APPLICATION NO.
ARN & Name of Distributor
Branch Code
(only for SBG)
EUIN*
(Employee Unique Identification Number)
Sub-Broker ARN Code
Reference No.
Sub-Broker Code
TEAR HERE
ACKNOWLEDGEMENT SLIP
APPLICATION NO.
(To be filled in by the First applicant/Authorized Signatory) :
Received from :
Signature,
Date &
Stamp
To be filled in by the Investor
Scheme Name
Bank and Branch Cheque / DD No. & Date
Cheque/ DD Amount (Rs.)
Sponsor : State Bank of India
Investment Manager : SBI Funds Management Pvt. Ltd.
(A Joint Venture between SBI & AMUNDI)
Attachments
All purchases are subject to realisation of cheque / demand draft
Plan (
)
Regular
Direct
Option (
)
Growth
Dividend
Dividend Facility(
)
Reinvestment Payout
Transfer
Declaration for "execution-only" transaction (only where EUIN box is left blank) (Refer Instruction 1 (p))
* I/We hereby confirm 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 or notwithstanding the advice of in-appropriateness, if any, provided by the employee/relationship manager/sales person of the distributor and the distributor has not charged any advisory fees on this transaction.
In case the subscription amount is Rs. 10,000/- or more and if your Distributor has opted to receive Transaction Charges, Rs. 150 (for first time mutual fund investor) or Rs. 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.
TRANSACTION CHARGES FOR APPLICATIONS THROUGH DISTRIBUTORS/AGENTS ONLY (SEE NOTE 15)
Upfront commission shall be paid directly by the investor to the AMFI registered Distributors based on the investors’ assessment of various factors including the service rendered by the distributor
SIGNATURE(S)
1
st
Applicant / Guardian / Authorised Signatory
3
rd
Applicant / Authorised Signatory
2
nd
Applicant / Authorised Signatory
3. JOINT APPLICANT DETAILS
Name
PAN /PEKRN
Second Applicant Third Applicant
KIN
(KYC Identification No.)
1. FIRST APPLICANT DETAILS
2. MODE OF HOLDING
(Please
)
Single
Joint
Anyone or Survivor
Name of Bank
(Please provide a copy of CANCELLED cheque leaf)
Account Type (Please )
Savings
Current
NRO
NRE
Branch Name
and Address
Account No.
City
Pin
FCNR
Others
9 digit MICR Code
IFS Code
4. BANK ACCOUNT (Pay Out) Details of First Applicant
(Mandatory to attach bank account proof in case the payout bank account is different from the source/investment bank account)
COMMON APPLICATION FORM FOR DEBT AND LIQUID SCHEMES (Please fill in BLOCK Letters)
(Enclose KYC Acknowledgement)
EXISTING FOLIO NO.
NAME
Address for Correspondence for NRI Applicants only ( Please (
) ) Indian by Default Foreign
Correspondence
Address of
1st Applicant
State
Foreign Address
(Mandatory for NRI / FII )
City
Country
City
Zip
Pin
Email ID
Mobile No.
Country Code
TIME STAMP HERE
Telephone (O)
Telephone (R)
Name
(Mr. / Ms. / M/s.)
Name of Guardian
PAN/PEKRN NO.
KIN
Relationship of Guardian
Date of Birth
D
DMMYY YY
Father
Mother
Legal Guardian
(CKYC Identification No.)
[Please mandatorily enclose the document evidencing the relationship of Minor with Guardian]
(in case of Minor)
(Enclose KYC Acknowledgement)
(Name should be as per PAN )
(Name should be as
per PAN )
QFUND.IN
TEAR HERE
Any communication in connection with this application should be addressed to the Registrar or the Invesment Manager
Registrar:
Computer Age Management Services Pvt. Ltd.,
SEBI Registration No. : INR000002813)
Rayala Towers, 158, Anna Salai,Chennai – 600 002
Email: enq_L@camsonline.com
Website: www.camsonline.com
Investment Manager :
SBI Funds Management Pvt. Ltd.
(A Joint Venture between SBI & AMUNDI)
9th Floor, Crescenzo, C-38 & 39,
G Block, Bandra Kurla Complex,
Bandra (East), Mumbai – 400 051
Tel: 022- 61793511
Email: customer.delight@sbimf.com
Is the applicant(s) Country of Birth / Nationality / Tax Residency other than “India” ?
8. TAX STATUS
(Please
)
Please note wherever units are allotted in Demat Mode, Statement of Account will be issued by the Depository concerned.
9. DEMAT ACCOUNT DETAILS (OPTIONAL)
National Securities Depository Limited (NSDL)
Central Depository Services (India) Limited (CDSL)
Depository
Participant Name
DP ID No.
Beneficiary Account No.
Depository
Participant Name
I
N
Beneficiary A/c No.
If you wish to hold units in Demat mode, please provide below details and enclose Latest Client Master / Demat Account Statement
Please ensure that the sequence of names as mentioned in the application form matches with that of the account held with the Depository Participant.
TOLL FREE NO : 1800 425 5425
Website : www.sbimf.com
Pension and Retirement Fund
Financial Institutions
Public Limited Company
Private Limited Company
Body Corporate
Partnership Firm
FII / FPI
Bank
NGO
LLP
PIO
NPO
[Please specify]
Others
[Please specify]
Resident Individual
Resident Minor (through Guardian)
NRI (Repatriable)
NRI (Non-Repatriable)
NRI– Minor (Repatriable)
NRI – Minor (Non-Repatriable)
Sole-Proprietor
HUF
Government Body
Society
Trust
NPS Trust
Fund of Fund
Gratuity Fund
AOP
BOI
7. STP ENROLMENT DETAILS
Opted for STP:
Yes No
(If Yes, please submit STP Enrolment Form/Transaction slip)
5. FATCA & CRS INFORMATION:
For Individuals / Proprietor (Mandatory). Non-Individual investors should mandatorily fill separate FATCA/CRS & UBO Form (Annexure-1).
If “YES”, please provide the following information (mandatory):
Yes
No
1.First Applicant (including Minor)
1. Second Applicant
1. Third Applicant
Yes
No
Yes
No
One time Investment
Systematic Investment Plan (SIP) (Please submit SIP Enrolment & OTM Form)
Drawn on Bank and Branch
Cheque / D.D. No. & Date
Cheque / DD Amount (Rs.)
1.First Applicant (including Minor)
1. Second Applicant
1. Third Applicant
Place/City of Birth
1. Details
Country of Birth
Country of Tax Residency 1
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]
^ In case Tax Identification Number is not available, kindly provide its functional equivalent. If no TIN is yet available or has not yet been issued, please provide an explanation and attach
this to the form. (Please attach additional sheets if necessary and mention all countries in which applicant is a tax resident & provide relevant details)
Nationality
Payment Mode
Cheque
DD (Third Party Declaration Mandatory)
Fund Transfer
RTGS
Daily Weekly Fortnightly Monthly Quarterly Annually
Scheme Name
Dividend Frequency
Plan (Please )
Regular
Direct
Option (Please )
Growth
Dividend
Dividend Facility (Please )
Reinvestment
Payout Transfer
Scheme / Plan / Option
In case of Dividend Transfer facility, please mention target scheme along with plan/option.

6. INVESTMENT AND PAYMENT DETAILS
10. OTHER PERSONAL INFORMATION
(Please
)
First Applicant
1. Second Applicant
1. Third Applicant
Gender
Male
Female Other
Male
Female Other
Father's Name
Male
Female Other
Spouse's Name
Date of Birth
D
D
MM Y Y Y Y
Occupation
(Please
)
Professional Business
Government Service Agriculturist
Private Sector Service Retired
Public Sector Service Housewife
Student Forex Dealer
Doctor
Others
Professional Business
Government Service Agriculturist
Private Sector Service Retired
Public Sector Service Housewife
Student Forex Dealer
Doctor
Others
Professional Business
Government Service Agriculturist
Private Sector Service Retired
Public Sector Service Housewife
Student Forex Dealer
Doctor
Others
Gross Annual Income in Rs.
(Please
):
Below 1 Lac 1-5 Lacs
5-10 Lacs 10-25 Lacs
25 Lacs - 1 Cr. > 1 Cr.
Below 1 Lac 1-5 Lacs
5-10 Lacs 10-25 Lacs
25 Lacs - 1 Cr. > 1 Cr.
Below 1 Lac 1-5 Lacs
5-10 Lacs 10-25 Lacs
25 Lacs - 1 Cr. > 1 Cr.
OR Networth in Rs.
Networth as of date
Politically Exposed Person [PEP]
Yes
No Related to PEP
Yes
No Related to PEP
Yes
No Related to PEP
Type of address given at KRA
Residential Business Reg. Office
Residential Business Reg. Office
Residential Business Reg. Office
D
DMMYY YY
D
DMMYY YY
D
DMMYY YY
D
DMMY
Y
YY
D
DMMYY YY
11. ONLY FOR SBI MAGNUM CHILDREN'S BENEFIT PLAN
SIGNATURE(S)
NOTE: Non-Individual investors should mandatorily fill separate FATCA/CRS & UBO Form (Annexure-I) alongwith this form.
For Foreign Exchange / Money Changer Services
Gaming / Gambling / Lottery Services (e.g. Casinos, Betting Syndicates)
Money Lending / Pawning
Is the entity involved / providing any of the following services
14.INSTITUTIONAL INVESTORS ADDITIONAL INFORMATION
Name of Contact Person
No
Yes
No
Yes
No
Yes
No
Yes
Name of the Nominee
Name of the Guardian
(In case Nominee is Minor)
Relationship with Nominee
Allocation %
(Mandatory if more than one Nominee)
Date of Birth* (Mandatory if Nominee is Minor)
Signature of Nominee/Guardian
(*Mandatory in case of Minor Nominee)
12. NOMINATION : I wish to nominate the following person/s to receive the proceeds in the event of my death. (With effect from 01/04/2011, for individual investors applying with
single holding, Nomination is mandatory. However, in case you do not wish to nominate please sign point 12)
Nominee 1 Nominee 2
Nominee 3
13. NOMINATION : I do not wish to nominate any person at the time of making the investment.
Signature
D
DMMYY YY
D
DMMYY YY
D
DMMYY YY
Name of Applicant
Relationship with Minor Unitholder
Name of Alternate Child
DoB of Alternate Child
Relationship with Minor Unitholder
D
DMMY
Y
YY
Mother Father
Legal Gardian
Others
Place
Date
1
st
Applicant / Guardian / Authorised Signatory
3
rd
Applicant / Authorised Signatory
2
nd
Applicant / Authorised Signatory
(ALL Applicants
must sign)
NOTE: Non-Individual investors should mandatorily fill separate FATCA/CRS & UBO Form (Annexure-I) alongwith this form.
16. DECLARATION :
I/We confirm that the information provided in this form is true & accurate. I/We have read and understood the contents of all the scheme related documents and I/We hereby confirm and declare that (i) I/We have not received or been
induced by any rebate or gifts, directly or indirectly, in making this investment; (ii) the amount invested/to be invested by me/us in the scheme(s) of SBI Mutual Fund (“the Fund”) is derived through legitimate sources and is not held or designed for the purpose of contravention of
any act, rules, regulations or any statute or legislation or any other applicable laws or any notifications, directions issued by any governmental or statutory authority from time to time; (iii) the monies invested by me in the schemes of the Fund do not attract the provisions of Foreign
Contribution Regulations Act (“FCRA”); (iv) I/We am/are aware that a U.S. person (within the definition of the term ‘US Person’ under the US Securities laws) / resident of Canada are not eligible for investments with the Fund and I/We am/are not a U.S. person/resident of Canada;
(v) the ARN holder has disclosed to me/us all the commissions (in the form of trail commission or any other mode), payable to him/her for the different competing schemes of various mutual funds from amongst which a scheme of the Fund is being recommended to me/us; (vi) * as
per the Memorandum and Articles of Association of the Company, Bye laws, Trust Deed or Partnership Deed and resolutions passed by the Company / Firm / Trust, I/We am/are authorised to enter into the transactions for and on behalf of the Company/Firm/Trust; (vii) ** I/We am/
are Non Resident of Indian Nationality/Origin and that funds for the subscriptions have been remitted from abroad through approved banking channels or from my/our Non Resident External/Ordinary account/FCNR Account; (viii) *** I/We do not hold a Permanent Account Number
and hold only a single PAN Exempt KYC Reference No. (PEKRN) issued by KYC Registration Agency and also confirm that the aggregate of lump sum and SIP installments in a rolling 12 months period or financial year does not exceed Rs. 50,000/- (Rupees Fifty Thousand); (ix) all
information provided in this application form together with its annexures is/are true and correct to the best of my/our knowledge and belief and I/We shall be liable in case any of the specified information is found to be false or untrue or misleading or misrepresenting; (x) that we
authorize you to disclose, share, remit in any form, mode or manner, all / any of the information provided by me/ us, including all changes, updates to such information as and when provided by me/ us to the Fund, its Sponsor, AMC, trustees, their employees/RTAs or any Indian or
foreign governmental or statutory or judicial authorities/agencies including but not limited to SEBI, the Financial Intelligence Unit-India, the tax/revenue authorities in India or outside India wherever it is legally required and other such regulatory/investigation agencies or such
other third party, on a need to know basis, without any obligation of advising me/us of the same; (xi) I/We shall keep you forthwith informed in writing about any changes/modification to the information provided or any other additional information as may be required by you from
time to time; (xii) Towards compliance with tax information sharing laws, such as FATCA and CRS: (a) the Fund may be required to seek additional personal, tax and beneficial owner information and certain certifications and documentation from investors. I/We ensure to advise you
within 30 days should there be any change in any information provided; (b) In certain circumstances (including if the Fund does not receive a valid self-certification from me) the Fund may be obliged to share information on my account with relevant tax authorities; (c) I/We am
aware that the Fund may also be required to provide information to any institutions such as withholding agents for the purpose of ensuring appropriate withholding from the account or any proceeds in relation thereto; (d) as may be required by domestic or overseas regulators/
tax authorities, the Fund may also be constrained to withhold and pay out any sums from my/our account or close or suspend my account(s) and (e) I/We understand that I am / we are required to contact my tax advisor for any questions about my/our tax residency; (f) I have
understood the information requirements of this Form (read along with the FATCA/CRS Instructions) and hereby confirm that the information provided by me/us on this Form including the taxpayer identification number is true, correct, and complete. I also confirm that I have read
and understood the FATCA Terms and Conditions below and hereby accept the same. (xiii) If the name given in the Application is not matching PAN application may liable to get rejected or further transactions may be liable to get rejected
* Applicable to other than Individuals / HUF; ** Applicable to NRIs; *** Applicable to “Micro investments”
15. GO-GREEN INITIATIVE:
As part of Go-Green initiative, issuance of physical copy of scheme-wise annual reports or abridged summary is limited to those investors whose email id is not available and
who specifically opt to receive it in physical form. Please tick here only if you wish to receive the same in physical mode