I / We declare that the particulars furnished here are correct. I / We authorise Axis Mutual Fund acting through its service providers to debit my / our bank account towards payment of SIP instalments through an Electronic Debit arrangement / NACH (National

Automated Clearing House). If the transaction is delayed or not effected at all for reasons of incomplete or incorrect information, I/we would not hold the user institution responsible. I/We will also inform Axis Mutual Fund about any changes in my bank account.

This is to inform you that I/We have registered for making payment towards my investments in AXISMF by debit to my /our account directly or through ECS (Debit Clearing) / NACH (National Automated Clearing House). I/We hereby authorize to honour such payments and

have signed and endorsed the Mandate Form. Further, I authorize my representative (the bearer of this request) to get the above Mandate verified. Mandate verification charges, if any, may be charged to my/our account.

I also hereby agree to read the respective SID and SAI of the mutual fund before investing in any scheme of Axis Mutual Fund using this facility.

Sole/ 1st Unit Holder / POA / Guardian 2nd Unit Holder

3rd Unit Holder

Upfront commission shall be paid directly by the investor to the AMFI registered distributor based on the investor's assessment of various factors including the service rendered by the distributor.

Serial No., Date & Time Stamp

Sub-Distributor ARN

Distributor ARN

EUIN

Sol ID / Internal Sub-Broker

Employee Code

PAN

Enclose

First Name

Middle Name

Last Name

Email ID

For receiving statements over email instead of post

2nd Applicant 3rd Applicant

First / Sole Applicant /

Guardian

Second Applicant

Third Applicant

Power of Attorney Holder

“I/We hereby confirm 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.”

Application Form No. (For New Applicants)

APPLICANT'S PERSONAL DETAILS (MANDATORY)

TRANSACTION CHARGES FOR APPLICATIONS THROUGH DISTRIBUTORS ONLY

In case the subscription amount is ` 10,000 or more and your Distributor has opted to receive Transaction Charges, the same are deductible as applicable from the purchase/ subcription amount and payable to the Distributor. Units will be issued against the balance amount invested.

I confirm that I am a first time investor across Mutual Funds.

I confirm that I am an existing investor in Mutual Funds.

Folio No. (For Existing Unit holders)

Sole / 1st Unitholder

1st Applicant

Attested PAN card

KYC Letter

Attested PAN card

KYC Letter

Attested PAN card

KYC Letter

DECLARATION AND SIGNATURE (To be signed by ALL UNIT HOLDERS if mode of holding is ‘joint’)

ARN ARN

First SIP Installment details

Drawn on bank / branch name

SIP Amount (figures)

(words)

Mode

Cheque / DD

Axis Bank Debit Mandate

Cheque / DD no.

D D M M Y Y

Dated

Scheme Name OptionPlan

SIP DETAILS

Cheque / DD Amount

MICR No.

Signature Primary Account holder

Name as in bank records

Signature of Account holder

Name as in bank records

Signature of Account holder

Name as in bank records

PERIOD

From

Until Cancelled

This is to confirm that the declaration (as mentioned overleaf) 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.

I/We hereby authorize

to debit (tick )

Bank a/c number

with Bank

Name of customers bank

an amount of Rupees

Folio No.

FREQUENCY

Mthly

Qtly H-

Yrly

As & when presented

DEBIT TYPE

Email ID

Reference 1

Reference 2

Axis Mutual Fund

SB CA CC SB-NRE SB-NRO

Other

CREATE

MODIFY

CANCEL

Tick ( )

IFSC

MICR

Fixed Amount

Maximum Amount

Phone No.

D D M M Y Y Y Y

Bank use

UMRN

Date

Sponsor Bank Code

Utility Code

D D M M Y Y

Y Y

Bank use Bank use

I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my accounts as per latest schedule of charges of the bank.

D D M M Y Y Y Y

Scheme Name

ACKNOWLEDGMENT SLIP (To be filled by the investor)

Stamp & Signature

Folio No.

Investor Name

Scheme Name

(Scheme Name)

Plan Option

SIP Period

D D M M Y Y

From

D D M M Y Y

MANDATORY FIELDS : •

• •

Account type Bank A/c number (core banking a/c no only)

until cancelled Account holder signature Account holder name as per bank record

• • • • • Bank name IFSC code or MICR code (as per the cheque / pass book) Amount in words (maximum amount) Period start date and end date or

Amount `

Guardian's Name

(in case of minor)

SIP period

SIP frequency (tick ü any one)

Monthly Yearly (Default Frequency Monthly)

th th st

Preferred Debit Date (Any date except 29 , 30 and 31 ) (ref 12(b))

D D

If no debit date is mentioned default date would

be considered as 7th of every month.

M M Y Y

If end date is not mentioned then the SIP will be considered for perpetuity (Dec 2099).

M M Y Y

from

9 9

End date (ref 12(i))

Tick whichever is applicable :

New SIP registration by new investor New SIP registration by existing investor

SIP Registration Mandate - NACH

(Investor must read Key Scheme Features and Instructions before completing this form.)

QFund.in Mutual Fund India

Mutual Fund India

1. Investors are advised to comply with applicable Know Your Customer (KYC) requirements from time to time and failure to comply with this

requirement may result in the purchase application being rejected.

2. Please read the Scheme Information Document(s), Key Information Memorandum(s) of the scheme(s) and Statement(s) of Additional

Information of the respective schemes and addenda issued for these documents carefully before investing.

3. Upon signing and submitting the Application Form and tendering payment it will be deemed that the investors have accepted, agreed to and

shall comply with the terms and conditions detailed in the respective Scheme Documents.

4. Applications incomplete in any respect are liable to be rejected. AMC / RTA shall have absolute discretion to reject any such Application

Forms.

5. Investors are advised to retain this acknowledgment slip till they receive a confirmation of processing of their SIP Mandate from the Axis

Mutual Fund Investor Service Centre (ISC)/ Karvy.

6. Investors/Unit holders should provide the Folio & Name of the Sole/Primary Holder. In case the name as provided in this application does not

correspond with the name appearing in the existing Folio, the application form may be rejected.

7. If both Folio & Name of the Sole/Primary Holder are not mentioned, the transaction shall be liable for rejection.

8. A minimum gap of 21 days needs to be maintained between the first and second SIP installments.

9. Investor shall have the option of choosing any date of the month as the SIP date except the dates 29th,30th and 31st .

10. All SIP installment cheques/payment instructions must be of the same amount and the same monthly debit date (excluding first cheque).

11. In case payment is made using “At Par” cheques, investors must mention the MICR number of his actual bank branch.

12. If the period is not specified by the unitholder then the SIP enrollment will be deemed to be for perpetuity and processed accordingly.

13. Mandatory fields for filling NACH mandate. In case any of these fields are not filled mandate will be rejected.

• Account Type

• Bank A/c. number

• Bank Name

• IFSC code or MICR code (As per the Cheque / Pass book)

• Amount in Words (Maximum amount)

• Amount in Figures (Maximum amount)

• Period Start Date and End date or until cancelled

• Account Holder Signature

• Account Holder Name as per Bank Record

14. The SIP will be discontinued automatically if payment is not received for three successive installments.

15. Investors can discontinue a SIP at any time by sending a written request to any Official Point of Acceptance or to the registrar Karvy.

Notice of such discontinuance should be received at least 20 days prior to the due date of the next installment / debit.

17. Please submit this form along with a copy of a cancelled cheque.

INSTRUCTION

Mutual Fund India