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Key Information Memorandum cum Application Form - Rrfinance.com

Key Information Memorandum cum Application Form - Rrfinance.com

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<strong>Key</strong> <strong>Information</strong> <strong>Memorandum</strong> Cum <strong>Application</strong> <strong>Form</strong>Please refer <strong>com</strong>plete details on all pages and scheme description/details while applying.Reliance Fixed HorizonFund - XXIV - Series 1(A Close Ended In<strong>com</strong>e Scheme)11th floor & 12th floor, One Indiabulls Centre, Tower 1, Jupiter Mills Compound, 841, Senapati Bapat Marg, Elphinstone Road, Mumbai - 400 013.App. No.NFO Opening Date : July 05, 2013NFO Closing Date : July 10, 2013TO BE FILLED IN CAPITAL LETTERS. Pl. use one box for each letter, leaving one box blank between two words. Please tick whichever is applicable.Tenure : 367 DaysEXISTING FOLIO NO.Broker / Agent Code Sub Broker / Sub Agent ARN Code *Employee Unique Identification Number Sub Broker / Sub Agent Code Date and Time of Receipt Registrar Serial No.*Please sign below in case the EUIN is left blank/not provided/transaction is “execution-only” in nature.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 hasnot charged any advisory fees on this transaction.SIGN HERESole / 1st applicant/Authorised Signatory2nd applicant/Authorised Signatory3rd applicant/Authorised SignatoryUpfront <strong>com</strong>mission 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.TRANSACTION CHARGES (Please tick any one of the below. Refer Instruction No. 26)I AM A FIRST TIME INVESTOR IN MUTUAL FUNDSI AM AN EXISTING INVESTOR IN MUTUAL FUNDSRs. 150 will be deducted as transaction charge for per purchase of ORRs. 100 will be deducted as transaction charge for perRs. 10,000 and morepurchase of Rs. 10,000 and moreUnitholding Option - Demat Mode Physical ModeDEMAT ACCOUNT DETAILS - (Please ensure that the sequence of names as mentioned in the application form matches with that of the account held with any one of theDepository Participant. Ref. Instruction No.21) Demat Account details are <strong>com</strong>pulsory if demat mode is opted above.NationalSecuritiesDepositoryLimitedAPPLICANT INFORMATIONMODE OF HOLDING OCCUPATION STATUS INDIVIDUAL STATUS NON-INDIVIDUALSingleBusiness Professional Service 1st Applicant Resident Indian Partnership firm FIIs SocietyJointRetired Student HousewifeNRIAnyone or Survivor(s) Civil Servant Politician Forex Dealer 2nd Applicant Resident IndianAOP/BOI Banks FIsCurrent/<strong>Form</strong>er MP/MLA/MLC/Head of StateNRITrustCompany/Body CorporateSenior Executive of State owned corporation3rd Applicant Resident IndianStudent Political Party OfficialNRIOthersHUFOthers ________________Name of Sole / 1st applicant/Minor/Karta of HUF/Non-Individual Mr. / Miss / Master / M/s.Date of Birth**D D M M Y Y Y Y(**Date of Birth Mandatory only if Applicant is Minor)Name of Parent / Guardian in case of Minor / or Contact Person for Non-Individual applicants Mr. Mrs. Miss Relation with Minor/DesignationM A N D A T O R YName of 2nd applicant Mr. Mrs. Miss Date of BirthD D M M Y Y Y YName of 3rd applicant Mr. Mrs. Miss Date of BirthD D M M Y Y Y YPERMANENT ACCOUNT NUMBER (PAN) & KYC Compliant - Mandatory (Ref. Instruction No.12 & 13)PAN/PEKRN 1st applicant Attached PAN ProofAttached KYC Acknowledgement CopyPAN/PEKRN 2nd applicant Attached PAN ProofAttached KYC Acknowledgement CopyPAN/PEKRN 3rd applicant Attached PAN ProofAttached KYC Acknowledgement CopyCONTACT DETAILSMailing Address (Please provide <strong>com</strong>plete address, P.O. Box alone is not adequate)Add 1Add 2DistrictAdd 3CityStateCountryPinOverseas Address (Mandatory for NRI/FII Applicants) Addess for Correspondence (for NRI Applicants only) Indian Foreign(Tick whicheveris applicable)Depositoryparticipant Name __________________________________________DP ID No.BeneficiaryAccount No.I NCentralDepositorySecuritiesLimitedDepositoryparticipant Name __________________________________Target ID No.City Country ZipTel. No. STD Code ______________________________ Office _____________________ Residence ____________________________ Fax ______________________________Mobile No. +________________________________________ Country CodeMobile NoE-mail ID. ___________________________________________________________________________________(Refer Instruction No. 28)*E-MAIL COMMUNICATION*If the investor has provided his E-mail Address in application form all future <strong>com</strong>munication shall be in the electronic mode.AcknowledgementReceived from _____________________________________________________________________________________________________An application for allotment of Reliance Fixed Horizon Fund - XXIV - Series 1 Growth OptionUnits underReliance Fixed Horizon Fund - XXIV - Series 1 - Direct Plan Dividend Payout Option1) Purchase <strong>Application</strong> Cheque / DD No. _________________________ Dated _____/_______/_______Rs. ___________________ Drawn on Bank ________________________________________________________________________________App. No.2) Switch Over From (Scheme) _________________________________________________________________Plan: ________________________________ Option: _____________________________________Amount Rs. Or UnitsAcceptance of the <strong>Application</strong> is subject to the application being <strong>com</strong>plete in all respects and submission of the relevant required do<strong>cum</strong>ents.Signature, Date & Stamp

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