Date of Birth
Enclosed (please ) KYC Proof
Enclosed (please
)
KYC Proof
Enclosed (please ) KYC Proof
Enclosed (please
)
KYC Proof
PAN/KRN & KIN (Mandatory)
PAN/KRN (10 Digit No.)
PAN/KRN (10 Digit No.)
PAN/KRN (10 Digit No.)
PAN/KRN (10 Digit No.)
PAN/KRN (10 Digit No.)
KIN (14 Digit No.)
KIN (14 Digit No.)
KIN (14 Digit No.)
KIN (14 Digit No.)
KIN (14 Digit No.)
Application Form for Lumpsum / SIP / Folio Creation
Please read instructions before lling the Form
Application No :
Application No :
Acknowledgement Slip (To be filled by the Applicant)
Signature, Stamp & Date
Received from
Date
Mr. / Ms. / M/s.
Towards Subscription under below Schemes
Invesco India Scheme Name
Amount ( ) Cheque/DD No.
Key Partner / Agent Information
Sub-Broker ARN Code
Distributor / Broker ARN
Registered Investment Advisor Code
ARN -
Employee Unique Identifi cation No. (EUIN)
(Of Individual ARN holder or Of employee /
Relationship Manager / Sales Person of the Distributor)
Internal Sub-Broker/Employee Code
ARN -
PAN/KRN (Refer Instruction no. 3), Date of birth is mandatory in case of Minor, additionally refer Instruction no. 2, KYC & Networth (Refer Instruction no. 13 ),
KIN: KYC Identification Number from Central KYC Registry
I/We hereby confi rm that the EUIN box has been intentionally left blank by 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. (Refer Instruction no.1(vii)).
Transaction Charges (Please tick any one of the below. For details refer KIM)
Upfront commission, if any, 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.
Sign Here
Sole/First Applicant/Guardian
Sign Here
Second Applicant
Sign Here
Third Applicant
I am a fi rst time investor in Mutual Funds / I am an existing investor in Mutual Funds
(Default)
Country of Birth / Citizenship / Nationality or Tax Residency, other than India, for any
applicant? ( ):
Yes
/
No (Mandatory to
ll FATCA / CRS declaration.
ll separate FATCA / CRS declarations.
ll separate FATCA / CRS & UBO declarations.
2. KYC Details Mandatory
( )
Gross Annual
Income
First/Sole
Private Service Public Sector / Govt. Service Business Professional Housewife
Retired Student Forex Dealer Agriculturist Others _____________________________ (Please specify)
Occupation
Details
Second
Private Service Public Sector / Govt. Service Business Professional Housewife
Retired Student Forex Dealer Agriculturist Others _____________________________ (Please specify)
Third
Private Service Public Sector / Govt. Service Business Professional Housewife
Retired Student Forex Dealer Agriculturist Others _____________________________ (Please specify)
First/Sole
Politically Exposed Person Related to Politically Exposed Person Not Applicable
Others
(For
individuals)
Second
Politically Exposed Person Related to Politically Exposed Person Not Applicable
Third
Politically Exposed Person Related to Politically Exposed Person Not Applicable
I
s the entity involved in any of the following services
(i) Foreign Exchange/Money Changer Services
Yes No (ii) Gaming/Gambling/Lottery/Casino Services/Betting Syndicates Yes No (iii) Money Lending/Pawning Yes No
Others (For Non-individuals)
First/Sole Below 1 Lac 1-5 Lacs (Default) 5-10 Lacs
10-25 Lacs 25 Lacs - 1 Crore > 1 Crore
Net-worth as on
in `
(Not older than 1 year) (Mandatory for Non-individuals)
Existing Unitholder : Pl. fill in Folio Number below and then proceed to section 2.
New Unitholder
Folio Number
Name of Sole /
First Unitholder
Mailing Address: (Address should be as per CKYC records, refer Instruction no. 13(ii))
Overseas Address:
(Mandatory in case of NRI / FII / FPI applicant)
City ytiCNIP State/Province
Mode of Holding
(Only for non-demat mode) ( ) Single Joint Anyone or Survivor (Default)
Mobile
E-mail
Country PINState
Tel. No.
(Residence)
Tel. No.
(Office)
Individual Minor Minor-NRI Repatriable Minor-NRI Non-Repatriable
HUF NRI Repatriable
NRI Non-Repatriable
Partnership
LLP Listed Co. Unlisted Co. Body Corporate
Society/Club Trust FII FPI
AOP Co. U/S 25/8 of Companies Act Others_________________
Status ( )
In case of Non-Profit Entity
(please )
(if Sole / First applicant is a Minor) Contact Person (in case of Non-individual Investors only)
Guardian/
Contact Person
Relation Father Mother Court appointed Guardian
(If the investment is being made by a Constituted Attorney, please furnish the details of POA Holder)
POA Holder
First/Sole
Mr. / Ms. / M/s.
City of Birth
Second
No joint holder where minor is first holder
Third
No joint holder where minor is first holder
1. Applicant’s Details Name (as per PAN)
Second
Below 1 Lac 1-5 Lacs (Default) 5-10 Lacs
10-25 Lacs 25 Lacs - 1 Crore > 1 Crore
Net-worth as on
in `
(Not older than 1 year)
Third Below 1 Lac 1-5 Lacs (Default) 5-10 Lacs
10-25 Lacs 25 Lacs - 1 Crore > 1 Crore
Net-worth as on
in `
(Not older than 1 year)
Country of Birth
City of Birth Country of Birth
City of Birth Country 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
D D M
M
Y Y Y Y
D D M M Y Y Y Y
D D M M Y Y Y Y
D D M M Y Y Y Y
D D M M Y Y Y Y
D D M M Y Y Y Y
Rs.
Qfund.in Mutual Fund
Mutual Fund India
Mutual Fund Mumbai
Mutual Fund
GET IN TOUCH
Invesco Mutual Fund
2101-A, A Wing, 21st Floor, Marathon Futurex, N. M. Joshi Marg,
Lower Parel, Mumbai - 400 013.
T +91 22 67310000 F +91 22 23019422
call : 1800-209-0007 > sms ‘Invest’ to 56677 > Invest Online www.invescomutualfund.com
Applicable in case of Third Party Payment: Minor Client Employee Distributor
Payment on behalf of (
)
4. For SIP / Micro SIP for Post Dated Cheques
Refer instruction no. 6
SIP Micro SIP
)mrof etadnam muc noitartsiger PIS evitcepser ll esaelp )HCAN/SCE/tibeD tceriD( tibeD-otuA hguorht PIS roF(
SIP through Post Dated Cheques (Use CTS (Cheque Truncation System) Cheques only)
To
Y Y Y Y M MY Y Y Y M M
PAN / KRN
Enclosed ( )
KYC Proof
Third
Applicant /
POA
Sole / First
Applicant /
Guardian /
POA
8. Declaration & Signature(s)
Second
Applicant /
POA
Date
Place
D D M M Y Y Y Y
( ) Yes No If NRI ( ) Repatriation basis Non-Repatriation basis
Please provide a cancelled cheque leaf of the same bank account as mentioned above. We will credit the redemption/dividend proceeds directly into investors account through electronic means if the details provided by the investors
are sufficient for the same. Mentioning your IFSC will help us transfer the amount to your bank account faster. To receive cheque payout, (
)
If you have provided multiple bank registration form ( ) .
Unit holders who have opted to hold Units in dematerialised form must provide Bank Account details linked with the Demat account, as mentioned under section 4. In case of discrepancy, bank details as per depository
records will be final.
6. Bank Account Details (Mandatory As Per SEBI Guidelines)
A/c. Type (
) Current Savings NRE NRO FCNR SNRR Others ____________
Bank A/c. No.
Bank Name
City
Refer instruction no. 4
MICR Code
(9 digit No. next to your Cheque No.)
(11 digit character code appearing on cheque leaf)
PIN
Branch
Address
DP ID #
( ) NSDL CDSL
I N
vorp eb dluohs woleb denoitnem sa c/A tameD eht htiw deknil tnuoccA knaB eht fo sliated ehT .)LSDC fo esac ni elbacilppa toN #( ided under section 5.
Beneficiary Account No.
DP Name
5. Demat Account Details
Optional, Refer instruction no. 11
7. Nomination Details (
Mandatory for investors who opt to hold units in non-demat form. )
Refer Instruction no. 10
% Share
Relationship Nominee PAN
Name
Guardian’s Relation (with the minor)
PAN of Guardian
Name of Guardian
(If Nominee is Minor)
Address
Date of Birth (for minor)
Nominee 1
D D M M Y Y Y Y
Nominee 2
D D M M Y Y Y Y
Nominee 3
D D M M Y Y Y Y
I do not intend to nominate ( the box , in case you do not wish to nominate)
To
Name of the person making payment
Frequency (
) Monthly (Default) or Quarterly
SIP Date ( )
3
rd
10
th
15
th
(Default)
20
th
25
th
Or
Applicable in case of Third Party Payment: Payment on behalf of ( ) Minor Client Employee Distributor (Refer instruction no. 6).
PAN/KRN
Name of the person making payment Enclosed ( )
KYC Proof
Payment Details (For Cash, refer instruction no. 7)
Investment Amt. (Rs)
Net Amt. (Rs) Cheque/DD No./UMRN
Mode of Payment ( ) Cheque DD Funds Transfer Cash NACH
Account Type ( ) Current Savings NRE NRO FCNR SNRR Others
Net of DD Charges
The Trustees, Invesco Mutual Fund
Having read and understood the contents of the Statement of Additional Information
/ Scheme Information Document(s) of the scheme, I / We hereby apply to the Trustees
of Invesco Mutual Fund for units of the Scheme / Option as indicated above and agree
to abide by the terms, conditions, rules and regulations of the Scheme. I / We have
understood the details of the Scheme and I / We have not received nor have been
induced by any rebate or gifts, directly or indirectly, in making this investment. I/We
do not have any existing Micro Investments which together with the current Micro
Investment application will result in aggregate investments exceeding Rs. 50,000/- in
a year (applicable
to Micro Investment investors only). The Distributor 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 hereby authorise
Invesco Mutual Fund, its Investment Manager and its Agents to disclose details of
my / our investment to my / our bank(s) / Invesco Mutual Fund’s Bank(s) and / or
Distributor / Broker/ Investment Advisor and to verify my/ our bank details provided
by me / us. I / We hereby declare that the particulars given above are correct.
If the transaction is delayed or not effected at all for reasons of incomplete or
incorrect inf
ormation, I/We would not hold Invesco Asset Management (India) Pvt.
Ltd. (Investment Manager to Invesco Mutual Fund), their appointed service providers
or representatives responsible. I / We will also inform Invesco Asset Management
(India) Pvt. Ltd., about any changes in my/ our bank account. I / We hereby declare
that the amount being invested by me / us in the Scheme of Invesco Mutual 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.
I / We confirm that I / We are not United States person(s) under the laws of
United
States or residents(s) of Canada as defined under the applicable laws of Canada.
Applicable to KRN holders : I, the first / sole holder hereby declare that I do not hold
a Permanent Account Number and hold only a single ‘PAN exempt KRN’ issued by
KRA and that my existing investment in schemes of Invesco Mutual Fund together
with current application will not result in aggregate investments exceeding Rs.
50,000/ - in a rolling 12 months period or in a financial year i.e. April to March.
Applicable to NRIs only : I / We confirm that I am / we are Non-Residents of Indian
Nationality /Origin and that the funds are remitted from abroad through approved
banking channels or from my /our NRE / NRO / FCNR/ SNRR Account. I / We confirm
that the details provided by me / us are
true and correct.
3. Investment Details
(Cheque / DD should be drawn in favour of the Scheme. Investors applying under direct plan must mention “Direct” in the box provided below.)
Invesco India Scheme Name Plan Option
Branch
Bank Name A/c. No.
Period
From
Cheque
Nos. From
Drawn
on Bank
NEFT/RTGS/
IFSC Code
Mention Date of your choice
DD Charges (Rs.)
Mutual Funds
Mutual Fund
Mutual fund India
Mumbai
Bandra West
www.qfund.in