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Simply send **SMS to 966 400 1111 to avail below facilities
Types of Facilities
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Balance
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Statement thru mail
Single Folio
SMS mynav
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SMS Transaction
SMS ESOA
Multiple Folio
SMS mynav <space> last 6 digits of folio
SMS balance <space> last 6 digits of folio
SMS txn <space> last 6 digits of folio
SMS ESOA <space> last 6 digits of folio
**SMS charges apply
Investor Service. A NIMF Virtual Branch Experience.
For more details : Visit : www.nipponindiamf.com
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I/We would like to invest in Nippon India_____________________________ subject to terms of the Statement of Additional Information (SAI), Scheme Information Document (SID), Key Information Memorandum (KIM)
and subsequent amendments thereto. I/We have read, understood (before filling application form) and is/are bound by the details of the SAI, SID & KIM including details relating to various services including but not
limited to Nippon India Any Time Money Card. I/We have not received nor been induced by any rebate or gifts, directly or indirectly, in making this investment. I / We declare that the amount invested in the Scheme is
through legitimate sources only and is not designed for the purpose of contravention or evasion of any Act / Regulations / Rules / Notifications / Directions or any other Applicable Laws enacted by the Government of
India or any Statutory Authority. I accept and agree to be bound by the said Terms and Conditions including those excluding/ limiting the Reliance Nippon Life Asset Management Limited (RNAM) liability. I understand
that the RNAM may, at its absolute discretion, discontinue any of the services completely or partially without any prior notice to me. I agree RNAM can debit from my folio for the service charges as applicable from time
to time. 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 hereby declare that the above information is given by the undersigned and particulars given by me/us are correct and complete. Further, I agree that the transaction charge
(if applicable) shall be deducted from the subscription amount and the said charges shall be paid to the distributors.
I confirm that I am resident of India. I/We confirm that I am/We are Non-Resident of Indian Nationality/Origin and I/We hereby confirm that the funds for subscription have been remitted from abroad through
normal banking channels or from funds in my/our Non-Resident External /Ordinary Account/FCNR Account. I/We undertake that all additional purchases made under this folio will also be from funds received from
abroad through approved banking channels or from funds in my/ our NRE/FCNR Account. I hereby declare that the information provided in the Form is in accordance with section 285BA of the Income Tax Act, 1961
read with Rules 114F to 114H of the Income Tax Rules, 1962 and the information provided by
me /us in the Form, its supporting Annexures as well as in the documentary evidence provided by me/us are, to the best of our
knowledge and belief, true, correct and complete.
++ I/We, have invested in the Scheme(s) of your Mutual Fund under Direct Plan. I/We hereby give you 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 Managed by you, to the above mentioned Mutual Fund Distributor / SEBI-Registered Investment Adviser. I hereby authorize the representatives of Reliance Nippon Life
Asset Management Ltd and its Associates to contact me through any mode of communication. This will override registry on DND / DNDC , as the case may be.
13. POWER OF ATTORNEY (POA) HOLDER DETAILS
(Refer Instruction No. II. 1)
PAN^
14. DECLARATION AND SIGNATURE
First Applicant POA Name
Second Applicant POA Name
Third Applicant POA Name
Nominee Name & Address
Guardian Name
(in case Nominee is Minor)
Guardian Relation
with Nominee
Allocation
(%)
Sign of
Nominee
Sign of
Guardian
Signature of Applicants
Date of Birth
of Nominee
Nominee Relation
With Investor
PAN of Nominee
(Optional)
(Mandatory if mode of holding is single) (Refer Instruction No. VI) In case of existing investor, nomination details mentioned in
the below table will replace the existing details registered in the folio. Signature of applicants is mandatory if you do not wise to nominate.
12. NOMINATION - I wish to Nominate
Yes No
%
In case Country of Tax Residence is only India then details of Country of Birth & Nationality need not be provided. In case Tax Identification Number is not available, kindly provide its functional equivalent
^**
Country of Nationality
^**
Country of Nationality
^**
Country of Nationality
Sole/First Applicant/Guardian
^**
Country of Birth
Second Applicant
^**
Country of Birth
Third Applicant
^**
Country of Birth
# Please indicate all Countries in which you are a resident for tax purpose, associated Taxpayer Identification Number and it's Identification type eg. TIN etc.
9. FATCA and CRS DETAILS For Individuals (Mandatory) Non Individual Investors should mandatory fill separate FATCA/CRS details form
Sole/First Applicant/Guardian Second Applicant Third Applicant
Identification
Type
Tax Payer
%
Ref. ID No
# ^**
Country
1
2
3
Identification
Type
Tax Payer
%
Ref. ID No
#
Country
1
2
3
Identification
Type
Tax Payer
%
Ref. ID No
#
Country
1
2
3
Equity & Sector Specific CAF / 24th Oct 2019 / Ver 4.2
Are you a Politically Exposed Person (PEP)^**
Are you related to a Politically Exposed Person (PEP)^**
^**
PEP DETAILS
1st Applicant
Yes No
Yes No
GROSS ANNUAL INCOME DETAILS^**
1st Applicant
2nd Applicant
3rd Applicant
Guardian
Below 1 Lac
1-5 Lacs 5-10 Lacs 10-25 Lacs 25 Lacs-1 Crore >1 Crore
^**
NET-WORTH in `
Date
10. ADDITIONAL KYC DETAILS
^**
OCCUPATION
st
1 Applicant
nd
2 Applicant
rd
3 Applicant
Guardian
Professional Agriculturist Housewife Retired
Government Service/PublicSector
Business
Forex Dealer Student
Private Sector Service
Others
SIGN
HERE
First / Sole Applicant / Guardian /
2 nd Applicant 3 rd Applicant Guardian
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Option Growth^^ Dividend Payout Dividend Reinvestment
Dividend Frequency
11. INVESTMENT & PAYMENT DETAILS (Separate Application Form is required for investment in each Plan/Option. Multiple cheques not permitted with single application form
(Refer instruction no. IV) OTBM facility is available to investors who have Invest Easy facility registered with NIMF.
Scheme
(Refer Instruction No. I-10) (For Product Labeling please refer last page of application form) (If you wish to invest in Direct Plan please mention Direct Plan against the scheme name)
[Please tick (
P
) the appropriate boxes only if applicable
to the scheme in which you plan to invest]
Investment
Amount ( ` )
DD Charges
(if applicable) ( ` )
Net Amount~
( ` )
Instrument No/Cash
Deposit Slip No/UTR No.
Date
Drawn on Bank Bank Branch
City
^^ $
( Default option if not selected) ~Units will be allotted for the net amount minus the transaction charges if applicable. Investors are requested to collect the cash deposit slip from the DISC
Reason for Investment:
House
Children’s education
Children’s Marriage
Car
Retirement
Others
$
Mode of Payment Cheque DD Funds Transfer OTBM Facility (One Time Bank Mandate) RTGS / NEFT Cash (Refer Instruction No. XV)