APPLICATION FORM FOR LUMPSUM / SIP INVESTMENTS
Application No.
Form 1
Distributor Code / ARN
Sub-distributor code / ARN / Sol ID
Serial Number, Date and Time Stamp
ARN-3086
Upfront commission shall be paid directly by the investor to the AMFI registered distributor based on the investor's assessment of various factors including the service rendered by the distributor.
1. EXISTING INVESTOR'S FOLIO NUMBER
(If you have an existing folio number with KYC validated, please mention the number here and skip to section 6. Mode of holding will be as per existing folio number.)
2. FIRST APPLICANT'S DETAILS
Name of 1st Applicant (should match with PAN card)
Title
Mr.
Ms.
M/s
Date of Birth D PAN*(1st Applicant/Guardian)
*Mandatory. Refer Instruction 5. Enclose (Please P Attested PAN card copy )
KYC Acknowledgment* Name of the Guardian if minor / Contact Person for non individuals / PoA Holder name
For Investments "On behalf of Minor"(Refer Instruction 6) (^Attach mandatory documents as per instructions.) School Certificate/Mark sheet Birth Certificate Proof of Date of Birth Attached^ Passport Any other Court Appointed^ Father Mother Guardian named below is PoA PAN
Correspondence Address / Overseas Address (For FIIs/NRIs/PIOs)
City
City
State
Mobile +91
Pin Code
Email ID (Refer instruction 11a)
STD Code
Tel (Office)
Tel (Resi)
Proprietor Other Professional
Status of Sole / 1st Applicant (Please P ) Resident Individual Trust Partnership Firm PIO Company Occupation (of 1st / Sole Applicant) Housewife Defence Service MICRO SIP (Refer instruction 5b.) Type of Supporting Document
HUF Specify
Retired
Minor
Society
FII
NRI
Business
Agriculture
Other
Specify
ID Document Number
Anyone or Survivor Single M/s
3. JOINT APPLICANTS DETAILS
Name of 2nd Applicant (Should match with PAN Card) PAN
Mode Of Holding (Please PJoint (Default) )
Title
Mr.
Ms.
(2nd applicant)
Enclose
Attested PAN card copy
KYC Acknowledgment*
*Mandatory. Refer Instruction 5.
Email ID
Name of 3rd Applicant (Should match with PAN Card) PAN
Enclose
Mobile +91
Title
Mr. Ms. M/s
(3rd applicant)
Attested PAN card copy
KYC Acknowledgment*
*Mandatory. Refer Instruction 5.
Email ID
Mobile +91
4. BANK ACCOUNT DETAILS FOR PAY-OUT (Mandatory. Refer instruction 4 and avail of Multiple Bank Registration Facility.)
Bank Name Bank A/c No.
Branch Address City IFSC Code (11 digit)* MICR Code (9 digit)* Pin
*Mentioned on your cheque leaf
A/c Type
Current
Savings
NRO
NRE
FCNR
Others Specify
5. DEBIT MANDATE (For Axis Bank account holders only. To be used to invest in one scheme at a time only. Refer instruction 3d.)
TO BE DETACHED BY THE REGISTRAR (KARVY) AND PRESENTED TO AXIS BANK CMS DEPARTMENT D D M M Y Y *To be processed in CMS software under client code AXISMF Date Application No. Name of the account holder(s) authorise you to debit my/our account no. I/ We
to pay for the purchase of Axis Income Saver amount of ` (in figures) Axis Triple Advantage Fund Axis Midcap Fund
Axis Tax Saver Fund Axis Equity Fund Please debit an
Signature of Account Holder
` (in words)
ACKNOWLEDGMENT SLIP (To be filled in by the investor)
Received subject to realisation, verification and conditions, an application for purchase of Units as mentioned in the application form. From Cheque no. Date Amount
Name of the account holder(s)
Scheme
Application No.
Stamp & Signature
Form 1
6. INVESTMENT & PAYMENT DETAILS
Payment type (Please 3 ) Non-Third Party Payment Scheme 1 Scheme 2 Scheme 3 Plan Plan Plan Third Party Payment (Please attach 'Third Party Payment Declaration Form') Dividend Frequency (Quarterly/ Half Yearly/ Annual)* Option Dividend Frequency (Quarterly/ Half Yearly/ Annual)* Option Option Dividend Frequency (Quarterly/ Half Yearly/ Annual)*
*Applicable only for Axis Income Saver
ONE TIME LUMP SUM INVESTMENT (Do not submit SIP Auto Debit Form for lump sum investments) Payment mode Cheque DD RTGS NEFT
SCHEME 1
Debit Mandate^
SCHEME 2 SCHEME 3
(^Facility available for Axis Bank account holders only. Please fill in section 5. The Debit Mandate can be used to invest in one scheme at a time only.)
LUMPSUM
Investment amount (`) Cheque / DD / RTGS / NEFT No. Cheque / DD / RTGS / NEFT date Drawn on bank / branch name Pay-in bank account no. (For cheques only) Account type (Please P )
DD/MM/YY
DD/MM/YY
DD/MM/YY
Savings NRE Others
Current NRO
Specify
FCNR
Savings NRE Others
Current NRO
Specify
FCNR
Savings NRE Others
Current NRO
Specify
FCNR
SIP INVESTMENT (normal SIP)
Monthly SIP amount `
TM
MICRO SIP INVESTMENT (Provide 'Type of Supporting Document' & 'ID Document Number' under section 2. Refer instruction 5b.)
(in figures) ` (in words)
SIP MATLAB SLEEP IN PEACE
First SIP Installment details
Mode of payment Cheque / DD no. Cheque / DD Electronic Debit (Facility available for Axis Bank account holders only. Please fill in section 5.) Cheque / DD date D D M M Y Y
Drawn On
Second and subsequent SIP Installment details Till you instruct Axis Mutual Fund to discontinue or SIP period
Preferred date for monthly debit (Pick any date except 29th, 30th and 31st of the month.) D SIP through post-dated cheques-Cheque Nos. From D
no. of installments from M M
to* M M
*Please fill only if no. of installments have been specified. Otherwise leave blank.
To
Date From D D M M Y
Y To D
M M
SIP through Electronic Auto Debit (Please fill and attach the SIP Auto Debit Form along with this form)
7. NOMINATION DETAILS (Nomination is advisable. If you do not wish to nominate, tick here . Refer instructions.)
Name Nominee 1 Nominee 2 Nominee 3 Date of Birth Address Guardian Name
(in case Nominee is a Minor)
Guardian Signature Allocation % (in case Nominee is a Minor)
Total=100%
8. DECLARATION AND SIGNATURE
Having read and understood the content of the SID / SAI of the scheme, I / we hereby apply for units of the scheme. I have read and understood the terms, conditions, rules and regulations governing the scheme. I / We hereby declare that the amount invested in the scheme is through legitimate source only and does not involve designed for the purpose of the contravention of any Act, Rules, Regulations, Notifications or Directives of the provisions of the Income Tax Act, Anti Money Laundering Laws, Anti Corruption Laws or any other applicable laws enacted by the Government of India from time to time. I / We have understood the details of the Scheme & I / we have not received nor have been induced by any rebate or gifts, directly or indirectly in making this investment. I / We confirm that the funds invested in the Scheme, legally belongs to me / us. In event Know Your Customer process is not completed by me / us to the satisfaction of the Mutual Fund, (I / we hereby authorize the Mutual Fund, to redeem the funds invested in the Scheme, in favour of the applicant, at the applicable NAV prevailing on the date of such redemption and undertake such other action with such funds that may be required by the law.) 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 Funds from amongst which the Scheme is being recommended to me / us. I/We confirm the I/We do not have any existing Micro SIP investments which together with the current application will result in aggregate investments exceeding ` 50,000 in a year (Applicable for Micro SIP investment only.) For NRIs only - I / We confirm that I am/ we are Non Residents of Indian nationality / origin and that I / We have remitted funds from abroad through approved banking channels or from funds in my/ our Non Resident External / Non Resident Ordinary / FCNR account. I / We confirm that details provided by me / us are true and correct.
First / Sole Applicant / Guardian
Second Applicant
Third Applicant
Power of Attorney Holder
QUICK CHECKLIST AND ENCLOSURES
KYC acknowledgement letter copy attached Self attested PAN card copy attached Email id provided for a greener planet Email id and mobile number provided for online transaction facility Plan / Option name mentioned in addition to scheme name SIP Auto Debit Form attached for SIP investments Multiple Bank Accounts Registration form attached (if you want to register multiple bank accounts so that future payments can be made from any of the accounts) Nomination facility opted Form signed by all applicants Relationship proof between Guardian and Minor (if application is in the name of a Minor) attached Additional documents attached for Third Party payments. Refer instructions.
Toll Free Website Email
1800 3000 3300 www.axismf.com customerservice@axismf.com
