KIM CAF Final Single Colour File.cdr

Transaction Charges for Applications routed through Distributors/agents only (Refer Instruction 1 (viii))

Employee Unique ID. No. (EUIN)

Sub Broker Code

Sub Broker Name & ARN/ RIA No.Distributor Name & ARN/ RIA No.

MUTUAL FUNDS

Aditya Birla Sun Life Mutual Fund

Common Application Form

For Resident Indians and NRIs/FIIs/FPIs

(Please read the instructions before filling up the form. All sections to be completed in english in black / blue coloured ink and in block letters.)

Application No.

EUIN is mandatory for “Execution Only” transactions.

I/we hereby confirm that the EUIN box has been intentionally left blank my me/us as this transaction is executed without any interaction or advice by the employee/relationship manager/sales person

of the above distributor/sub broker or notwithstanding the advice of in-appropriateness, if any, provided by the employee/relationship manager/sales person of the distributor/sub broker.

Ref. Instruction No. 9

First Applicant / Authorised Signatory

Second Applicant

Third Applicant

In case the subscription (lumpsum) amount is 10,000/- or more and your Distributor has opted to receive Transaction Charges, 150/- (for first time mutual fund investor) or 100/- (for investor

other than first time mutual fund investor) will be deducted from the subscription amount and paid to the distributor. Units will be issued against the balance amount invested.

` ` `

Existing Unitholder please fill in your Folio No., Name & Email ID and then proceed to Section 5 (Applicable details and Mode of holding will be as per the existing Folio No.)

Existing Folio No.

FIRST / SOLE APPLICANT INFORMATION (MANDATORY) (Refer Instruction No. 2,3,4) Fresh / New Investors fill in all the blocks. (1 to 8) In case of investment "On behalf of Minor", Please Refer Instruction no. 2(ii)

Name of First/Sole Applicant

(as per PAN/ Aadhaar Card)#

Mr. Ms.

M/s.

PAN / PEKRN (Mandatory)

Date of Birth**

D D

M M Y Y Y Y

AADHAR

Card Number

CKYC

Number

(Prefix

if any)

14 digit CKYC Number

Name of the Second Applicant

(as per PAN/ Aadhaar Card)#

Mr. Ms.

M/s.

PAN / PEKRN (Mandatory)

Date of Birth**

D D

M M Y Y Y Y

AADHAR

Card Number

CKYC

Number

(Prefix

if any)

14 digit CKYC Number

Name of the Third Applicant

(as per PAN/ Aadhaar Card)#

Mr. Ms.

M/s.

PAN / PEKRN (Mandatory)

Date of Birth**

D D

M M Y Y Y Y

AADHAR

Card Number

CKYC

Number

(Prefix

if any)

14 digit CKYC Number

Name of the Guardian (In case First / Sole Applicant is minor) / Contact Person - Designation - Poa Holder (In case of Non-individual Investors)(as per PAN/ Aadhaar Card)#

Mr. Ms.

M/s.

PAN / PEKRN (Mandatory)

Date of Birth**

D D

M M Y Y Y Y

AADHAR

Card Number

CKYC

Number

(Prefix

if any)

14 digit CKYC Number

Relationship of Guardian (Refer Instrcution No. 2(ii))

ISD CODE

TEL: OFF.

TEL: RESI

Proof of the Relationship with Minor**

** Mandatory in case the First / Sole Applicant is Minor

Tax Status [Please tick (3)] (Applicable for First / Sole Applicant)

Resident Individual FIIs NRI - NRO HUF Club / Society PIO Body Corporate Minor Government Body

Trust NRI - NRE Bank and FI Sole Proprietor Partnership Firm QFI Provident Fund Others

(Please Specify)

Acknowledgement Slip (To be filled in by the Investor)

Common Application Form

Application No.

Received from Mr. / Ms. __________________________________________________________ Date : _____/_____/___________

Collection Centre /

ABSLAMC Stamp & Signature

PAN/PEKRN Proof

KYC Complied

Yes

[Please Tick (3)] Enclosed

NECS Form

Aditya Birla Sun Life AMC Limited (Investment Manager to Aditya Birla Sun Life Mutual Fund)

(Formerly known as Birla Sun Life Asset Management Company Limited)

Regn. No.: 109. Regd Office: One Indiabulls Centre, Tower 1, 17th Floor, Jupiter Mill Compound,

841, Senapati Bapat Marg, Elphinstone Road, Mumbai - 400013

+91 22 4356 7000 | [email protected] | www.adityabirlasunlifemf.com | CIN: U99999MH2000PLC128110

1800-270-7000

adityabirlacapital.com

#The application is liable to get rejected if

does not match with PAN card/ Aadhar card

Below 1 Lac 1-5 Lacs 5-10 Lacs 10-25 Lacs > 25 Lacs - 1 Crore > 1 Crore

Below 1 Lac 1-5 Lacs 5-10 Lacs 10-25 Lacs > 25 Lacs - 1 Crore > 1 Crore OR Net Worth ______________________________________

No.

Scheme Name

Plan / Option

Net Amount Paid (`)

Payment Details

Cheque/DD No./UTR No.

(in case of NEFT/RTGS)

Bank and Branch

ABSL

GO GREEN [Please tick (3)] (Refer Instruction No. 10)

BANK ACCOUNT DETAILS (Please note that as per SEBI Regulations it is mandatory for investors to provide their bank account details) Refer Instruction No. 3(A)

INVESTMENT DETAILS [Please tick (3)] (Refer Instruction No. 5, 9 & 14) (If this section is left blank, only folio will be created)

Joint Single Anyone or Survivor (Default option is Anyone or survivor)

MODE OF HOLDING [Please tick (3)] (Please Refer Instruction No. 2(v))

MAILING ADDRESS OF FIRST / SOLE APPLICANT (P. O. Box Address is not sufficient. Please provide full address.) (Indian Address in case of NRIs/FIIs)

CITY

STATE PINCODE

SMS Transact Online Access

Mobile No.

+91

I/ We would like to register for my/our SMS Transact and/

or Online Access

Email Id

Facebook Id

Twitter Id

Default Communication mode is E-mail only, if you wish to receive following document(s) via physical mode: [Please tick (3)]

Account Statement Annual Report Other Statutory Information

Name of the Bank

Branch Address

Pin Code

City

Account No.

Account Type [Please tick (3)]

11 Digit IFSC Code 9 Digit MICR Code

SAVINGS CURRENT NRE NRO FCNR OTHERS

(Please Specify)

Seperate cheque/ demand draft must be issued for each investment drawn in favour of respective scheme name and the instrument should be crossed “A/c Payee Only”.

Please write appropriate scheme name as well as the Plan/Option/Sub Option

No.

Cheque / DD Favouring

Scheme Name* (refer Instruction 5)

Plan/Option

Sweep to

(applicable only for Dividend option)

Cheque

Date

Amount

Invested (`)

Charges^

Net Amount

Paid (`)

Cheque/DD No./UTR No.

(in case of NEFT/RTGS)

Bank, Branch and Account Number#

(In case different from point 3 above)

ABSL

Scheme Name

Plan / Option

ABSL

Scheme Name

Plan / Option

ABSL

Scheme Name

Plan / Option

OCCUPATION [Please tick (3)]

FIRST APPLICANT

Private Sector Service Public Sector Service

Government Service

Business

Professional

Agriculturist

Retired

Housewife

Student Forex Dealer

Others .............................................................................................. (please specify)

SECOND APPLICANT

Private Sector Service Public Sector Service

Government Service

Business

Professional

Agriculturist

Retired

Housewife

Student Forex Dealer

Others .............................................................................................. (please specify)

THIRD APPLICANT

Private Sector Service Public Sector Service

Government Service

Business

Professional

Agriculturist

Retired

Housewife

Student Forex Dealer

Others .............................................................................................. (please specify)

GROSS ANNUAL INCOME [Please tick (3)]

FIRST APPLICANT

[Not older than 1 year]

D D

M M Y Y Y Y

SECOND APPLICANT

THIRD APPLICANT

# (Type of Account : Saving / Current / NRE / NRO / FCNR / NRSR) *All purchases are subject to realization of funds ^Refer to Instruction No. 5 (vi)

Net worth (Mandatory for Non - Individuals) Rs. ______________________________________ as on

KYC DETAILS (Mandatory)

I am Politically Exposed Person

For Individuals

I am Related to Politically Exposed Person

Not Applicable

For Individuals

Is the company a Listed Company or Subsidiary of Listed Company or Controlled by a Listed Company:

(If No, please attach mandatory UBO Declaration)

Yes No

Foreign Exchange / Money Charger Services

Yes No

Gaming / Gambling / Lottery / Casino Services

Yes No

Money Lending / Pawning

Yes No

DEMAT ACCOUNT DETAILS (OPTIONAL) (Please ensure that the sequence of names as mentioned in the application form matches with that of the A/c. held with the depository participant.) Refer Instruction No. 3(B)

Depository Participant Name: _______________________________

Depository Participant Name: ______________________________________

Beneficiary A/c No.

DPID No.:

Beneficiary A/c No.

I N

NSDL:

CDSL:

Enclosed:

Client Master

Transaction/ Statement Copy/ DIS Copy

NOMINATION DETAILS (Mandatory) (Refer Instruction No. 7)

I/We wish to nominate I/We DO NOT wish to nominate and sign here ................................................................................................. 1st Applicant Signature (Mandatory)

Nominee Name and Address

Guardian Name (in case of Minor)

Allocation %

Nominee/ Guardian Signature

Nominee 1

Nominee 2

Nominee 3

To register multiple nominee please fill separate Multiple nomination Form.

FATCA & CRS INFORMATION [Please tick (3)] For Individuals & HUF (Mandatory) Non Individual investors should mandatorily fill separate FATCA detail form

The below information is required for all applicant(s)/ guardian

Address Type:

Is the applicant(s)/ guardian's Country of Birth / Citizenship / Nationality / Tax Residency other than India?

If Yes, please provide the following information [mandatory]

Please indicate all countries in which you are resident for tax purposes and the associated Tax Reference Numbers below.

Residential or Business Residential

Business Registered Office (for address mentioned in form/existing address appearing in Folio)

Yes No

Category

First Applicant (including Minor)

Second Applicant/ Guardian

Third Applicant

Name of Applicant

Place/ City of Birth

Country of Birth

Country of Tax Residency#

Tax Payer Ref. ID No^

Identification Type

[TIN or other, please specify]

Country of Tax Residency 2

Tax Payer Ref. ID No. 2

Identification Type

[TIN or other, please specify]

Country of Tax Residency 3

Tax Payer Ref. ID No. 3

Identification Type

[TIN or other, please specify]

#To also include USA, where the individual is a citizen/green card holder of USA. ^In case Tax Identification Number is not available, kindly provide its functional equivalent.

Signature of First Applicant / Authorised Signatory Signature of Second Applicant Signature of Third Applicant

CONFIRMATION CLAUSE

I/We hereby give consent to the Company or its Authorized Agents and third party service providers to use information/data provided by me to contact me through any channel of

communication including but not limited to email, telephone, sms, etc. and further authorise the disclosure of the information contained herein to its affiliates/group companies or

their Authorized Agents or Third Party Service Providers in order to provide information and updates to me on various financial and investment products and offering of other services.

I/We agree that all personal or transactional related information collected/provided by me can be shared/transferred and disclosed with the above mentioned parties including with

any regulatory, statutory or judicial authorities for compliance with any law or regulation in accordance with privacy policy as available at the website of the Company. Yes No

VALUE ADD

I/We hereby give consent to the Company or its Authorized Agents and third party service providers to use information/data provided by me to contact me through any channel of

communication including but not limited to email, telephone, sms, etc. and further authorise the disclosure of the information contained herein to its affiliates/group companies or

their Authorized Agents or Third Party Service Providers in order to provide information and updates to me on various financial and investment products and offering of other services.

I/We agree that all personal or transactional related information collected/provided by me can be shared/transferred and disclosed with the abovementioned parties including with

any regulatory, statutory or judicial authorities for compliance with any law or regulation in accordance with privacy policy as available at the website of the Company. Yes No

I/We am/are interested in knowing my/our credit score and am/are happy to receive help in this regard.

I / We hereby provide my consent to :-

1. Aditya Birla Sun Life AMC Limited and its group companies & associates to conduct check on my/our credit information with any of the credit bureau.

2. Aditya Birla Sun Life AMC Limited and its group companies & associates to conduct a background check either by their employees or through any third party vendor. Yes No

DECLARATION(S) & SIGNATURE(S) (Refer Instruction No. 1)

Date

D D

M M Y Y Y Y

To,

The Trustee,

Aditya Birla Sun Life AMC Ltd.

Having read and understood the contents of the Statement of Additional Information / Scheme Information Document of the Scheme, I/We hereby apply for units of the scheme and agree

to abide by the terms, conditions, rules and regulations governing the scheme. I/We hereby declare that the amount invested in the scheme is through legitimate sources only and does not

involve and is not designed for the purpose of the contravention of any Act, Rules, Regulations, Notifications or Directions 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.

For Non-Individual Investors: I/We hereby confirm that the object clause of the constitution document of the entity (viz. MOA / AOA / Trust Deed, etc.), allows us to apply for investment

in this scheme of Aditya Birla Sun Life AMC Ltd. and the application is being made within the limits for the same. I/We are complying with all requirements / conditions of the entity while

applying for the investments and I/We, including the entity, if the case may arise so, hereby agree to indemnify ABSLAMC / ABSLMF in case of any dispute regarding the eligibility, validity

and authorization of the entity and/or the applicants who have applied on behalf of the entity.

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. (Refer Inst. No. 6)

I/We confirm that details provided by me/us are true and correct.**

I have voluntarily subscribed to the on-line access for transacting through the internet facility provided by Aditya Birla Sun Life AMC Ltd. (Investment Manager of Aditya Birla Sun Life

Mutual Fund) and confirm of having read, understood and agree to abide the terms and conditions for availing of the internet facility more particularly mentioned on the website www.adityabir-

lacapital.com and hereby undertake to be bound by the same. I further undertake to discharge the obligations cast on me and shall not at any time deny or repudiate the on-line transactions

effected by me and I shall be solely liable for all the costs and consequences thereof.

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 acknowledge that the RIA has entered into an agreement with the AMC / MF for accepting transaction feeds under the code. I / We hereby indemnify, defend and hold harmless the AMC /

MF against any regulatory action, damage or liability that they may suffer, incur or become subject to in connection therewith or arising from sharing, disclosing and transferring of the aforesaid

information."

I/We hereby provide my /our consent in accordance with Aadhaar Act, 2016 and regulations made thereunder, for (i) collecting, storing and usage (ii) validating/authenticating and (ii) updating

my/our Aadhaar number(s) in accordance with the Aadhaar Act, 2016 (and regulations made thereunder) and PMLA.

I/We hereby provide my/our consent for sharing/disclosing of my Aadhaar number(s) including demographic information with the asset management companies of SEBI registered mutual fund

and their Registrar and Transfer Agent (RTA) for the purpose of updating the same in my/our folios.

FATCA & CRS Declaration: I/ We have understood the information requirements of this Form (read along with FATCA & CRS Instructions) and hereby confirm that the information provided

by me/ us on this Form is true, correct, and complete. I/ We also confirm that I/ We have read and understood the FATCA & CRS Terms and Conditions and hereby accept the same. (Refer

Inst. No. 14)