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COMMON APPLICATION FORM

excluding for ICICI Prudential Childcare Plan (Please read the instructions before investing) Broker Code

Lumpsum Investment Systematic Investment Plan (SIP).


SIP payment options: Bank Standing Instruction Auto Debit (ECS) Post Dated Cheques

Sub-broker Code

Serial Number, Date & Time of Receipt

Upfront commission 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. Folio No. If you have an existing folio with PAN validation & KYC validation (if applicable), please mention the folio number in the space provided and proceed to Step 4.

FOR EXISTING UNITHOLDERS

[Refer to Instruction II(a)]

Application No.

ABOUT YOU

Name of First Applicant Mr. Ms. M/s. Name of Guardian (in case of minor) / Contact Person (In case of non-individual investors) Mr. Ms. Mailing Address (Please provide full address) (Mandatory)

Date: Date of Birth (Mandatory) D D M M Y Y Y Y

Status [Please tick ()] Minor NRI/PIO Resident Individual HUF Sole Proprietorship Trust Bank/FI AOP/BoI Club/Society Company

City
(Mandatory)

(Mandatory)

PIN

State
(Mandatory)

Country Tel. (Off.)

FII Partnership Firm Others (Please specify) _______________________ Mobile

Contact Details Tel. (Res.) E-Mail

Communication: As a part of the Go Green initiative, Account Statement/Annual Report/other statutory information will be sent only by email to the above mentioned email ID. Please tick () if you wish to receive Account Statement/Annual Report/other statutory information via physical documents instead of email. Overseas Address (in case of NRIs/FIIs)

City State Name of Second Applicant Mr. Ms. Name of Third Applicant Mr. Ms. PAN & KYC [Please refer the instruction Nos.II-b(4), V(l), X] (Mandatory) APPLICANT DETAILS 1st Applicant Guardian (in case 1st applicant is minor) 2nd Applicant 3rd Applicant PAN (Please attach proof) Know Your Customer (KYC) (Please ) KYC acknowledgement /Copy enclosed KYC acknowledgement /Copy enclosed KYC acknowledgement /Copy enclosed KYC acknowledgement /Copy enclosed (Refer instruction No.III) Country
(Mandatory)

ZIP/P I N
(Mandatory)

Mode of holding [Please tick ()] Single Anyone or Survivor Joint (Default option: Anyone or Survivor)

Occupation [Please tick ()] Professional Business Retired Housewife Service Student

Others (Please specify)

3
MANDATORY

BANK ACCOUNT DETAILS OF FIRST APPLICANT


Bank Particulars (Name of the Bank) Branch Address

City Account Number 9 Digit MICR code IFSC Code (11 digit) Account Type Current Savings NRO NRE If Mandatory Details are not provided, your application is liable to be rejected.

ACKNOWLEDGEMENT SLIP
(To be filled in by the investor) Received from:
ress Add

Application No.

Application for Units of ICICI Prudential_______________________________________ Option :___________________________

Signature, Stamp & Date

3
Ver01/25/May/2010

4
I

INVESTMENT DETAILS (Refer Instruction No.IV) PLANS, OPTIONS & SUB-OPTIONS (See the Key Features for Scheme specific options & sub-options)
NAME OF THE SCHEME (Please leave one box blank between words) C I C I P R U D E N T I A L [Please tick () the appropriate boxes, only if it is applicable to the scheme/plan in which you wish to invest] Retail Dividend Payout AEP-Regular* Growth/ Cumulative Institutional Dividend Reinvestment AEP-Appreciation
AEP frequency :

Dividend Frequencies:

Daily

Weekly

Fortnighly

Monthly

Quarterly

Half Yearly

Dividend Transfer Plan (DTP) (Please refer to instruction No. IV (f): Scheme Name: _______________________________________________________ Option: ______________________________________
PAYMENT DETAILS (LUMPSUM INVESTMENT / FIRST CHEQUE FOR SIP) Amount Paid (A) DD Charges (B) Rs. Bank Name & Branch City Rs. Amount Invested (C) = (A) + (B) Rs.

SIP through Standing Instruction/Direct Debit ECS PDCs SIP Frequency Monthly [Please tick()]  Quarterly (Default is Monthly) SIP TOP UP (Optional) TOP UP Amount*: Rs.________________________ *TOP UP amount has to be in multiples of Rs.500 only. TOP UP Frequency (Mandatory): Half Yearly Yearly [In case of Quarterly SIP, only Yearly frequency is available under SIP TOP UP. Please refer to the instruction V(k)]

Cheque/DD No.

Cheque/DD Date

Account Type (For NRI Investors)

D
SUBSEQUENT SIP INSTALMENT DETAILS THROUGH PDCS Cheque Number From Cheque Number To Number of Cheques Installment Amount SIP Date Start From End to

D
Rs.

NRO

NRE

FCNR

7th

10th

15th

25th

Drawn on Bank & Branch

*Cumulative AEP Regular Option : Encashment of Units is subject to declaration of dividend in the respective Scheme(s). Please refer to instruction no. IV(c).

Trigger Please () (Trigger can be done only from ICICI Prudential Target Returns Fund Growth sub-option)
NAV appreciation (Please ) ICICI Prudential Liquid Plan 12% 20% 50% 100% Trigger Amount Plan A Plan B Appreciation amount only All units Appreciation Regular Amounts/units to be triggered to Retail Option under (Please ): ICICI Prudential Floating Rate Plan ICICI Prudential Short Term Plan ICICI Prudential Flexible Income Plan Default Trigger Options: NAV appreciation: 20%; Scheme: ICICI Prudential Liquid Plan - Growth Option. *Cumulative - AEP Regular option: Encashment of units is subject to declaration of dividend into respective scheme(s). Sub-options (Please  ): Growth AEP*Growth/Cumulative

ICICI Prudential Income Plan

Dividend Pay-out

Dividend Reinvestment

Micro SIPs Please () (Investment of equal to or less than Rs.50,000/- per annum under SIP registration) (Please refer instruction No. V(l))
Photo Identifcation Document Type (Mandatory) (Only in case of PAN not provided) 1st Applicant 2nd Applicant 3rd Applicant ID Card No. / Reference No.

NOMINATION DETAILS (Optional) For Single nomination, please fill in the details below. For multiple nominations, please use the form available separately. I/We hereby nominate the undermentioned Nominee to receive the amounts to my/our credit in event of my/our death. I/We also understand that all payments and settlements made to such Nominee and signature of the Nominee acknowledging receipt thereof, shall be a valid discharge by the AMC / Mutual Fund / Trustees. Date of Birth (If nominee is minor) Name of the Nominee
Mr. Ms. M/s. Address of Nominee (Please provide full address) D D M M Y Y Y Y

PIN Code

Name of the Guardian (If nominee is minor) - Mnadatory Address of Guardian


PIN Code

Relationship with minor Signature of Guardian

YOUR CONFIRMATION/DECLARATION
First Applicant

The Trustee, ICICI Prudential Mutual Fund, I/We have read and understood the Scheme Information DD MM YYYY Document/Key Information Memorandum of the Scheme(s). I/We apply for the units of the Fund and agree to abide by the terms, conditions, rules and regulations of the scheme and other statutory requirements of SEBI, AMFI, Prevention of Money Laundering Act, 2002 and such other regulations as may be applicable from time to time.I/We confirm to have understood the investment objectives, investment pattern, and risk factors applicable to Plans/Options under the Scheme(s). I/we have not received nor been induced by any rebate or gifts, directly or indirectly, in making this investment. I/We declare that the amount invested in the Scheme is through legitimate sources only and is not designed for the purpose of contravention or evasion of any Act, Regulations or any other applicable laws enacted by the Government of India or any Statutory Authority. I/We agree that in case my/our investment in the Scheme is equal to or more than 25% of the corpus of the plan, then ICICI Prudential Asset Management Co. Ltd.(the 'AMC'), has full right to refund the excess to me/us to bring my/our investment below 25%. I/We hereby declare that I am/we are not US Person(s). I/We hereby declare that I/we do not have any existing Micro SIPs which together with the current application will result in a total investments exceeding Rs.50,000 in a year. The ARN holder 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 interested in receiving promotional material from the AMC via mail, SMS, telecall, etc. If you do not wish to receive, please call on tollfree no. 1800 222 999 (MTNL/BSNL) or 1800 200 6666 (Others).

SIGNATURE(S)

Second Applicant

Third Applicant

Drawn on (Name of Bank & Branch)

FOLIO No.: _________________________________


Cheque/DD No. Dated Amount (Rs.)

ACKNOWLEDGEMENT SLIP
(To be filled in by the investor) SIP TOP UP Amount Rs.______________________________ Frequency: Half Yearly Yearly
Note: All future communications in connection with this application should be addressed to the nearest ICICI Prudential Customer Service Centre, quoting full name of the first applicant, the application serial number, the name of the scheme, the amount invested, date and the place of the Customer Service Centre where application was lodged.

Ver01/25/May/2010

Application Form for Debt Schemes


Continuing a tradition of trust.
HDFC INCOME FUND l HDFC SHORT TERM PLAN l HDFC LIQUID FUND HDFC HIGH INTEREST FUND l HDFC FLOATING RATE INCOME FUND HDFC CASH MANAGEMENT FUND l HDFC GILT FUND

CD

Offer of Units At NAV Based Prices


Investors must read the Key Information Memorandum and the instructions before completing this Form.

KEY PARTNER / AGENT INFORMATION


Name and AMFI Reg. No. (ARN) Sub Agents Name and Code

FOR OFFICE USE ONLY


Date of Receipt Folio No. Branch Trans. No. ISC Name & Stamp

ARN1. EXISTING UNIT HOLDER INFORMATION (If you have existing folio, please fill in your folio number, complete details in section 2 and proceed to section 6. Refer instruction 2).
Folio No. The details in our records under the folio number mentioned alongside will apply for this application.

2. PAN AND KYC COMPLIANCE STATUS DETAILS (MANDATORY)


PAN # (refer instruction 13) First / Sole Applicant / Guardian * Second Applicant Third Applicant KYC Compliance Status** (if yes, attach proof) Yes Yes Yes
STATUS (of First/Sole Applicant) MODE OF HOLDING

No No No
OCCUPATION (of First/Sole Applicant)

*If the first/sole applicant is a Minor, then please state the details of Guardian. # Please attach PAN proof. If PAN is already validated, please dont attach any proof. ** Refer instruction 15

3.

[Please tick (4)] Resident Individual HUF Minor through guardian Society / Club NRI Partnership Trust AOP Company FIIs BOI Body Corporate Others _____________________ (please specify)

[Please tick (4)] Single Joint Anyone or Survivor

[Please tick (4)] Service Student Professional Housewife Business Retired Agriculture Others ________________ (please specify)
DATE OF BIRTH
DD MM YYYY

4. UNIT HOLDER INFORMATION (refer instruction 3)


NAME OF FIRST / SOLE APPLICANT Mr. Ms. M/s.

Nationality NAME OF GUARDIAN (in case of First / Sole Applicant is a Minor) / CONTACT PERSON DESIGNATION (in case of non-individual Investors) Mr. Ms. Nationality

NAME OF THE SECOND APPLICANT


Mr. Ms. Nationality NAME OF THE THIRD APPLICANT Mr. Ms. Nationality

Resident Individual

NRI [Mandatory Please tick (4)]

Resident Individual

NRI [Mandatory Please tick (4)]

MAILING ADDRESS OF FIRST / SOLE APPLICANT (P.O. Box Address may not be sufficient)

CITY

STATE

PIN CODE

OVERSEAS ADDRESS (in case of NRIs/FIIs) (P.O. Box Address may not be sufficient)

CONTACT DETAILS OF FIRST / SOLE APPLICANT Telephone : Off. Fax E-Mail

STD Code Res. Mobile

5. BANK ACCOUNT DETAILS (refer instruction 4) Please note that as per SEBI Regulations it is mandatory for investors to provide their bank account details
Account No. Branch Account Type [Please tick (4)] SAVINGS CURRENT Name of the Bank Bank City NRE Account Statement NRO Newsletter Annual Report FCNR Other Statutory Information

I/We wish to receive the following documents via 6. E-MAIL COMMUNICATION (refer instruction 7) e-mail in lieu of physical document(s) [Please (4)]

7. ELECTRONIC CLEARING SERVICE (ECS) (refer instruction 8)


You may choose to receive dividend, if declared, in your bank account through the Electronic Clearing Service. I / We authorise HDFC Mutual Fund to credit my / our dividend through ECS. Please (4) The 9 digit MICR Code number of my/our Bank & Branch is : (The 9 digit code appears on your cheque next to the cheque number)

8.

HDFCMFOnline PERSONAL IDENTIFICATION NUMBER (HPIN) (refer instruction 10)


Do you want a HPIN assigned ? Yes No

... continued overleaf

ACKNOWLEDGEMENT SLIP (To be filled in by the Investor) HDFC MUTUAL FUND


Head office : Ramon House, 3rd Floor, H.T. Parekh Marg, 169, Backbay Reclamation, Churchgate, Mumbai 400020 Date : Received from Mr. / Ms. / M/s. an application for Purchase of Units of HDFC Income Fund HDFC Short Term Plan HDFC Liquid Fund HDFC High Interest Fund HDFC Floating Rate Income Fund HDFC Cash Management Fund HDFC Gilt Fund alongwith Cheque / DD as detailed overleaf. Please Note : All Purchases are subject to realisation of cheques / demand drafts.

CD
ISC Stamp & Signature

9.

INVESTMENT DETAILS Please (4) Choice of Scheme / Plan / Option (refer instruction 5)

HDFC Income Fund


Growth Option Dividend Option
Payout Reinvestment

HDFC Short Term Plan


Growth Option Dividend Option
Reinvestment Only

HDFC Liquid Fund


Growth Option Dividend Option Daily Dividend Weekly Dividend Option Option Reinvestment Only Payout Reinvestment Growth Option Monthly Dividend Option Payout Reinvestment

HDFC Liquid Fund Premium Plan


Dividend Option Daily Dividend Option Weekly Dividend Option Reinvestment Only Payout Reinvestment

HDFC High Interest Fund-STP


Growth Option Dividend Option (Monthly)
Payout Reinvestment

HDFC Liquid Fund Premium Plus Plan


Growth Option Weekly Dividend Option Payout Reinvestment Long Term Plan Growth Option Dividend Option Reinvestment Only

HDFC High Interest Fund


Growth Plan Dividend Plan Quarterly Dividend
Payout Reinvestment

HDFC Floating Rate Income Fund


Yearly Dividend
Payout Reinvestment

Half-Yearly Dividend
Payout Reinvestment

Short Term Plan Wholesale Option Growth Option

Retail Option Dividend Option Daily (Reinvestment Only) Weekly Monthly Payout Reinvestment

HDFC Cash Management Fund


Savings Plan Savings Plus Plan Growth Option Wholesale Option Dividend Option Growth Daily (Reinvestment only) Weekly Payout Reinvestment Retail Option Dividend Daily (Reinvestment Only) Weekly Monthly Payout Reinvestment Call Plan Growth Option Daily Dividend Reinvestment Only Short Term Plan Growth Option Dividend Option
Payout Reinvestment

HDFC Gilt Fund


Long Term Plan Growth Option Dividend Option
Payout Reinvestment

10. PAYMENT DETAILS (refer instruction 6) Scheme Name Cheque / DD No. Amount of Cheque/DD in figures (Rs.) (i) DD charges, if any, in figures (Rs.) (ii) Total Amount (i) + (ii)
Account Type [Please (4)]

Plan Cheque / DD Date Drawn on (Bank / in figures (Rs.) in words


SAVINGS CURRENT NRE

Option

Branch Name) Account No. (For Cheque only)


NRO FCNR

11. NOMINATION (refer instruction 12) I / We do hereby nominate the person more particularly described hereunder to receive the amount to my / our credit in event of my / our death.

NOMINEE DETAILS
Name Address Date of Birth Relationship : : :
(to be furnished in case the Nominee is a minor)

The Nominee is a minor whose guardian is Address of the Guardian

: :

Signature of the Guardian


(to be deleted if not applicable)

Note : The Nomination shall supercede previous nomination in the folio, if any.

12. DOCUMENTS ENCLOSED (Please 4) Memorandum & Articles of Association Trust Deed Bye-Laws Partnership Deed Resolution / Authorisation to invest List of Authorised Signatories with Specimen Signature(s)

APPLICATIONS ENCLOSED (Please 4)


Systematic Investment Plan Cheques SIP Auto Debit Facility STP Enrolment Form

Power of Attorney

13. DIRECT CREDIT OF REDEMPTION / DIVIDEND PROCEEDS - IF ANY (refer instruction 9)


Unitholders having bank accounts with ABN AMRO Bank NV, Axis Bank Limited, Citibank N.A, Centurion Bank of Punjab Ltd., Deutsche Bank AG, HDFC Bank Limited, The Hongkong and Shanghai Banking Corporation, ICICI Bank Limited, IDBI Bank Limited, Kotak Mahindra Bank Ltd., Standard Chartered Bank and YES Bank Limited will receive their redemption / dividend proceeds (if any) directly into their bank account (as furnished in Section 5). In case you wish to receive a cheque / demand draft, please indicate your preference below : I / We want to receive the redemption / dividend proceeds (if any) by way of a cheque / demand draft instead of direct credit into my / our bank account. (Please 4 in this box)

14. DECLARATIONS & SIGNATURE/S (refer instruction 11)


S I G N AT U R E / S
I / We have read and understood the terms and contents of the Offer Documents of the respective Scheme(s) of HDFC Mutual Fund. I / We hereby apply to the Trustee of HDFC Mutual Fund for allotment of Units of the Scheme(s) of HDFC Mutual Fund, as indicated above and agree to abide by the terms, conditions, rules and regulations of the relevant Scheme(s). I / We have understood the details of the Scheme(s) and I / we have not received nor been induced by any rebate or gifts, directly or indirectly, in making this investment. I/We hereby declare that I/We am/are authorised to make this investment and that the amount invested in the Scheme is through legitimate sources only and does not involve and is not designed for the purpose of any contravention or evasion of any Act, Rules, Regulations, Notifications or Directions issued by any regulatory authority in India. I/We declare that the information given in this application form is correct, complete and truly stated. Applicable to NRIs only : I / We confirm that I am / We are Non-Resident of Indian Nationality / Origin and I / We hereby confirm that the funds for subscription have been remitted from abroad through normal banking channels or from funds in my / our Non-Resident External / Ordinary Account / FCNR Account.

First / Sole Applicant / Guardian Second Applicant

Please write Application Form No. / Folio No. on the reverse of the Cheque / Demand Draft.

Please (4) If yes, (4)

Yes No Repatriation basis Non-repatriation basis

DD

MM

YYYY

Third Applicant

Particulars
Scheme Name / Plan / Option Cheque / DD No. / Date Drawn on (Name of Bank and Branch) Amount in figures (Rs.)

SCHEME NAME / PLAN / OPTION

SCHEME NAME / PLAN / OPTION

WE00118715

WE00118715

WE00118715

Application Form
For Office Use Only D D M M
Channel Partner / Agent Information Agents Name and ARN 1.Sub Agent Code 2.Sub Agent Code 3.Sub Agent Code

1. Existing Investor Information (Please fill in your Folio No. and then proceed to Section 3) Please note that applicant details and mode of holding will be as per existing Folio Number. 2. New Investor Information (refer instruction 2) Name of First/Sole Applicant

CAMS Folio No

Permanent Account Number

KYC completed s Yes s No Date of Birth

Name of Guardian (in case of First / Sole Applicant is a Minor) / Contact Person Designation (in case of non-individual Investors)

Permanent Account Number Mailing Address of First / Sole Applicant

KYC completed s Yes s No

Relationship

CITY

STATE STD Code Mobile

PIN CODE

Contact Details of First / Sole Applicant


Telephone E-Mail

Mode of Holding [Please ()] s Single s Joint

Status of First / Sole Applicant [Please ()] s Individual s Minor through guardian s HUF s Company s Body Corporate s Trust s Others ____________________________ (please specify) s Partnership s Mutual Fund s Society/Club s Fund of Funds in India

s Anyone or Survivor

Monthly Income (optional): s < Rs 10,000 s < Rs 25,000 s < Rs 50,000 s < Rs 1,00,000 s > Rs 1,00,000 Profession:.......................................... Name of Second Applicant

Permanent Account Number Name of Third Applicant

KYC completed s Yes s No

Permanent Account Number

KYC completed s Yes s No 3B. Plans (refer instruction 3) s Regular Plan s Institutional Plan (for eligibility to avail the Institutional Plan, refer instructions, KIM and Offer Document) 3C. Options (refer instruction 3) s Growth s Dividend Payout s Dividend Re-investment (If you do not indicate an option, for default option refer instruction 3)

3A. Please tick the fund you wish to invest and make Cheque/DD in the chosen fund name (refer instruction 3) s Sundaram BNP Paribas Select Focus s Sundaram BNP Paribas Select Midcap s Sundaram BNP Paribas Growth Fund s Sundaram BNP Paribas S.M.I.L.E Fund s Sundaram BNP Paribas India Leadership s Sundaram BNP Paribas Tax Saver s Sundaram BNP Paribas CAPEX Opportunities s Sundaram BNP Paribas Rural India s Sundaram BNP Paribas Balanced Fund

Acknowledgement Sundaram BNP Paribas Asset Management, II Floor, 46 Whites Road, Chennai - 600 014. Toll Free: 1800-425-1000 (MTNL/BSNL) Ph : (044) 28578700

Received From Mr./Mrs./Ms. ....................................................................................................................................................... Address ....................................................................................................................................................................................... ....................................................................................................................................................................................................


Communication in connection with the application should be addressed to the Registrar Computer Age Management Services (P) Ltd., (Unit: Sundaram BNP Paribas Mutual Fund), Rayala Towers 3, 1st Floor, No. 158, Anna Salai, Chennai 600 002. Tel: (044) 30212401/02/03/04 / 28521596 / 28520516 / 28520788 quoting full name of Sole/First applicant, Application Form No., Date, Name of the Bank & Branch and Centre where it was lodged.

ISCs Signature & Stamp Please Note: All Purchases are subject to realisation of cheques / demand drafts.

www.sundarambnpparibas.in

Sundaram BNP Paribas Asset Management

Application Form
4. How do you wish to receive the following (refer instruction 4)

Account Statement
s E-Mail s Courier s Post

Dividend
s Direct Credit (DC) s Electronic Clearing Service (ECS) s RTGS/NEFT s Warrant

Redemption
s Direct Credit (DC) s RTGS/NEFT s Warrant

Direct Credit is now available with: ABN Amro Bank, AXIS Bank, BNP Paribas Bank, Citibank, HDFC Bank, HSBC Bank, ICICI Bank, IDBI Bank, IndusInd Bank, Kotak Mahindra Bank, Standard Chartered Bank, YES Bank. Do you wish to receive updates (refer instruction 4) [Please ()] by E-Mail s Yes s No 5. Please indicate details of your SIP (skip this section if you wish to make a one-time investment) Each SIP Amount Rs SIP Period Mode of SIP or by SMS s Yes s No s Auto Debit (also submit SIP Auto Debit form) s Post-dated cheques Number of SIP installments s 1 year s 2 years s 3 years s 5 years s 10 years s others.........................
from M M Y
Y Y Y

(Minimum amount Rs 250/- Minimum No of installments 20) SIP Frequency s Monthly (Minimum amount Rs 750/- Minimum No of installments 7) s Quarterly SIP Date s 1 s 7 s 14 s 20 s 25
If you opt for SIP through post dated cheques, please indicate

to

M M

First SIP Cheque No

Last SIP Cheque No

6. Bank Account Details are Mandatory (refer instruction 6) Name of the Bank Branch Address Account No If you opt for ECS fill Cheque MICR No Account Type [Please ()] s SAVINGS s CURRENT s Others............................................................................ RTGS / NEFT IFSC Code Branch City (redemption & dividend will be payable at this location)

If you have chosen RTGS / NEFT please fill: Beneficiary Name Name of the Bank

Branch

City

7. Payment Details (refer instruction 7) Please issue a separate Cheque/Demand Draft in favour of the fund you wish to invest Cheque / DD No. Amount in words (Rs) Amount in figures (Rs) DD Charges Net Amount Date

D D M M Y

Drawn on Bank Branch Name

8. Receive PIN to track investment online [Please ()] (refer instruction 8) s Yes s No First / Sole Applicant / Guardian

10. Signature/s (refer instruction 10)

Declaration: I/We having read and understood the contents of the Offer Document hereby apply for units as indicated in the application form agree to abide by the terms, conditions, rules and regulations of the scheme have not received nor been induced by any rebate or gifts, directly or indirectly in making this investment.

9. Nominee (available only for individuals) (refer instruction 9) Name:....................................................................................................... Address:.................................................................................................... ................................................................................................................. If nominee is a minor: Nominees date of birth:........................Relationship:................................ Name of Guardian:.................................................................................... Address of Guardian:................................................................................. ................................................................................................................. ................................................................................................................. Signature of Nominee/Guardian of Nominee:

Second Applicant

Third Applicant

.................................................................................................................

Scheme Name:
Cheque / DD No. Amount in words (Rs) Amount in figures (Rs) DD Charges Net Amount

s Regular Plan s Institutional Plan

s Growth s Dividend Payout s Dividend Re-investment


Date

Drawn on Bank Branch Name

www.sundarambnpparibas.in

Sundaram BNP Paribas Asset Management

SBNPP-KIM-EQ/May 08

D D M M Y

Common Application Form for Equity, Monthly Income and Balanced Schemes
(For Lumpsum / Systematic Investments) Sr. No.:
1.

Please refer the instructions while filling the Application Form. Tick (3) whichever is applicable. (Strike out which is not required)
DISTRIBUTOR INFORMATION (Only empanelled Distributors / Brokers will be permitted to distribute Units of Tata Mutual Fund) Sub-Broker Code Distributor / Broker ARN

Upfront commission 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.

Existing Folio Number: MICRO SIP - Refer instruction E

SIP Form Attached

For Micro SIP please mention MICROSIP in PAN area for 1st applicant / Guardian / 2nd applicant / 3rd applicant wherever applicable. Mentioning the date of Birth in section 4 below mandatory for Micro SIP applications. Micro SIP document submitted (any one mentioned in the instruction {E.2} :_______________________________________________________________________________ Document Enclosed Document Id Validity of document First Second Third I/We hereby declare that I/We do not have any existing Micro SIPs which together with the current application will result in aggregate investments exceeding Rs.50,000/- in a year.

MANDATORY [Please tick (3 )] (Refer Instruction - F)


APPLICANT DETAILS FIRST APPLICANT SECOND APPLICANT THIRD APPLICANT GUARDIAN/POA HOLDER PAN * please attach proof
Proof Proof Proof Proof

Know Your Client (KYC)


KYC Complied KYC Complied KYC Complied KYC Complied

STATUS Resident Individual Partnership Societies NRI/NRO Public Ltd. Co. HUF NRI/NRE Pvt. Ltd. Co. PIO Trust FII Body Corporate Proprietorship On behalf of Minor FOF Please specify Others _______________________________________________

2. SOLE / FIRST APPLICANTS PERSONAL DETAILS (Please fill in Block Letters use one box for one alphabet leaving one box blank between two words, as it appears in your Bank Account) Name Mr Ms M/s D D M M Y Y Y Y Status: (3) RI NRI

Date of Birth Name

Guardian Name (in case of Minor) Contact Person - Designation (non individual) / PoA Holder (investments made of constitutional attorney). Mr Ms M/s

Date of Birth D D M M Y Y Y Y Status: (3) RI NRI Address [P O. Box Address is not sufficient] (Indian address in case of NRIs / FIIs) .

City State Country Extn. Fax Mobile

Pin code Mandatory

Contact Details
Phone O R e-mail

I/We wish to receive the following via e-mail in lieu of physical document(s) (Please 3 ) Account Statement Overseas Address (Mandatory in case of NRI / FII applicant in addition to mailing address)

Annual Report

Other Communication

City State Country Zip code I/We confirm that I am/we are non-residents of indian nationality/origin & that I/We have remitted funds from abroad through approved banking channels or from funds in my/our NRE/FCNR Account.

Occupation (please 3)

Agriculture

Business

Service

Professional

Housewife

Retired

Student

Other

3. JOINT APPLICANTS DETAILS Second Applicant


Name Mr Ms M/s D D M M Y Y Y Y Status: (3) RI NRI

Date of Birth

Third Applicant
Name Mr Ms M/s D D M M Y Y Y Y Status: (3) Joint OR RI NRI Default Option: Joint

Date of Birth

Mode of Holding (please 3)

Single OR

Anyone or Survivor

ACKNOWLEDGEMENT SLIP (To be filled by the investor)


Received from Mr. / Ms. / M/s. an application for Units of Plan alongwith Cheque / DD No. Option Dated Amount (Rs.) Sub-option

Sr. No.:

Drawn on (Bank) Signature, Stamp & Date

Subject to realisation of cheque / Demand Draft and verification of mandatory information / document.

4. FIRST HOLDERS BANK ACCOUNT DETAILS (Mandatory) Refer Instruction G All communication/payments will be made to first applicant or to Karta in case of HUF. Bank account details of First Unitholder required without which the application would be rejected Name of the Bank Branch Account No. (in Fig.) Account No. (in words) Bank Address City PIN
* IFSC Code for NEFT

Account Type

Savings

Current

NRO

NRNR

NRE

State
MICR Code

(To be filled in only if dividend is to be paid through ECS). 6 Six 1 One 5 Five 2 Two

Example for filling the Account No.

Ac. No. In words

9 Nine

7 Seven

4 Four

* This is a 11 Digit Number, kindly obtain it from your Bank Branch.

(Please attach copy of cancelled cheque)

5. DIRECT CREDIT FACILITY FOR REDEMPTION / DIVIDEND / REFUND PAYOUTS Tata Mutual Fund directly credits the Redemption/Dividend/Refund payout into the investors Bank Account in case the account is with ICICI Bank Ltd./HDFC Bank Ltd./Axis Bank/IDBI Bank/Standard Chartered Bank/Kotak Mahindra Bank/HSBC Bank/Deutsche Bank/ABN Amro Bank/Oriental Bank of Commerce/ Centurion Bank of Punjab/State Bank of India (Core banking centers only - subject to validation). I/We understand that the instruction to the bank for Direct Credit/NEFT/ECS will be given by the Mutual Fund & such instruction will be adequate discharge of Mutual Fund towards redemption/dividend/refund proceeds. In case of bank not crediting my/our bank account with/without assigning any reason thereof or if the transaction is delayed or not effected at all for reasons of incomplete or incorrect information, I/We would not hold Tata Mutual Fund responsible. I/We understand that in case account number furnished by me/us, if found incorrect, I/We would not hold Tata Mutual Fund responsible for the credit going to the wrong account. 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. If however you wish to receive payouts by cheque, please tick here 6. SCHEME DETAILS Refer Page 3 & 4 for correct scheme name Scheme Name ______________________________________________________________________ Plan __________________________________________________________ Options ____________________________________________________________________________ Dividend Frequency [A] INVESTMENT DETAILS (Strike off whichever is not applicable) Gross Amount (A) DD Charges (if any) (B) Net Amount (Cheque / DD Amount) Rs. Rs. A A A minus B Dated Mode of Payment A/c No. _________________________ A/c Type __________________________ Cheque / DD No. __________________________ D D M M Drawn on Bank Branch Branch City [B] SYSTEMATIC INVESTMENT Installment Amount (Rs.) No. of Installments Rs. x First SIP Installment Cheque Details : Cheque No. Rs. SIP Date (Please 3 ) Drawn on Bank Branch City 1st OR 07th OR

Total Amount = Rs. Dated 10th OR 20th OR

SIP Period From M M

Y Y Y

Y Y

Y Y

To

M M

D D
25th

M M

SIP Frequency (Please 3)

Monthly

OR

Quarterly

SIP THROUGH AUTO-DEBIT (ECS) Please fill up enclosed SIP Auto Debit (ECS) Facility Form and submit it together with this Application Form. Name and Address of the Nominees(s) Proportion (%) by which the units Nominees Relationship shared by will be shared by each with the nominee (% to aggregate to 100%) 1st unitholder

SIP THROUGH POST-DATED CHEQUES

Please fill attached SIP form for Post Dated Cheques (PDCs)
Date of Birth Name & Address of Guardian Signature of Guardian

7. NOMINATION DETAILS (To be filled in by Individual(s) applying singly or jointly) Refer Instruction - J
(to be furnished in case the nominee is minor)

Nominee 1 Nominee 2 Nominee 3 8. DECLARATION AND SIGNATURES. Refer Instruction - C


The Trustee, Tata Mutual Fund a) Having read & understood the contents of the Offer Document of the Scheme, I/ We hereby apply for units of the scheme & agree to abide by the terms, conditions, rules & regulations governing the scheme. I/ We hereby declare that the amount invested in the scheme is through legitimate sources only & does not involve & is not designed for the purpose of the contravention of any Act, Rules, Regulations, Notifications or Directions of the provisions of the Income Tax Act, Anti Money Laundering Laws, Anti Corruption Laws or any other applicable laws enacted by the Govt of India from time to time. I/ We have understood the details of the scheme & I/ We have not received nor have been induced by any rebate or gifts, directly or indirectly in making this investment. I/ We confirm that the funds invested in the Scheme, legally belong to me / us. In the event Know Your Customer process is not completed by me/us to the satisfaction of the AMC, I/ We hereby authorise the AMC, to redeem the funds invested in the Scheme, in favour of the applicant at the applicable NAV prevailing on the date of such redemption & undertaking such other action with such funds that may be required by the Law. b) For NRls: I/ We confirm that I am / we are Non Residents of Indian Nationality / Origin & that I / we have remitted funds from abroad through approved banking channels or from funds in my / our Non-Resident External / Non-Resident Ordinary. c) The ARN holder 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. d) I/ We confirm that details provided by me / us are true and correct. e) I/We have read & understood the SEBI Circular No. MRD/DoP/Cir-05/2007 dt. April 27, 2007 & SEBI Circular No. 35/MEMCOR/18/07-08 dt. June 26, 2007 regarding mandatory requirement of PAN. I/We confirm that I/we are holding valid PAN card. f) For Micro SIP: I/We hereby declare that I/We do not have any existing Micro SIPs which together with the current application will result in aggregate investments exceeding Rs.50,000/- in a year. Date: _____________________

1st Unitholder Signature / Thumb Impression

2nd Unitholder Signature / Thumb Impression

3rd Unitholder Signature / Thumb Impression

CHECKLIST
Tata Mutual Fund: Toll Free No. 1800-209-0101 (Open on all days). Email: kiran@tataamc.com, Website: www.tatamutualfund.com. Checklist: Documents as listed below are submitted along with this application . Document List Document List Document List 9. Overseas Auditors Certificate 10. Notarised Power of Attorney 11. Foreign Invest Remittance Certificate (FIRC) 12. MICROSIP document 13. Others _______________________________ All documents in 3 to 8 above should be originals / true copies certified by the Directors / Trustee / Company Secretary / Authorised Signatory / Notary Public.
1. 2. 3. 4. PAN KYC Resolution / Authorisation to invest Authorised Signatories List with Specimen Signature 5. 6. 7. 8. Memorandum & Articles of Association Trust Deed Bye-Laws Partnership Deed

Application Form for Equity, Balanced, MIP and ELSS Schemes


Continuing a tradition of trust.
HDFC GROWTH FUND l HDFC EQUITY FUND l HDFC TOP 200 FUND l HDFC CAPITAL BUILDER FUND HDFC BALANCED FUND l HDFC PRUDENCE FUND l HDFC LONG TERM ADVANTAGE FUND (an open - ended equity linked savings scheme with a lock-in period of 3 years) l HDFC TAXSAVER (an open - ended equity linked savings scheme with a lock-in period of 3 years) l HDFC INDEX FUND l HDFC CORE & SATELLITE FUND HDFC ARBITRAGE FUND l HDFC PREMIER MULTI-CAP FUND l HDFC MF MONTHLY INCOME PLAN (an open-ended income scheme. Monthly income is not assured and is subject to availability of distributable surplus)

CEQ

Offer of Units At NAV Based Prices


Investors must read the Key Information Memoramdum and the instructions before completing this Form. The Application Form should be completed in English and in BLOCK LETTERS only.

KEY PARTNER / AGENT INFORMATION


Name and AMFI Reg. No. (ARN) Sub Agents Name and Code / Bank Branch Code M O Code

FOR OFFICE USE ONLY


Date of Receipt Folio No. Branch Trans. No. ISC Name & Stamp

ARN1. EXISTING UNIT HOLDER INFORMATION (If you have existing folio, please fill in your folio number, complete details in section 2 and proceed to section 6. Refer instruction 2).
Folio No. The details in our records under the folio number mentioned alongside will apply for this application.

2. PAN AND KYC COMPLIANCE STATUS DETAILS (MANDATORY)


PAN # (refer instruction 12) First / Sole Applicant / Guardian Second Applicant Third Applicant KYC Compliance Status (Mandatory for Rs.50,000 & above)** (if yes, attach proof) Yes No Yes No Yes No
OCCUPATION (of First/Sole Applicant)

3.

# Please attach PAN proof. If PAN is already validated, please dont attach any proof. ** Refer instruction 14 STATUS (of First/Sole Applicant) MODE OF HOLDING

[Please tick (4)] Resident Individual Trust Minor through guardian Society / Club NRI-Repatriation NRI-Non-Repatriation HUF AOP PIO Company BOI Body Corporate Others _____________________ (please specify) Partnership FIIs

[Please tick (4)] Single Joint Anyone or Survivor

[Please tick (4)] Service Student Professional Housewife Business Retired Agriculture Proprietorship Others ________________ (please specify)
DATE OF BIRTH (Mandatory in case of Minor)

4a. UNIT HOLDER INFORMATION (refer instruction 3)


NAME OF FIRST / SOLE APPLICANT Mr. Ms. M/s.

DD

MM

YYYY

Nationality NAME OF GUARDIAN (in case of First / Sole Applicant is a Minor) / NAME OF CONTACT PERSON DESIGNATION (in case of non-individual Investors) Mr. Ms. Nationality NAME OF THE SECOND APPLICANT Mr. Ms. Nationality NAME OF THE THIRD APPLICANT Mr. Ms. Nationality MAILING ADDRESS OF FIRST / SOLE APPLICANT (P.O. Box Address may not be sufficient) Resident Individual NRI [Mandatory Please tick (4)] Resident Individual Designation NRI [Mandatory Please tick (4)] Contact No.

CITY

STATE

PIN CODE

OVERSEAS ADDRESS (Mandatory in case of NRIs/FIIs) (P.O. Box Address may not be sufficient)

CONTACT DETAILS OF FIRST / SOLE APPLICANT Telephone : Off. Fax E-Mail

STD Code Res. Mobile

4b. POWER OF ATTORNEY (PoA) HOLDER DETAILS


NAME OF PoA Mr. Ms. M/s. PAN* [Please tick (4)] KYC Compliance Status Proof** * Refer Instruction 12 ** Refer Instruction 14

5. BANK ACCOUNT DETAILS OF FIRST / SOLE APPLICANT (refer instruction 4a) Please note that as per SEBI Regulations it is mandatory for investors to provide their bank account details
Account No. Branch IFSCCode*** *** Refer Instruction 4b (Mandatory for Credit via NEFT / RTGS) (11 Character code appearing on your cheque leaf. If you do not find this on your cheque leaf, please check for the same with your bank) Account Type [Please tick (4)] Name of the Bank Bank City SAVINGS CURRENT NRE NRO FCNR OTHERS______________ (please specify) (The 9 digit code appears on your cheque next to the cheque number)

6.

eSERVICES OPTIONS (SAVE PAPER, SAVE TREES) [Please tick (4)] (refer instruction 9)
i)

The 9 digit MICR Code number of my/our Bank & Branch is**: ** Refer Instruction 8 (Mandatory for Dividend Payout via ECS)

- I/ We would like register for my/our HDFCMF Personal Identification Number (HPIN) to transact online. Mandatory information to be provided: a) Email address: _______________________________________________________________________________ _______________________________________________ (if the address given herein is different from the email address under section 4a, the email address under section 6(i) will be considered during registration for HPIN). b) Mother's maiden name: ______________________________________________________________________________________________________________________________ I/ We have read and understood the terms and conditions and confirm I/ we shall bound by them (Terms & Conditions available in the eServices booklet as well as on our website) ii) : I/ We wish to receive account statements, newsletters, annual reports and other statutory information documents by email in lieu of physical documents (Email address is mandatory). : I/ We would like to receive SMS updates (Mobile number in section 4a is mandatory). iii)
... continued overleaf

Head office : Ramon House, 3rd Floor, H.T. Parekh Marg, 169, Backbay Reclamation, Churchgate, Mumbai 400020 Date : Received from Mr. / Ms. / M/s. an application for Purchase of Units of HDFC Growth Fund HDFC Equity Fund HDFC Top 200 Fund HDFC Capital Builder Fund HDFC Balanced Fund HDFC Prudence Fund HDFC Long Term Advantage Fund HDFC TaxSaver HDFC Index Fund HDFC MF Monthly Income Plan HDFC Core & Satellite Fund HDFC Arbitrage Fund HDFC Premier Multi-Cap Fund Please Note : All Purchases are subject to realisation of cheques / demand drafts. alongwith Cheque / DD as detailed overleaf.

ACKNOWLEDGEMENT SLIP (To be filled in by the Investor) [For any queries please contact our nearest Investor Service Centre or call us at our Customer Service Number 60006767 (do not prefix STD code) or 18002336767 (Toll Free)] HDFC MUTUAL FUND CEQ
ISC Stamp & Signature

7.

INVESTMENT DETAILS Please (4) Choice of Scheme / Plan / Option (refer instruction 5)

HDFC Growth Fund


Growth Plan Dividend Plan
Payout Reinvestment

HDFC Equity Fund


Growth Plan Dividend Plan
Payout Reinvestment

HDFC Top 200 Fund


Growth Plan Dividend Plan
Payout Reinvestment

HDFC Capital Builder Fund


Growth Plan Dividend Plan
Payout Reinvestment

HDFC Balanced Fund


Growth Plan Dividend Plan
Payout Reinvestment

HDFC Prudence Fund


Growth Plan Dividend Plan
Payout Reinvestment

HDFC Long Term Advantage Fund (Lock-in Period : 3 years)


Growth Plan Dividend Plan
Payout Reinvestment

HDFC TaxSaver (Lock-in Period : 3 years)


Growth Plan Dividend Plan
Payout Reinvestment

HDFC Index Fund


SENSEX Plan Nifty Plan SENSEX Plus Plan Growth Option only Retail Plan Growth Option

HDFC Core & Satellite Fund


Growth Option Dividend Option
Payout Reinvestment

HDFC Arbitrage Fund


Wholesale Plan Growth Dividend Option Option Monthly Quarterly
Payout Reinvestment Payout Reinvestment

Dividend Option
Monthly Payout Reinvestment Quarterly Payout Reinvestment

HDFC Premier Multi-Cap Fund


Growth Option Dividend Option
Payout Reinvestment

HDFC MF Monthly Income Plan


Short Term Plan Growth Dividend Option Monthly Quarterly Option
Payout Reinvestment Payout Reinvestment

Long Term Plan Growth Dividend Option Monthly Quarterly Option


Payout Reinvestment Payout Reinvestment

8.

PAYMENT DETAILS (refer instruction 6) (Please write Application Form No. / Folio No. on the reverse of the Cheque / Demand Draft.) Cheque / DD No. Amount of Cheque/DD/RTGS in figures (Rs.) (i) DD charges, if any, in figures (Rs.) (ii) Total Amount (i) + (ii)
Account Type [Please (4)]

Cheque / DD Date Drawn on (Bank / Branch Name) in figures (Rs.) in words


SAVINGS CURRENT NRE

Account No. (For Cheque only)


NRO FCNR OTHERS______________ (please specify)

9. NOMINATION (refer instruction 11) I/ We __________________________________________, __________________________________________ and _____________________________________________


(Unit holder 1) (Unit holder 2) (Unit holder 3)

*do hereby nominate the person(s) more particularly described hereunder/ and*/ cancel the nomination made by me/ us on the _________ day of ______________________ in respect of the Units under Folio No.___________________ (* strike out which is not applicable) Name and Address of Nominee(s) Date of Name and Address of Guardian Signature of Guardian Proportion (%) by which the Birth units will be shared by each (to be furnished in case the Nominee is a minor) Nominee (should aggregate to 100%) Nominee 1 Nominee 2 Nominee 3 10. DOCUMENTS ENCLOSED (Please 4) Memorandum & Articles of Association Trust Deed Bye-Laws Partnership Deed Resolution / Authorisation to invest List of Authorised Signatories with Specimen Signature(s) PAN Proof KYC Compliance Status Proof APPLICATIONS ENCLOSED (Please 4)
Systematic Investment Plan Cheques SIP Auto Debit Facility STP Enrolment Form

Power of Attorney

11. MODE OF PAYMENT OF REDEMPTION / DIVIDEND PROCEEDS VIA DIRECT CREDIT / NEFT / ECS (refer instruction 8)
Unitholders will receive their redemption / dividend proceeds (if any) directly into their bank account (as furnished by them in Section 5) as per the following arrangements: (i) Direct Credit for bank accounts with ABN AMRO Bank NV, Axis Bank Limited, Citibank N.A, Deutsche Bank AG, HDFC Bank Limited, The Hongkong and Shanghai Banking Corporation, ICICI Bank Limited, IDBI Bank Limited, Kotak Mahindra Bank Ltd., Standard Chartered Bank and YES Bank Limited. (ii) Electronic credit through National Electronic Funds Transfer (NEFT) System of RBI for bank accounts other those mentioned in section no 11 (i). (iii) Electronic credit through Electronic Clearing System (ECS) facility of RBI to receive dividend proceeds, if any, for bank accounts other those mentioned in section no. 11 (i). I / We want to receive the redemption / dividend proceeds (if any) by way of a cheque / demand draft instead of direct credit / credit through NEFT system/ credit through ECS into my / our bank account

12. DECLARATIONS & SIGNATURE/S (refer instruction 10)


S I G N AT U R E / S
I / We have read and understood the terms and contents of the Offer Document(s) / SID(s) of the respective Scheme(s) of HDFC Mutual Fund. I / We hereby apply to the Trustee of HDFC Mutual Fund for allotment of Units of the Scheme(s) of HDFC Mutual Fund, as indicated above and agree to abide by the terms, conditions, rules and regulations of the relevant Scheme(s). I / We have understood the details of the Scheme(s) and I / we have not received nor been induced by any rebate or gifts, directly or indirectly, in making this investment. I/We hereby declare that I/We am/are authorised to make this investment and that the amount invested in the Scheme is through legitimate sources only and does not involve and is not designed for the purpose of any contravention or evasion of any Act, Rules, Regulations, Notifications or Directions issued by any regulatory authority in India. I/ We declare that the information given in this application form is correct, complete and truly stated. Applicable to NRIs only : I / We confirm that I am / We are Non-Resident of Indian Nationality / Origin and I / We hereby confirm that the funds for subscription have been remitted from abroad through normal banking channels or from funds in my / our Non-Resident External / Ordinary Account / FCNR Account.

First / Sole Applicant / Guardian Second Applicant Third Applicant

Please (4) If yes, (4)

Yes No Repatriation basis

DD Non-repatriation basis

MM

YYYY

Particulars
Scheme Name / Plan / Option Cheque / DD No. / Date Drawn on (Name of Bank and Branch) Amount in figures (Rs.)

SCHEME NAME / PLAN / OPTION

SCHEME NAME / PLAN / OPTION