*Mandatory information - If left blank, the application is liable to be rejected.**Mandatory in case the Sole/First applicant is minor. Individual client who has registered under KYC Records Registry (CKYCR) can fill

the 14 digit KYC Identification Number (KIN)

Relationship with Minor applicant Natural guardian

Court appointed guardian

Foreign Portfolio Investor

Resident Individual

Foreign National Public Limited Company Government Body AOP/BOI

Defence Establishment

Other

Specify

Trust / Society / NGO

Non Profit Organization/Charities

QFI

Financial Institution

Fll

Private Limited Company

Body Corporate

Bank

Sole Proprietorship

Partnership Firm

LLP

On behalf of Minor

HUF

NRI

1st APPLICANT

GUARDIAN NAME IF MINOR/CONTACT PERSON

(FOR NON INDIVIDUAL) /POA HOLDER

2nd APPLICANT

3rd APPLICANT

POA HOLDER

Correspondence Address

Default Communication mode is E-mail only, if you wish to receive following document(s) via physical mode: (please here)

Account

Statement

Annual

Report

Other Statutory

Information

Overseas Address (Mandatory for NRI / Fll Applicants)

PAN/PEKRN*

Aadhaar No.

KIN

Proof Attached

Date of Birth

Date of Birth**

KIN

Aadhaar No.

Tel. No.

Mobile No.

Email ID

HOUSE / FLAT NO. HOUSE / FLAT NO.

STREET ADDRESS STREET ADDRESS

CITY / TOWN CITY / TOWN

COUNTRY

PIN CODE

Office Residence

STATE STATE

D M M Y Y

M/s

Mr Ms M/s

Date of Birth

D D M M

Y Y

Date of Birth

D D M M Y Y

Gender

Male

Female

Gender

Male Female

Gender

Male

Female

Gender

Male Female

Gender

Male

Female

Single

Joint

(Default option)

Anyone or

Survivor

CORRESPONDENCE DETAILS OF SOLE/FIRST APPLICANT (AS PER KYC RECORDS)

TAX STATUS (Please ) (For First / Sole Applicant)

EXISTING INVESTOR DETAILS (If you have existing folio, please provide Folio No. and proceed to section 11 (Refer instruction C)

Folio No.

The details in our records under the folio no. mentioned alongside will apply for this application.

Common Application Form

Investors must read the Key Information Memorandum, the instructions and Product Labeling on cover page before completing this Form.

The Application Form should be completed in English and in BLOCK LETTERS only.

KEY PARTNER/AGENT INFORMATION (Investors applying under Direct Plan must mention “Direct” in ARN column.)

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.

Distributor Name/ARN No. Sub-broker Name/Code

EUIN No.

First Holder Second Holder Third Holder

TRANSACTION CHARGES FOR APPLICATIONS THROUGH DISTRIBUTORS ONLY (refer Instruction B)

In case the subscription (lumpsum) amount is Rs. 10,000/- or more and your distributor has opted to receive Transaction Charges, Rs. 150/- (for the first time mutual fund investor) or Rs. 100/-

(for the 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.

MODE OF HOLDING / OPERATION

APPLICANT’S DETAILS (Please refer to the Instruction No. A, C, D, R) All fields are mandatory.

Proof of relationship with minor

Resident Individual NRI (Second Applicant is not allowed in case of minor as first/sole applicant.)

Resident Individual NRI (Third Applicant is not allowed in case of minor as first/sole applicant.)

Resident Individual NRI

Mutual fund India

NSDL: Depository Participant (DP) ID (NSDL only)

Beneficiary Account Number (NSDL only)

CDSL: Beneficiary ID (CDSL only)

DEMAT ACCOUNT DETAILS (Optional - Refer Instruction k) (Nomination Provided in Demat Account shall be considered)

DP Name

NSDL

CDSL

Mandatory information - If left blank, the application is liable to be rejected.

For unit holder opting to hold units in demat form, please ensure that the bank account linked with the demat account is mentioned here.Redemption/Dividend/Refund Payout will be credited into

this bank account.

( Mandatory to attach proof, in case the pay-out bank account is different from the bank account mentioned under Section 11 Below.)

Account Number

Bank Name & Branch

Branch City

IFSC Code MICR Code

Account Type

Current

Savings

NRO NRE FCNR

Others

(please specify)

11 digit 9 digit

Parag Parikh Long Term Equity Fund

Scheme

Plan

Option

Sub-Option

Mode of Payment

Self

Third Party Payment (please fill the ‘Third Party Payment Declaration Form)

Cheque/DD/UTR/UMR No.Amount (figures)

Account No.

Bank & Branch Name

Regular

Direct (Default Plan)

Dividend

Growth (Default Plan)

Parag Parikh Liquid Fund

Div - Monthly Payout

Payment mode Cheque

DD Common CAMS OTM / PPFAS OTM

Fund Transfer

RTGS/NEFT Transfer Letter DD Charges

Weekly Monthly

Div - Reinvest

BANK DETAILS (The name of the Sole/First applicant must be pre printed on the cheque.)

NOMINATION DETAILS Individuals (single or joint applicant)

are advised to avail Nomination facility.

I/We wish to nominate

I/We DO NOT wish to nominate and sign here

Nominee Name & Address

Guardian Name & Address

In case of Minor

Date of birth

Allocation %

Relationship

with Investor

Nominee/Guardian

sign

Nominee 1

Nominee 2

Nominee 3

INVESTMENT & PAYMENT DETAILS (refer instruction F) Please write Cheque/DD in favour of the Scheme name only.

Unitholders will receive redemption / dividend proceeds directly into their bank account (as furnished in Section 9) via Direct credit / NEFT / ECS facility

I wish to receive a cheque instead of direct credit into my account.

MODE OF PAYMENT OF REDEMPTION / DIVIDEND VIA DIRECT CREDIT / NEFT / ECS (refer instruction I )

For Non-Individuals Please tick ( ) (Please attach mandatory Ultimate Beneficial Ownership (UBO) declaration form - Refer instruction no. IV (h)):

(i)Foreign Exchange / Money Changer Services

Politically Exposed Person (PEP)

Related to Politically Exposed Person (RPEP)

Not applicable

(ii) Gaming / Gambling / Lottery / Casino Services (iii) Money Lending / Pawning

Y Y Y NNN

First Applicant/

Guardian

Second Applicant

Third Applicant

POA Holder

Below 1 Lac

For Individuals Please tick ( )

I am Politically Exposed Person (PEP)

I am Related to Politically Exposed Person (RPEP) Not applicable

OR Net worth (Mandatory for Non-Individuals) `

1-5 Lacs

5-10 Lacs

10-25 Lacs

>25 Lacs-1 crore

>1 crore

>1 crore OR Net worth `

as on

(Not older than 1 year)

D D M M

Y Y Y Y

POA Holder

First Applicant/

Guardian

Second Applicant

Third Applicant

GROSS ANNUAL INCOME [Please tick ( )]

OTHERS[Please tick ( )]

Proprietorship Others

Private Sector

Service

Public Sector

Service

Government

Service

Business

Non Profit

Organisation

Professional

Retired Housewife

Agriculturist

Third Applicant

POA Holder

Second Applicant

First Applicant/Guardian

KYC DETAILS (Mandatory)

OCCUPATION [Please tick ( )]

(N/A for Parag Parikh Long Term Equity Fund (PPLTEF))

Daily

(Default Option)

mutual fund India

Mutual fund India

Fund India

Mutual funds India

If “YES” please fill for ALL countries (other than Indian in which you are a Resident for tax purpose i.e. where you are a Citizen/ Resident/ Green Card holder/ Tax Resident in the respective countries.)

The country where the Account Holder is liable to pay tax does not issue Tax Identification Number to its residents.

No TIN required (Select this reasons Only if the authorities of the country of tax residence do not require the TIN to be collected )

Address Type of Sole / 1st Holder

Residential Residential Residential

Registered Office Registered Office Registered Office

Business Business Business

Address Type of 2nd Holder Address Type of 3rd Holder

Others please state the reasons there of:

Country of Tax Residency

Tax Identification Number

or Functional Equivalent

Identification Type

(TIN or other please specify)

Identification Type

(TIN or other please specify)

Are you a tax resident (i.e. are you assessed for tax) in any other country outside India?

YES No

Second Applicant

Third Applicant

POA Holder

Reason A

Reason B Reason C

First Applicant / Guardian

(please tick )

Reasons A

Reasons

Declaration for UBO (Ultimate Beneficial Owner) (Mandatory in case of a Non-individual investor)

The Below information is required for all applicant(s)/ Guardians

In case of an Individual Investor Name of an UBO

Are you the UBO of this account/ Folio

If you are not UBO for this Account/ Folio, then state the name of UBO

along with separate declaration for UBO.

Note: The beneficial owner means the natural person or persons, who ultimately own

being conducted, and includes a person who exercises ultimate effective control over a legal person or arrangement.

Instructions: An investor needs to provide these details to allow PPFAS Mutual Fund to comply with applicable SEBI and PMLA guidelines.

or control or influence a client and/or persons on whose behalf a transaction is

DECLARATION

Instructions

I/We am/are not prohibited from accessing capital markets under any order/ruling/judgment etc. of any regulation, including SEBI. I/We confirm that my application

is in compliance with applicable Indian and foreign laws. I/We hereby confirm and declare as under:-

For Non-Individual Investor: I/We hereby confirm that the object clause of the constitution document of the entity (viz. MOA / AOA / Trust Deed, etc.), allows us to apply

for investment in this scheme of PPFAS Mutual Fund and the application is being made within the limits for the same. I/We are complying with all requirements /

conditions of the entity while applying for the investments and I/We, including the entity, if the case may arise so, hereby agree to indemnify PPFAS AMC / PPFAS

Mutual Fund in case of any dispute regarding the eligibility, validity and authorization of the entity and/or the applicants who have applied on behalf of the entity.

For NRIs only: I/We confirm that I am/we are Non Residents of Indian Nationality/Origin and that I/we have remitted funds from abroad through approved banking

channels or from funds in my/our Non-Resident External/Non-Resident Ordinary/FCNR account. (Refer Inst. No. F)

Applicable to PEKRN Holders: I, the first / sole holder, also hereby declare that I do not hold a permanent Account Number and hold only a single PAN Exempt KYC

Reference No. (PEKRN) issued by KYC Registration Authority and that my existing investments together with the current application will not result in aggregate

investments exceeding Rs. 50,000/-in a rolling 12 months period or in a financial year.

‘If the Name given in the application does not match the name as appearing on the PAN Card/Aadhaar card, authentication, application may be liable to get

rejected or further transactions may be liable to get rejected’

I /We have understood the information requirement of this Form (read along with the FATCA & CRS Instructions) and hereby confirm that the information

provided by me/us on this Form is true, correct, and complete. I / We also confirm that I /We have read and understood the FATCA & CRS Terms and

Conditions below and hereby accept the same.

Politically Exposed Persons (PEP) are defined as individuals who are or have been entrusted with prominent public function in a foreign country, e.g., Heads of States

or of Governments, senior politicians, senior government/judicial/military officers, senior executive of state-owned corporations, important political party officials,

etc.

Country of Tax Residence and Tax ID number: Tax Regulations require us to collect information about each investor’s tax residency. In certain circumstances

(including if we do not receive a valid self-certification from you) we may be obliged to share information on your account with relevant tax authorities. If you have any

questions about tax residency, please contact your tax advisor. Should any information provided change in the future, please ensure you advise us of the change. If

you are a US citizen or resident, please include United States in this related field along with your US Tax Identification Number.

Place/City of Birth Country of Birth Country of Citizenship / Nationality

First Applicant / Guardian

Second Applicant

Third Applicant

Indian

U.S. Others

Please specify

Others

U.S.

Indian

Please specify

Others

U.S.

Indian

Please specify

Others

U.S.

Indian

FATCA and CRS Information/Foreign Tax Law (Self Certification) (Required for all applicant(s)/Guardians, Sole Proprietor & POA Holder)

For Non-Individual investor : You are required to submit separate FATCA/CRS/UBO declaration form.

POA Holder

Mutual funds in India

Bandra

Mutual funds India

Mutual funds Worli

Bandra West

Khar, Worli, Napean Sea Road, Mutual Funds

Mutual funds

PPFAS MUTUAL FUND

Corporate Office :

81/82, 8th Floor, Sakhar Bhavan, Ramnath Goenka Marg, 230, Nariman Point, Mumbai - 400 021.

Received, subject to realisation, verification and conditions, an application for purchase of Units as mentioned in the application form.

ISC Stamp & Signature

Cheque No. Dated Amount (Rs)

Scheme

Application No.

From

ACKNOWLEDGMENT SLIP (To be filled in by the Investor)

Aadhaar Updation Form

FIRST OR SOLE APPLICANT/ GUARDIAN/POA

SECOND APPLICANT

THIRD APPLICANT

SIGN HERE SIGN HERE SIGN HERE

DECLARATION

FIRST OR SOLE APPLICANT/ GUARDIAN/POA

SECOND APPLICANT

THIRD APPLICANT

I declare that the information is to the best of my knowledge and belief, accurate and complete.

I agree to notify PPFAS Mutual Fund/PPFAS Asset Management Private Limited immediately in the event the information in the self-certification changes.

SIGN HERE SIGN HERE SIGN HERE

I/We hereby provide my /our consent in accordance with Aadhaar Act, 2016 and regulations made thereunder, for (i) collecting, storing and usage (ii) validating/authenticating and

(ii) updating my/our Aadhaar number(s) in accordance with the Aadhaar Act, 2016 (and regulations made thereunder) and PMLA.

I/We hereby provide my/our consent for sharing/disclosing of my Aadhaar number(s) including demographic information with the asset management companies of

SEBI registered mutual fund and their Registrar and Transfer Agent (RTA) for the purpose of updating the same in my/our folios.

10.

11.

12.

13.

14.

I have voluntarily subscribed to the online access for transacting the internet facility provided by PPFAS Asset Management Private Ltd. (Investment Manager of PPFAS

Mutual Fund) and confirm of having read, understood and agree to abide the terms and conditions for availing of the internet facility more particularly mentioned on

the website www.amc.ppfas.com and hereby undertake to be bound by the same. I further undertake to discharge the obligations cast on me and shall not at any

time deny or repudiate the online transactions effected by me and I shall be solely liable for all the costs and consequences there of.

I/We have read, understood and hereby agree to comply with the terms and conditions of the scheme related documents and apply for allotment of Units of the

Scheme(s) of PPFAS Mutual Fund (’Fund’) indicated above.

I/We am/are eligible Investor(s) as per the scheme related documents and am/are authorised to make this investment as per the Constitutive

documents/authorization(s). The amount invested in the Scheme(s) is through legitimate sources only and is not for the purpose of contravention and/or evasion of

any act, rules, regulations, notifications or directions issued by any regulatory authority in India.

The information given in/ with this application form is true and correct and further agree to furnish such other further/additional information as may be required by

the PPFAS Asset Management Private Limited (AMC)/Fund and undertake to inform the AMC/Fund/Registrars and Transfer Agent (RTA) in writing about any change

in the information furnished from time to time.

That in the event, the above information and/or any part of it is/are found to be false/untrue/misleading, I/We will be liable for the consequences arising there from.

I/We hereby authorize you to disclose, share, remit in any form/manner/mode the above information and/or any part of it including the changes/updates that may

be provided by me/us to the Mutual Fund, its Sponsor/s, Trustees, Asset Management Company, its employees, agents and third party service providers, SEBI

registered intermediaries for single updation/ submission, any Indian or foreign statutory, regulatory, judicial, quasi- judicial authorities/agencies including but not

limited to Financial Intelligence Unit-India (FIU-IND) etc without any intimation/advice to me/us.

I/We will indemnify the Fund, AMC, Trustee, RTA and other intermediaries in case of any dispute regarding the eligibility, validity and authorization of my/our

transactions.

The ARN holder (AMFI registered Distributor) has disclosed to me/us all the commissions (in the form of trail commission or any other mode), payable to him/them for

the different competing Schemes of various Mutual Funds from amongst which the Scheme is being recommended to me/us.

I/We hereby confirm that I/We have not been offered/ communicated any indicative portfolio and/ or any indicative yield by the fund/amc/its distributor for this

investment.

Preferred mode of payment Electronic Credit. RTGS IFSC/NEFT code will help us transfer the amount to your bank account quicker, electronically. In case the bank

does not credit my /our bank account with / without assigning any reason thereof, or if the transaction is delayed or not effected at all or credited into the wrong

account for reasons of incomplete or incorrect information, I / We would not hold PPFAS Mutual Fund responsible. Further the Mutual Fund reserves the right to issue

a demand draft / payable at par cheque in case it is not possible to make payment by DC/NEFT/ECS.

I/We acknowledge that in case any of the above specified information is found to be false or untrue or misleading or misrepresenting, I/We am/are aware that I/We

may liable for it. I/We hereby authorize you [Fund/AMC/RTA/Other participating entities] to disclose, share, remit in any form, mode or manner, all / any of the

information provided by me, including all changes, updates to such information as and when provided by me to Mutual Fund, its Sponsor, Asset Management

Company, trustees, their employees / RTAs ('the Authorized Parties') or any Indian or foreign governmental or statutory or judicial authorities / agencies including but

not limited to the Financial Intelligence Unit-India (FIU-IND), the tax / revenue authorities in India or outside India wherever it is legally required and other investigation

agencies without any obligation of advising me/us of the same. Further, I/We authorize to share the given information to other SEBI Registered Intermediaries /or any

regulated intermediaries registered with SEBI / RBI / IRDA / PFRDA to facilitate single submission / update & for other relevant purposes. I/We also undertake to keep

you informed in writing about any changes / modification to the above information in future and also undertake to provide any other additional information as may

be required at your / Fund’s end. As may be required by domestic or overseas regulators/ tax authorities, I/We authorize Fund/AMC/RTA to withhold and pay out any

sums from your account or close or suspend your account(s) without any obligation of advising me of the same