank) (Refer Inruction 1) I/We hereby confirm that the EUIN box has been intentionally left blank by me/us as this transaction is executed without any interaction or advice by the employee/relationship manager/sales person of the above diributor/sub broker or notwithaing the advice of in-appropriateness, if any, provided by the employee/relationship manager/sales person of the diributor/sub broker. TRANSACTION CHARGES FOR APPLICATIONS THROUGH DISTRIBUTORS ONLY (Refer Inruction 2) In case the purchase/ subscription amount is Rs. 10,000 or more a your Diributor has opted in to receive Transaction Charges, the same are deductible as applicable from the purchase/ subscription amount a payable to the Diributor. Units will be issued again the balance amount inveed. Upfront commission shall be paid directly by the inveor to the ARN Holder (AMFI regiered Diributor) based on the inveors assessment of various factors including the service reered by the ARN Holder. 1. EXISTING UNIT HOLDER INFORMATION (IF YOU HAVE EXISTING FOLIO, PLEASE FILL IN SECTIONS viz. 1, 5, 6, 10 AND 13 ONLY. Refer inruction 3). Folio No. 2. MODE OF HOLDING [Please tick ( ) Single Joint The details in our recos uer the folio number mentioned alongside will apply for this application. Anyone or Survivor 3. UNIT HOLDER INFORMATION (Refer inruction 4) DATE OF BIRTH@ NAME OF FIRST / SOLE APPLICANT (In case of Minor, there shall be no joint holders) Ensure that name is as per Aadhaar Ca Proof of date of birth@ Please ( ) Attached [Please tick ( )] () Status of Fir/ Sole [Please tick ( )] Iividual Non - Iividual [Please attach FATCA, CRS & Ultimate Beneficial Ownership (UBO) Self Certification Form a Aadhaar Updation Form ] (Refer Inruction 4, 19 & 18 c) () Resident Iividual NRI-Repatriation NRI-Non Repatriation Partnership Tru HUF AOP PIO Company FIIs Minor through guaian BOI OCI Body Corporate LLP Society / Club Foreign National Resident in Iia FPI Sole Proprietorship Non Profit Organisation Others (please specify) NAME OF GUARDIAN (in case of Fir / Sole is a Minor) / NAME OF CONTACT PERSON DEATION (in case of non-iividual Inveors) Mr. Ms. Fir/ Sole / Guaian Designation Seco Contact No. Thi [Please tick ( )] () Relationship with Minor@ Please ( ) Father Mother Court appointed Legal Guaian Proof of relationship with minor@ Please ( ) Attached @ MAILING ADDRESS OF FIRST / SOLE APPLICANT () (Refer Inruction 4a) CITY STATE PIN CODE CONTACT DETAILS OF FIRST / SOLE APPLICANT Country Code STD Code Telephone : Off. Res. Fax ealerts Mobile edocs Email^ I/ We would like to regier for my/our HDFCMF Personal Identification Number (HPIN) to transact online as per the terms & coitions displayed on website:www.hdfcfu.com (Email id maatory). ^ On providing email-id inveors shall receive scheme wise annual report or an abridged summary thereof/ account atements/ atutory a other documents by email. (Refer Inruction 10 & 12) 4. JOINT APPLICANT DETAILS, If any (Refer inruction 4) (In case of Minor, there shall be no joint holders) 1. NAME OF SECOND APPLICANT 2. NAME OF THIRD APPLICANT 5. ADDITIONAL KYC DETAILS (Refer inruction 4b) Occupation details for 3 Guaian Politically Exposed Person (PEP) details: Is a PEP Related to PEP Not Applicable Private Sector Service Public Sector Service Government Service 3 Business Guaian Professional Agriculturi Authorised Signatories Retired Promoters Housewife Partners Student Karta Proprietorship Whole-time Directors Others (Please specify) Truee Non-Iividual Inveors involved/ providing any of the mentioned services Foreign Exchange / Money Changer Services Money Leing / Pawning Gaming / Gambling / Lottery / Casino Services None of the above # Please attach Proof. Refer inruction No 16 for PAN/PEKRN a No 18a for KYC (KRA). Refer inruction No 18b for KYC Identification Number issued by CKYCR. ACKNOWLEDGEMENT SLIP (To be flled in by the Inveor) [For any queries please contact our neare Inveor Service Centre or call us at our Cuomer Service Number 1800 3010 6767 / 1800 419 7676 (Toll Free)] HDFC MUTUAL FUND [Please tick ( )] () [Please tick ( )] () Head Office : HDFC House, 2 Floor, H.T. Parekh Marg, 165-166, Backbay Reclamation, Churchgate, Mumbai - 400 020. Received from Mr. / Ms. / M/s. an application for Purchase of Units of the Scheme(s) alongwith Cheque / DD / Payment Inrument as detailed overleaf. Date : ISC Stamp & Signature... continued overleaf
5. ADDITIONAL KYC DETAILS, If any (Refer inruction 4b) Contd. Gross Annual Income Range (in Rs.) Below 1 lac 1-5 lac 5-10 lac OR Networth in Rs. ( for Non Iividual) (not older than 1 year) 3 Guaian Gross Annual Income Range (in Rs.) 10-25 lac 25 lac- 1 cr > 1 cr as on DD MM YYYY AADHAAR DETAILS (Ensure all details are as per Aadhaar Ca) (for Iividual including Sole Proprietor) Not maatory for NRIs (Refer inruction 18c) Particulars Aadhaar Number* (Please enclose copy of front & back side) Date of Birth 3 Guaian PIN Code Mobile No. Enrolment Proof# 3 Guaian POA * All the applicants whose Aadhaar Number is mentioned are required to sign the form. # If Aadhaar number is applied for, please enclose proof of enrolment. 6. FATCA AND CRS INFORMATION (for Iividual including Sole Proprietor) (Self Certification) (Refer inruction 4) The below information is required for all applicant(s)/ guaian Address Type: Residential or Business Residential Business Regiered Office (for address mentioned in form/exiing address appearing in Folio) Is the applicant(s)/ guaian's Country of Birth / Citizenship / / Tax Residency other than Iia? Yes No If Yes, please provide the following information [maatory] Please iicate all countries in which you are resident for tax purposes a the associated Tax Reference Numbers below. Category Place/ City of Birth Country of Birth Country of Tax Residency# Fir (including Minor) Seco / Guaian Thi Tax Payer Ref. ID No^ Country of Tax Residency 2 Tax Payer Ref. ID No. 2 Country of Tax Residency 3 Tax Payer Ref. ID No. 3 #To also include USA, where the iividual is a citizen/ green ca holder of USA. ^In case Tax Identification Number is not available, kily provide its functional equivalent. 7. POWER OF ATTORNEY (PoA) HOLDER DETAILS Name of PoA [Please tick ( )] () # Please attach Proof. Refer inruction No 16 for PAN/PEKRN a No 18a for KYC (KRA). Refer inruction No 18b for KYC Identification Number issued by CKYCR. 8. BANK ACCOUNT DETAILS OF THE FIRST / SOLE APPLICANT (For redemption/ divide if any) (refer inruction 5) ( to attach proof, in case the pay-out bank account is different from the bank account mentioned uer Section 10 below.) For unit holders opting to hold units in demat form, please ensure that the bank account linked with the demat account is mentioned here. Bank Name Branch Name Bank City Account Number MICR Code (The 9 digit code appears on your cheque next to the cheque number) Account Type (Please ) Savings Current NRO NRE FCNR Others (please specify) *** Refer Inruction 5C ( for Credit via NEFT / RTGS) (11 Character code appearing on your IFSC Code*** cheque leaf. If you do not fi this on your cheque leaf, please check for the same with your bank) Particulars Scheme Name / Plan / Option / Sub-option / Payout Option Cheque / DD / Payment Inrument / UTR No. / Date Drawn on (Name of Bank a Branch) Amount in figures (Rs.) Please Note: All Purchases are subject to realisation of cheques / dema drafts / Payment Inrument.
9. MODE OF PAYMENT OF REDEMPTION / DIVIDEND PROCEEDS (refer inruction 11) Unitholders will receive redemption/ divide proceeds directly into their bank account (as furnished in Section 8) via Direct credit/ NEFT/ECS facility I/We want to receive the redemption / divide proceeds (if any) by way of a dema draft inead of direct credit / credit through NEFT syem / credit through ECS into my / our bank account 10. INVESTMENTS & PAYMENT DETAILS [Please ( )] (refer inruction 6 & 7 for Scheme details a inruction 8 & 9 for Payment Details) The name of the fir/ sole applicant mu be pre-printed on the cheque. Regular Plan (Purchase/ Subscription routed through Diributor) Mention valid ARN in Key Partner/ Agent Information Scheme/Plan/Sub Option Payment Type [Please ( )] Non-Thi Party Payment Pay-In Bank Account No. (For Cheque Only) Thi Party Payment (Please attach Thi Party Payment Declaration Form ) Cheque/ DD/ Payment Inrument/ UTR No. Direct Plan (Purchase/ Subscription made directly with the Fu) Mention DIRECT in Key Partner/ Agent Information Mode of Payment Cheque Dema Draft NEFT/ RTGS/ Fu Transfer One Time Maate (OTM) Please note that OTM can be selected as mode of payment provided OTM is already regiered. In case OTM is not regiered please fill in the attached OTM Debit Maate to make future transactions via OTM Drawn on Bank / Branch Cheque/ DD/ Payment Inrument/ UTR Date Amount of Cheque / DD / Payment Inrument / RTGS/ NEFT in figures (Rs.) DD Charges, Net Cheque/ DD if any Amount 11. UNIT HOLDING OPTION DEMAT MODE* PHYSICAL MODE (Default) *Demat Account details are maatory if the inveor wishes to hold the units in Demat Mode NSDL DP Name DP ID I N ( refer inruction 13) Beneficiary Account No. CDSL DP Name Beneficiary Account No. *Inveor opting to hold units in demat form, may provide a copy of the DP atement enable us to match the demat details as ated in the application form. 12. NOMINATION (refer inruction 15) ( for new folios of Iividuals where mode of holding is single) (For Units in Non-Demat Form) [Please ( ) a sign] I/We do not wish to Nominate Fir / Sole Seco Thi OR I/We wish to nominate as uer: Name a Address of Nominee(s) Nominee 1 Nominee 2 Nominee 3 Relationship with Date of Birth Name a Address of Guaian Signature of Nominee (Optional)/ Guaian of (to be furnished in case the Nominee is a minor) Nominee () Proportion (%) in which the units will be shared by each Nominee (should aggregate to 100%) 13. DECLARATION & ATURE/S (refer inruction 14) I / We have read, uerood the terms a coitions of the scheme related documents a agree to comply with the same as an Unitholder. I /We hereby apply for allotment of Units of the Scheme(s) of HDFC Mutual Fu ( Fu ) a confirm a declare as uer: (a) I/We am/are eligible Inveor(s) as per the scheme related documents a not prohibited by any oer/ruling /judgement passed by SEBI/ Statutory Authority or Courts in Iia a Foreign laws. I am/we are authorised to make this invement as per the Conitutive documents/ authorization(s). The amount inveed in the Scheme(s) is through legitimate sources only a is not for the purpose of contravention a/or evasion of any act, rules, regulations, notifications or directions issued by any regulatory authority in Iia. (b) The information given by me /us in or along with this application form is true a correct a shall furnish such other further/additional information as may be required by the HDFC Asset Management Company Limited (AMC)/ Fu.I/We uertake to promptly inform the AMC / Fu/Regirars a Transfer Agent (RTA) in writing about any change in the information furnished by me/us from time to time. (c) I/We hereby authorize you to disclose, share, remit in any form/manner/mode the above information a/or any part of it including the changes/updates that may be provided by me/us to the Fu, its Sponsor/s, Truees, Asset Management Company, its employees, agents a thi party service providers, SEBI regiered intermediaries for single updation/ submission, any Iian or foreign atutory, regulatory, judicial, quasi- judicial authorities/agencies including but not limited to Financial Intelligence Unit-Iia (FIU-IND) etc without any intimation/advice to me/us. (d) I/We shall be liable a responsible for any loss, claims suffered, directly or iirectly by AMC/ Fu/ RTA/ SEBI Intermediaries, arising out of any false, misleading, inaccurate a incomplete information furnished by me/us at the time or inveing/redeeming the units. I/We hereby uncoitionally a irrevocably iemnify a at all time keep iemnified, save a harmless AMC/Fu/Truee a their officers, directors a employees again all actions, proceedings, claims, losses, damages, charges a expenses incurred or suffered /paid by AMC/Fu in this rega a in case of any dispute regaing the eligibility, validity a authorization of my/our transactions. (e) The ARN holder (AMFI regiered Diributor) has disclosed to me/us all the commissions (in the form of trail commission or any other mode), payable to him/them for the different competing Schemes of various Mutual Fus from among which the Scheme is being recommeed to me/us. (f) 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. Consent for Telemarketing (Refer Inruction 20): I/We hereby acco my/our consent to HDFC AMC for receiving the promotional information/ material via email, SMS, telemarketing calls etc. on the mobile number a email provided by me/us in this Application Form. Consent for authentication a sharing of Aadhaar data: I/We hereby provide my consent in accoance with Aadhaar Act, 2016 a regulations made thereuer, for (i) collecting, oring a usage (ii) validating/authenticating a (ii) updating my/our Aadhaar number(s) in accoance with the Aadhaar Act, 2016 (a regulations made thereuer) a PMLA. I/We hereby provide my/our consent for sharing/ disclose of the Aadhaar number(s) including demographic information with the asset management companies of SEBI regiered mutual fu a their Regirar a Transfer Agent (RTA) for the purpose of updating the same in my/our folios with my PAN. For Foreign Nationals Resident in Iia only: I/We will redeem my/our entire invement/s before I/We change my/our Iian residency atus. I/We shall be fully liable for all consequences (including taxation) arising out of the failure to redeem on account of change in residential atus. For NRIs/ PIO/OCIs only: I/We confirm that my application is in compliance with applicable Iian a foreign laws. Please ( ) Yes No If Yes, ( ) Repatriation basis Non-repatriation basis ATURE(S) Fir / Sole / Guaian Seco Thi HERE (Please write Application Form No. / Folio No. on the reverse of the Cheque / Dema Draft / Payment Inrument.)
Please ensure that your Application Form is complete in all respect a signed by all applicants: CHECKLIST Name, Address a Contact Details are mentioned in full. Status of Fir/Sole is correctly iicated. Bank Account Details are entered completely a correctly. Permanent Account Number (PAN) of all s is mentioned irrespective of the amount of purchase a proof attached (if not already validated) OR PAN Exempt KYC Reference Number (PEKRN) in case of PAN exempt invement. Please attach proof of KYC Compliance atus if not already validated. Appropriate Plan / Option is selected. If units are applied by more than one applicant, Mode of Operation of account is iicated. Your invement Cheque / DD is drawn in favour of 'the Specific Scheme A/c PAN' or 'the Specific Scheme A/c Inveor Name' dated, signed a crossed A/c Payee only. Application Number / Folio No. is mentioned on the reverse of the Cheque/DD. Documents as lied below are submitted along with the Application Form (as applicable to your specific case). Documents Companies / Trus / FPI NRI/ Minor Invements through Societies/ Partnership Firms / OCI/ Conituted Attorney LLP / FIIs* PIO 1. Boa/ Committee Resolution/ Authority Letter 2. Li of Authorised Signatories with Specimen Signature(s) @ 3. Notarised Power of Attorney 4. Account Debit Certificate in case payment is made by DD from NRE / FCNR A/c. where applicable 5. PAN Proof # 6. KYC Acknowledgement Letter / Print out of KYC Compliance Status downloaded from CDSL Ventures Ltd. website (www.cvliia.com) # 7. Proof of Date of Birth 8. Proof of Relationship with Guaian 9. PIO / OCI Ca (as applicable) 10. Certificate of regiration granted by Designated Depository Participant on behalf of SEBI 11. Ultimate Beneficial Owner 12. FATCA & CRS 13. Aadhaar updation form for non iividuals @ Should be original or true copy certified by the Director / Truee / Company Secretary / Authorised Signatory / Notary Public, as applicable. * For FIIs, copy of SEBI regiration certificate should be provided. # If PAN/PEKRN/KYC proof of Minor is not available, PAN/PEKRN/KYC proof of Guaian should be provided.
(tick ) Bank A/c No.: With Bank: CREATE MODIFY CANCEL an amount of Rupees Reference 1 Folio No: Sponsor Bank Code Reference 2 Appln No: I/We hereby authorize: OTM Debit Maate Form NACH/ECS/DIRECT DEBIT/SI [Applicable for Lumpsum Additional Purchases as well as SIP Regirations] Utility Code Bank Name & Branch IFSC OR MICR Phone No: Email ID: Date to debit (tick ) SB / CA / CC / SB-NRE / SB-NRO / Other FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented DEBIT TYPE Fixed Amount Maximum Amount 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 UMRN HDFC Mutual Fu Signature of Primary Account Holder Signature of Account Holder Signature of Account Holder to or Until Cancelled 1. 2. 3. Name as in Bank Recos Name as in Bank Recos Name as in Bank Recos 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, based on the inructions as agreed a signed by me. I have uerood that I am authorized to cancel/ ame the maate by appropriately communicating the cancellation/ amement reque to the User entity/ corporate or the bank where I have authorized the debit. `