Unit Holding Option Existing Investor'S Folio Number
Unit Holding Option Existing Investor'S Folio Number
Unit Holding Option Existing Investor'S Folio Number
ARN-0018 ARN E
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.
^I/We, have invested in the scheme(s) of Axis Mutual Fund under Direct Plan. I/We hereby give my/our consent to share/provide the transactions data feed/ portfolio holdings/ NAV etc. in respect of my/our investments under Direct Plan of all schemes of Axis Mutual Fund, to the above
mentioned SEBI Registered Investment Adviser:
“I/We hereby confirm that the EUIN box has been intentionally left blank by me/us as this transaction is First / Sole Applicant /
executed without any interaction or advice by the employee/relationship manager/sales person of the above Second Applicant Third Applicant Power of Attorney Holder
distributor/sub broker or notwithstanding the advice of in-appropriateness, if any, provided by the Guardian
employee/relationship manager/sales person of the distributor/sub broker.”
TRANSACTION CHARGES FOR APPLICATIONS THROUGH DISTRIBUTORS ONLY (Refer 20) In case the subscription amount is ` 10,000 I confirm that I am a first time investor across Mutual Funds.
or more and your Distributor has opted to receive Transaction Charges, the same are deductible as applicable from the purchase/ subscription amount and payable to the Distributor.
Units will be issued against the balance amount invested. I confirm that I am an existing investor in Mutual Funds.
1 UNIT HOLDING OPTION (To be filed in case of demat holding only) 2 EXISTING INVESTOR'S FOLIO NUMBER
DEMAT MODE PHYSICAL MODE (If you have an existing folio with KYC validated, please mention here and skip to section 6/8.)
Demat Account Details of First / Sole Applicant Folio Number
(Name should be as per demat account)
Depository Participant Name 3 INVESTMENT TYPE (Please tick any one)
DP ID IN CDSL Beneficiery ID LUMP SUM LUMP SUM WITH SIP LUMP SUM WITH STP
NSDL
Beneficiery ID Note: Please attach copy of Client Master List.
4 MODE OF HOLDING (in case of Demat Purchase Mode of Holding should be same as in Demat Account) Single Joint (Default) Anyone or Survivor
5 FIRST APPLICANT'S DETAILS (Non-individual invertors please fill in FATCA / CRS, UBO annexure and attach along with application form) Ref. 9 & 22. All fields are mandatory. Gender Male Female
st
Name (1 ) (As in PAN card/
KYC/ Aadhaar records)
PAN (Minor/1st Holder) KIN CKYC FORM SUPPLEMENTARY CKYC FORM
Ref. 10 (Refer 8A)
Aadhaar No. (Ref. 23)
Father’s Name Date of birth (Minor / 1st Holder)
(as per Aadhaar records) D D M M Y Y
Name of the Guardian (in case of minor please attach proof of date of birth) / POA (Contact person for non individuals / PoA holder name) Guardian / PoA PAN
Occupation Pvt. Sector Service Public Sector Gov. Service Housewife Defence Professional Retired Business
Agriculture Student Forex Dealer Other Specify
Are you FATCA Compliant (Please tick any one) Yes No (if no, please fill below details)
Address of tax residence would be taken as available in KRA database. In case of any change please approach KRA & notify the changes
Type of address given at KRA Residential or Business Residential Business Registered Office
Permissible documents are Passport Election ID Card PAN Card Govt. ID Card Driving License UIDAI Card NREGA Job Card Others specify
Gross Annual Income <1L 1-5L 5-10L 10-25L >25L <1L 1-5L 5-10L 10-25L >25L 25L-1C >1C Is the entity involved in any of the following:
NON-INDIVIDUALS
OR
INDIVIDUALS
6 DEBIT MANDATE (For Axis Bank A/c only.) To be processed in CMS software under client code “AXISMF” TO BE DETACHED BY KARVY & PRESENTED TO AXIS BANK CMS Application No.
I/ We Name of the account holder(s) authorise you to debit my/our account no. Date D D M M Y Y
Account type Savings NRO NRE Current FCNR Others Specify to pay for the purchase of
Axis Income Saver Axis Midcap Fund Axis Triple Advantage Fund Axis Equity Fund Axis Focused 25 Fund Axis Long Term Equity Fund Axis Enhanced Arbitrage Fund Axis Equity Saver Fund
Signature of First Account Holder Signature of Second Account Holder Signature of Third Account Holder
ACKNOWLEDGMENT SLIP Received subject to realisation, verification and conditions, an application for purchase of Units as mentioned in the application form. Application No.
From
#To also include USA, where the individual is a citizen / green card holder of the USA %In case Tax Identification Number is not available, kindly provide its functional equivalent $
SECOND APPLICANT'S DETAILS (All fields are mandatory) Gender Male Female
nd
Name (2 ) (As in PAN card/
KYC/ Aadhaar records)
INDIVIDUALS
NRI PIO Partnership Firm Trust Company Other Specify OR as on D D M M Y Y
Net-worth* in ` Politically Exposed Related to Not
Occupation Pvt. Sector Service Public Sector Gov. Service Housewife Defence Retired
*Should not be older than one year Person (PEP) a PEP Applicable
Professional Business Agriculture Student Forex Dealer Other Specify Any other information
Are you FATCA Compliant (Please tick any one) Yes No (if no, please fill below details)
Address of tax residence would be taken as available in KRA database. In case of any change please approach KRA & notify the changes
Type of address given at KRA Residential or Business Residential Business Registered Office
Permissible documents are Passport Election ID Card PAN Card Govt. ID Card Driving License UIDAI Card NREGA Job Card Others specify
Are you a tax resident of any country other than India? Yes No (If yes, please indicate all countries in which you are resident for tax purposes and the associated Tax ID Numbers below.)
Country# Tax identification number % Identification type (TIN or Other, please specify)
#To also include USA, where the individual is a citizen / green card holder of the USA %In case Tax Identification Number is not available, kindly provide its functional equivalent $
THIRD APPLICANT'S DETAILS (All fields are mandatory) Gender Male Female
Name (3rd) (As in PAN card/
KYC/ Aadhaar records)
Mobile Date of birth Enclose Attested PAN card copy KYC Acknowledgment (Refer 8)
(as per Aadhaar records) D D M M Y Y
Are you FATCA Compliant (Please tick any one) Yes No (if no, please fill below details)
Address of tax residence would be taken as available in KRA database. In case of any change please approach KRA & notify the changes
Type of address given at KRA Residential or Business Residential Business Registered Office
Permissible documents are Passport Election ID Card PAN Card Govt. ID Card Driving License UIDAI Card NREGA Job Card Others specify
Are you a tax resident of any country other than India? Yes No (If yes, please indicate all countries in which you are resident for tax purposes and the associated Tax ID Numbers below.)
Country# Tax identification number % Identification type (TIN or Other, please specify)
#To also include USA, where the individual is a citizen / green card holder of the USA %In case Tax Identification Number is not available, kindly provide its functional equivalent $
QUICK CHECKLIST
KYC acknowledgement letter (Compulsory for MICRO Investments) SIP Registration Mandate - NACH for SIP investments
Multiple Bank Accounts Registration form (if you want to register multiple bank accounts so that future payments can be made
Self attested PAN card copy from any of the accounts)
Email id and mobile number provided for online transaction facility 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.
Plan / Option / Sub Option name mentioned in addition to scheme name
FATCA Declaration.
7 BANK ACCOUNT DETAILS FOR PAY-OUT (Mandatory. Refer 6 and avail of Multiple Bank Registration Facility.) (Please attach cancelled cheque copy or latest bank account statement.) (All fields are mandatory)
Bank Name
Bank A/c No. Type Current Savings NRO NRE FCNR Others Specify
8 INVESTMENT & PAYMENT DETAILS (Investors applying under Direct Plan must mention "Direct" against scheme name, refer 2) (All fields are mandatory)
Payment type Non-Third Party Payment Third Party Payment (Please attach 'Third Party Payment Declaration Form')
Scheme Plan Option Sub Option# Dividend Frequency (Quarterly/ Half Yearly/ Annual)*
# Dividend Re-Investment is not available for Axis Long Term Equity Fund *Applicable only for Axis Income Saver
SIP frequency (tick ü any one) If no debit date is mentioned default date would
Monthly Yearly (Default Frequency Monthly) Preferred Debit Date (Any date except 29th, 30th and 31st) (ref 13(b)) D D
be considered as 7th of every month.
OR If end date is not mentioned then the SIP
SIP period Start Date M M Y Y End Date M M Y Y End date (ref 13(i)) 1 2 9 9 will be considered for perpetuity (Dec 2099).
First SIP Installment details Mode Cheque / DD Axis Bank Debit Mandate (Please fill section 3.) Dated D D M M Y Y
PAN
Date of Birth D D M M Y Y Y Y D D M M Y Y Y Y D D M M Y Y Y Y
Address
Guardian Name
(in case Nominee is a Minor)
Signature
(Guardian in case Nominee is a Minor)
Unit Holder's Signature First / Sole Applicant Second Applicant Third Applicant Power of Attorney Holder
If you do not wish to nominate sign here.
Date : D D M M Y Y Place :
FORM 2 - SIP REGISTRATION MANDATE - NACH
(Investor must read Key Scheme Features and Instructions before completing this form.)
THE APPLICATION FORM SHOULD BE FILLED IN BLOCK LETTERS ONLY.
Distributor ARN Sub-Distributor ARN Internal Sub-Broker / Sol ID Employee Code EUIN RIA CODE^ Serial No., Date & Time Stamp
ARN-0018 ARN E
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.
^I/We, have invested in the scheme(s) of Axis Mutual Fund under Direct Plan. I/We hereby give my/our consent to share/provide the transactions data feed/ portfolio holdings/ NAV etc. in respect of my/our investments under Direct Plan of all schemes of Axis Mutual Fund, to the above
mentioned SEBI Registered Investment Adviser:
“I/We hereby confirm that the EUIN box has been intentionally left blank by me/us as this transaction is First / Sole Applicant /
executed without any interaction or advice by the employee/relationship manager/sales person of the above Second Applicant Third Applicant Power of Attorney Holder
distributor/sub broker or notwithstanding the advice of in-appropriateness, if any, provided by the Guardian
employee/relationship manager/sales person of the distributor/sub broker.”
TRANSACTION CHARGES FOR APPLICATIONS THROUGH DISTRIBUTORS ONLY
I confirm that I am a first time investor across Mutual Funds. I confirm that I am an existing investor in Mutual Funds.
In case the subscription amount is ` 10,000 or more and your Distributor has opted to receive Transaction Charges, the same are deductible as applicable from the purchase/ subcription amount and payable to the Distributor. Units will be issued against the balance amount invested.
Tick whichever is applicable : New SIP registration by new investor New SIP registration by existing investor
1 APPLICANT'S PERSONAL DETAILS (MANDATORY)
Application Form No. (For New Applicants) OR Folio No. (For Existing Unit holders)
Sole / 1st Unitholder First Name Middle Name Last Name
Guardian's Name Email ID For receiving statements over email instead of post
(in case of minor)
PAN 1st Applicant 2nd Applicant 3rd Applicant
Enclose Attested PAN card KYC Letter Attested PAN card KYC Letter Attested PAN card KYC Letter
KIN
(Refer 8A)
CKYC FORM SUPPLEMENTARY CKYC FORM CKYC FORM SUPPLEMENTARY CKYC FORM CKYC FORM SUPPLEMENTARY CKYC FORM
Aadhaar No.
(Ref. 23)
2 SIP DETAILS
Scheme Name Plan Option
SIP frequency (tick ü any one) Monthly Yearly (Default Frequency Monthly) th th st If no debit date is mentioned default date would
Preferred Debit Date (Any date except 29 , 30 and 31 ) (ref 12(b)) D D be considered as 7th of every month.
SIP period from M M Y Y to M M Y Y OR End date (ref 13(i)) 1 2 9 9 If end date is not mentioned then the SIP will be considered for perpetuity (Dec 2099).
First SIP Installment details Drawn on bank / branch name Cheque / DD Amount
Mode Cheque / DD Axis Bank Debit Mandate Cheque / DD no. MICR No. Dated D D M M Y Y
3 DECLARATION AND SIGNATURE (To be signed by ALL UNIT HOLDERS if mode of holding is ‘joint’)
I / We declare that the particulars furnished here are correct. I / We authorise Axis Mutual Fund acting through its service providers to debit my / our bank account towards payment of SIP instalments through an Electronic Debit arrangement / NACH (National
Automated Clearing House). If the transaction is delayed or not effected at all for reasons of incomplete or incorrect information, I/we would not hold the user institution responsible. I/We will also inform Axis Mutual Fund about any changes in my bank account.
This is to inform you that I/We have registered for making payment towards my investments in AXISMF by debit to my /our account directly or through ECS (Debit Clearing) / NACH (National Automated Clearing House). I/We hereby authorize to honour such payments and
have signed and endorsed the Mandate Form. Further, I authorize my representative (the bearer of this request) to get the above Mandate verified. Mandate verification charges, if any, may be charged to my/our account.
I also hereby agree to read the respective SID and SAI of the mutual fund before investing in any scheme of Axis Mutual Fund using this facility.
X Sole/ 1st Unit Holder / POA / Guardian X 2nd Unit Holder X 3rd Unit Holder
Tick ( ) Sponsor Bank Code Bank use Utility Code Bank use
CREATE I/We hereby authorize Axis Mutual Fund to debit (tick ) SB CA CC SB-NRE SB-NRO Other
MODIFY
Bank a/c number
CANCEL
an amount of Rupees `
FREQUENCY Mthly Qtly H-Yrly Yrly As & when presented DEBIT TYPE Fixed Amount Maximum Amount
Reference 1 Folio No. Phone No.
PERIOD
From D D M M Y Y Y Y
To D D M M Y Y Y Y Signature Primary Account holder Signature of Account holder Signature of Account holder
Or Until Cancelled 1. 2. 3.
Name as in bank records Name as in bank records Name as in bank records
This is to confirm that the declaration (as mentioned overleaf) has been carefully read, understood & made by me / us. I am authorizing the User Entity / Corporate to debit my account, based on the instructions as agreed and signed by me.
I have understood that I am authorized to cancel / amend this mandate by appropriately communicating the cancellation / amendment request to the User entity / Corporate or the bank where I have authorized the debit.
MANDATORY FIELDS : • Instrument Date • Account type • Bank A/c number (core banking a/c no only) • Bank name • IFSC code or MICR code (as per the cheque / pass book) • Amount in words (maximum amount) • Period start date and end
date or until cancelled • Account holder signature • Account holder name as per bank record
ACKNOWLEDGMENT SLIP (To be filled by the investor)
Folio No. Investor Name
Scheme Name (Scheme Name) Plan Option
SIP Period From D D M M Y Y to D D M M Y Y Amount ` Stamp & Signature