III. INDIVIDUAL / NON-INDIVIDUAL DECLARATION:
I/We have read and understood the contents of the Scheme Information Document/s to the Scheme(s) including the sections on “Prevention of Money Laundering and Know Your Customers”. I / We hereby apply to the Trustees
of the Principal Mutual Fund (the Mutual Fund) for units of the Scheme as indicated above [“the Scheme”] and agree to abide by the terms and conditions, of the Scheme and such other scheme(s) of the Mutual Fund [Scheme(s)]
into which my/our investment may be moved pursuant to any instruction received from me/us to sweep/switch the units as applicable to my / our investment including any further transaction under the Scheme(s). I / We have not
received nor have been induced by any rebate or gifts, directly or indirectly, in making this investment. I/We further declare that the amount invested by me/us in the Scheme(s) is derived through legitimate sources and is not held
or designed for the purpose of contravention of any act, rules, and 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 further confirm that I/we have the express authority from the relevant constitution to invest in the units of the Scheme and the Principal Pnb Asset Management Company Pvt. Ltd. [AMC], its Trustee and the Mutual
Fund would not be responsible if the investment is ultra vires the relevant constitution. I/We further confirm that the ARN holder (Broker/Sub-Broker) 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(s) has been recommended to me/us. I / We authorize AMC to reject the application, reverse the
units credited, restrain me/us from making any further investment in any of the Scheme/s of Principal Mutual Fund, recover / debit my/our folio(s) with the penal interest and take any appropriate action against me/us in case the
cheque(s) / payment instrument is /are returned unpaid by my/our bank for any reason whatsoever. I/We hereby further agree that AMC can directly credit all the dividend payouts and redemption amount to my / our bank account,
where AMC has such arrangement with my / our Bank. I/We hereby agree for the AMC/Trustees to compulsorily redeem any Units held directly or beneficially by me/us if I/we fail to provide the information called for by the AMC
/ Principal Mutual Fund or if the units are found to be held in contravention of any regulatory requirements / prohibitions issued from time to time.
Applicable to NRIs only: I / We confirm that I am / we are Non- Residents of Indian Nationality / Origin and I / We hereby confirm that the funds for subscription have been remitted from abroad through approved banking
channels or from funds in my/our Non-Residents External / Ordinary Account /FCNR Account.
13 FATCA & CRS DECLARATION AND CERTIFICATION (Please consult your professional tax advisor for further guidance on FATCA & CRS classification)
PART A (to be filled by Financial Institutions or Direct Reporting NFEs)
1. We are a, Financial institution
6
or
Direct reporting NFE
7
(please tick as appropriate)
GIIN
Note: If you do not have a GIIN but you are sponsored by another entity, please provide your sponsor's GIIN above and indicate your
sponsor's name below:
Name of sponsoring entity
GIIN not available (please tick as applicable) Applied for
If the entity is a financial institution, Not required to apply for - please specify 2 digits sub-category
10
Not obtained – Non-participating FI
PART B (Please fill any one as appropriate “to be filled by NFEs other than Direct Reporting NFEs”)
1. Is the Entity a publicly traded company
1
(that is, a company whose shares are regularly traded on an established securities market)
Yes
(If yes, please specify any one stock exchange on which the stock is regularly traded)
Name of stock exchange _______________________________________________________________________
2. Is the Entity a related entity
2
of a publicly traded company
(a company whose shares are regularly traded on an established securities market)
Yes
(If yes, please specify name of the listed company and one stock exchange on which the stock is regularly traded)
Name of listed company ________________________________________________________________________
Nature of relation:
Subsidiary of the Listed Company or Controlled by a Listed Company
Name of stock exchange ________________________________________________________________________
3. Is the Entity an active
3
NFE
Yes
(If yes, please fill UBO declaration in the next section.)
Nature of Business ______________________________________________________________________________
Please specify the sub-category of Active NFE (Mention code - refer 2c of Part D)
4. Is the Entity a passive
4
NFE
Yes
(If yes, please ?ll UBO declaration in the next section.)
Nature of Business ______________________________________________________________________________
1
Refer 2a of Part D |
2
Refer 2b of Part D |
3
Refer 2c of Part D |
4
Refer 3(ii) of Part D |
6
Refer 1 of Part D |
Refer 3(vii) of Part D |
10
Refer 1A of Part D
I. FOR NON-INDIVIDUAL / ENTITY:
II. ALL APPLICANTS:
I / We 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 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.
Signature of
1st Applicant /
POA Holder / Guardian
APPLICANT SIGNATURE POA HOLDER SIGNATURE
Enclosed (please ) PAN KYC
Attach copy of PAN & KYC^)
POA Details - Enclosed Notarised Power of Attorney
Name
Signature of
2nd Applicant /
POA Holder
APPLICANT SIGNATURE POA HOLDER SIGNATURE
Enclosed (please ) PAN KYC
Attach copy of PAN & KYC^)
POA Details - Enclosed Notarised Power of Attorney
Name
PAN
Signature of
3rd Applicant /
POA Holder
APPLICANT SIGNATURE POA HOLDER SIGNATURE
Enclosed (please ) PAN KYC
Attach copy of PAN & KYC^)
POA Details - Enclosed Notarised Power of Attorney
Name
PAN
^ Refer Instruction No. D
IV. SIGNATURE:
PAN
14 CHECKLIST
Please ensure that:
All relevant particulars are filled in / ticked in the form
PAN details are furnished [Refer Instruction No. D]
KYC acknowledgement letter is enclosed [Refer Instruction No. D].
Your investment is not less than the minimum investment amount.
Your application is completed and signed by all applicants.
To prevent fraudulent practices, Investors are urged to make the payment instruments (cheque / Demand draft / Pay Order etc.) favouring "Name of the Scheme A/c. First Investor
Name" OR "Name of the Scheme A/c. Permanent Account Number" OR "Name of the Scheme A/c. Folio Number".
On the reverse of the payment instrument submitted please mention the Application Number, PAN and Name of the First Applicant.