DECLARATION & SIGNATURES (Mandatory. If left blank, the application is liable to be rejected)
I/We have read and understood the respective Scheme Information Document, Statement of Additional Information and Key Information Memorandum of L&T Mutual Fund. I/We hereby declare that I/We do not have any existing Micro SIPs which together with the current
application will result in aggregate investments exceeding Rs. 50,000 in a year. I/We have neither received nor been induced by any rebate or gifts directly or indirectly in making this Systematic Investment. The ARN holder has disclosed to me/us all the commissions (in trail
commission or any other), payable to him for the different competing schemes of Mutual Funds from amongst which the Scheme is being recommended to me/us. I/We hereby declare that the particulars given here are correct and express my/our willingness to make payments
referred above through participation in ECS/ACH/Auto Debit. If the transaction is delayed or not effected at all for reasons of incomplete or incorrect information, I/We would not hold L&T Mutual Fund, their Investment Manager - L&T Investment Management Limited, or any of
their appointed service providers or representatives responsible. I/We will also inform L&T Investment Management Limited about any changes in my/our bank account. I/We have read and agreed to the terms and conditions mentioned overleaf.
Applicable for AADHAAR SUBMISSION : I/We hereby give you my/our consent to validate Aadhaar with UIDAI and for updating/linking my Aadhaar number based on the PAN given in all my accounts maintained with CAMS serviced Mutual Funds for KYC & other related
due diligence purpose in line with PMLA requirements and Account enrichment purpose.
SIGNATURE/S AS PER L&T MUTUAL FUND (To be signed as per Mode of Holding)
Sole/First Applicant/Guardian
Second Applicant
Third Applicant
Systematic Investment Plan (SIP) / Micro SIP Form
Please refer to the general instructions for assistance and complete all sections in English. For legibility, please use BLOCK LETTERS in black or dark ink.
Distributor/RIA Code Sub-Distributor ARN Sub-Distributor Code EUIN Branch Code
Initial Commission will be paid by the investor directly to the distributor, based on assessment of various factors including the service rendered by the Distributor.
Transaction Charges: SEBI (Mutual Fund) Regulations allow deduction of transaction charges of Rs. 100/- from your investment for payment to your distributor if your distributor has opted to receive transaction charges for
investments sourced by him. The transaction charges deductible are Rs. 150/- if you are investing in Mutual Funds for the rst time. If you are making a SIP Investment, the transaction charges would be deducted over 3-4 instalments.
No transaction charges would be levied if you are not investing through a Distributor or your investment amount is less than Rs.10,000/-. If this is the rst time, you are investing in any mutual fund, please tick here
Investor’s Declaration where EUIN is not furnished: I/We conrm 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 distributor and/or notwithstanding the advice of inappropriateness, if any, provided by the employee/relationship manager/sales person of distributor and the distributor has not charged any advisory fees on this transaction.
Sole/1st Applicant
2nd Applicant
3rd Applicant
Time Stamp
APPLICANT INFORMATION
Name of Sole/1st Unit Holder
First Name Middle Name Last Name
Folio No.
PAN/PEKRN**
First Unit Holder
Second Unit Holder
Third Unit Holder
KIN*
First Unit Holder
Second Unit Holder
Third Unit Holder
Date of Birth*
(1st Unit Holder)
D D M M Y Y Y Y
Date of Birth*
(2nd Unit Holder)
D D M M Y Y Y Y
Date of Birth*
(3rd Unit Holder)
D D M M Y Y Y Y
Mobile No. +91- E-mail ID
SIP & INVESTMENT DETAILS (Mandatory. If left blank, the application is liable to be rejected)
New SIP Registration
SIP Renewal
Update new OTM debit mandate for already registered SIP
(If selected, move to Section 4)
OTM Debit Mandate to be registered in the folio.
(If selected, Section 4 to be lled in mandatorily)
OTM Debit Mandate is already registered in the folio.
Please ll, Unique Mandate Reference Number (UMRN)
Debit Bank Name Account No.
Scheme Name L&T
Option (ü)
Growth*
Dividend Payout
Dividend Reinvestment
Bonus^
Dividend Frequency
First Instalment Details: Instrument No. Instrument Date
D D M M Y Y Y Y
Account Type (ü)
Savings
Current
NRE
NRO
Others
Drawn On
Bank Name Bank Branch Bank City
SIP Amount `
SIP Frequency
Monthly*
Quarterly
SIP Debit Date
1st 5th 10th* 15th 20th 25th 28th All seven dates
SIP Period From
M M Y Y Y Y
To
M M Y Y Y Y
OR
Until Cancelled
(Note: Minimum gap of 30 days required between rst cheque and subsequent instalment. In case of discrepancy in the SIP Period,the one mentioned in the Debit Mandate will be considered.) (For SIP amount Minimum 500 for
Equity schemes & 1000 for Non Equity schemes) ^Available in select schemes only
Reason for your SIP (ü)
Children’s Education
Children’s Marriage
House
Car
Retirement
Others
SIP Top Up (Optional) - Available only for investments effected through Auto Debit.
Top Up to continue till SIP amount reaches^ ` OR Top Up to continue till
#
D D M M Y Y Y Y
Top Up Amount
`
Amount in multiples of ` 500 only
Top Up Frequency
(Please üany one)
Half Yearly
Yearly*
^ SIP Top Up will cease once the mentioned amount is reached.
#
It is the date from which SIP Top-Up amount will cease. *Default option if not selected
OTM DEBIT MANDATE FORM FOR NACH/ECS/AUTO DEBIT
UMRN
Date D D M M Y Y Y Y
Sponsor Bank Code CITI000PIGW Utility Code CITI00002000000037
I/We hereby authorize
L&T Mutual Fund
to debit (
ü
)
SB CA CC SB-NRE SB-NRO Other
Bank A/c No.
With Bank Bank Name IFSC or MICR
an amount of Rs
Amount in words
`
Frequency
Monthly Quarterly Half Yearly
ü
As & when presented
Debit Type
Fixed Amount
ü
Maximum Amount
Scheme All schemes of L&T Mutual Fund Email Id
Folio No.
Mobile No. +91-
I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank.
Period
From
D D M M Y Y Y Y
To
3 1 1 2 2 0 9 9
or Until Cancelled
Signature of First Account Holder
Signature of Second Account Holder
Signature of Third Account Holder
1. Name as per Bank Records
2.
Name as per Bank Records
3.
Name as per Bank Records
Tick (
ü
)
ü
CREATE
MODIFY
CANCEL
Ofce use only
This is to conrm that the declaration 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.
QFUND.IN
GENERAL INSTRUCTIONS
call 1800 4190 200 or 1800 2000 400 email investor.line@lntmf.co.in www.ltfs.com
Please note our lines are open from 9 am to 6 pm, Monday to Friday and 9 am to 1 pm on Saturday.
Mutual Fund investments are subject to market risks, read all scheme related documents carefully. CL05298
CHECK LIST FOR SIP INVESTMENT FORM
Application No./Folio No. quoted on the Form
Name of the Sole/First Holder furnished in the Form
SIP details listed below are furnished
SIP installment amount No. of SIP installments SIP date SIP frequency SIP period SIP Scheme
Complete Bank details are furnished in the form
Name of the Sole/1
st
Holder of the Bank Account Bank A/c No MICR IFSC
All holders have signed in accordance with the Mode of Holding as provided to us at the relevant place
All Bank Account Holders have signed in the same manner and sequence as their Bank Account in the relevant place
Please read the below instructions carefully before lling the form. Please ll up the form in English in BLOCK LETTERS with black or dark ink. All
information sought in the form is mandatory except where it is specically indicated as optional. All instructions & notes are subject to SEBI & AMFI
guidelines as amended from time to time. Please note in case of any error while lling the form all applicants must sign against the corrections.
1. Applicant Information: Please furnish the Folio Number, Name and PAN
of Sole/First Applicant Section 1 of the Form. Your investment would be
processed in the specied folio.
Your personal information and bank account details would apply to this
investment as well.
Please provide the Mobile Number and E-Mail Address of the Sole / First
Applicant in the form in case of Individuals and Key Contact in case of Non
Individuals. This would help us seamlessly communicate with you on your
investments.
KYC is mandatory. Please enclose copies of KYC acknowledgement letters
for all applicants. **PEKRN required for Micro investments upto Rs. 50,000
in a year.
* 14 digit KYC Identication Number (KIN) and Date of Birth is mandatory
for Individual(s) who has registered under Central KYC Records Registry
(CKYCR).
Permanent Account Number (PAN): Furnishing of PAN is mandatory for
all applicants except where specic dispensation is provided under law.
2. SIP & Investment Details:
a. New Investors who wish to enroll for SIP investment are required to ll
(i) OTM Mandate Form (ii) SIP Registration Form and (iii) the respective
Scheme Application form (included in the Key Information Memorandum).
New Investors can apply for SIP into respective Scheme / Plans / Option
without any existing investment /folio. Please mention the name of the
Scheme where you plan to make your investment and your preferred
option. If you do not indicate your preferred option, your application would
be processed based on the terms & conditions set out in the Scheme
Information Document. If you are not investing through a Distributor, please
sufx “Direct Plan” after the scheme name.
b. Where a One Time Mandate is already registered in a folio for a bank
account, the Unit Holder(s) is not required to ll the OTM debit mandate
again. However, please mention the UMRM, debit bank name & account
number.
c. Where the OTM mandate is getting submitted for the rst time, please
ll the OTM debit mandate form for NACH/ ECS/ Auto debit mandatorily.
Enclose cancelled cheque leaf of the bank where OTM is getting registered
if the initial purchase cheque is not from the same bank account.
d. Micro SIP: As per AMFI notication and guidelines issued on July 4, 2009,
SIPs or Lumpsum purchases by eligible investors in a rolling 12 month
period not exceeding Rs. 50,000 shall be exempt from the requirement of
PAN. From January 1, 2012, KYC is mandatory for all holders of Micro
investments.
• The exemption of PAN requirement is only available to individuals.
• Eligible investors may invest through SIP or lumpsum purchase without
providing PAN subject to the threshold amount as mentioned above.
• Eligible investors should attach a copy of KYC acknowledgment letter
quoting PAN exempt KYC Reference No. (PEKRN) along with the
application form.
e. Third Party Payments: Third Party Payments for investments are not
accepted except in the below cases
• Payments made by Grand Parents/related persons on behalf of a minor
in consideration of natural love and affection for value not exceeding
Rs. 50,000
• Payment by employer on behalf of employees under SIP or lump sum
subscription through Pay Roll deductions or deductions out of expense re
imbursements.
• Custodian on behalf of an FPI or Client made by Custodian.
• Payment by an AMC to its empanelled distributor on account of commission/
incentive etc. in the form of Mutual Fund units through SIP or lump sum/one
time subscription.
• Payment by a Corporate to its Agent/Dealer/Distributor on account of
commission or incentive payable for sale of its goods/services in the form of
Mutual Fund units through SIP or lump sum/one time subscription.
In the above cases, necessary declaration / banker’s certicate needs to be
provided conrming the source of funds for the investment. Please refer the SAI
for more details.
f. SIP Top-Up Facility: Investors can opt for SIP Top Up facility wherein the
amount of SIP can be increased at xed intervals.
• The minimum amount of increase under SIP Fixed Amount Top-Up facility
should be Rs. 500/- and in multiples of Rs.500/- thereof.
• SIP Top-Up frequency in case of investors availing Monthly SIP facility will
be half yearly and yearly and for availing Quarterly SIP facility, the frequency
will be yearly. In case the SIP Top-Up frequency is not indicated under
Monthly SIP, it will be considered as yearly.
g. Your investment cheque should be crossed “Account Payee only” and drawn
favoring the scheme name where the investment is in a specic scheme
h. Please ensure that the investment cheque issued by you complies with CTS
2010 requirement stipulated by the Reserve Bank of India. The words “CTS
2010” should appear on the face of the cheque.
i. Payments made by Cash/Money Order/Postal Order, Non- MICR cheque,
outstation cheques are not accepted.
j. For detailed terms and conditions on SIP, SIP Top-up, OTM facility, please
visit our website www.ltfs.com and also refer to scheme related documents.
3. Declarations & Signatures:
Unit holders need to sign here in accordance to the Mode of Holding
provided to us and as per the mode of holding in the bank account in the
same sequence and manner in the relevant boxes provided in the form.
4. Debit Mandate:
a. Please ll all the required details in the OTM Debit Mandate Form for NACH/
ECS/Auto Debit. The sole/rst holder must be one of the holders in the bank
account.
b. The UMRN, the Sponsor Bank Code and the Utility Code are meant for
ofce use only and need not be lled by the investors.
c. The 9 digit MICR code and the 11 digit IFSC are mandatory requirements
without which your SIP applications will be rejected. You should nd these
codes on your cheque leaf.
Mutual fund Investors need to assess their risk appetite before investing and then make an investment
decision. The gilt funds are suitable for high security; and offer reasonable returns are for longer
investment horizons. A gilt funds maturity is lower than other types of mutual funds. The tenure
depends on the bond in which you invest. Don't invest in the funds solely because of the government
security or your mutual fund advisor or mutual fund distributor told you to invest but because these
mutual funds are also a good opportunity to be a part of the Nation building process through investing
while earning financial returns.
