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Explanation With Documents - Inder

The document is a letter providing clarification on a student visa application. It includes details of funds, passport information, and travel history. For funds, it explains that mutual fund redemptions from the applicant's grandmother's account were the source, providing transaction records. It also attaches passport pages and describes the applicant's history of traveling between India and Qatar from 2007 to 2017 while living there. The letter aims to provide transparency around funding, identity, and residence to support the visa application.

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Inderpaal Singh
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0% found this document useful (0 votes)
106 views95 pages

Explanation With Documents - Inder

The document is a letter providing clarification on a student visa application. It includes details of funds, passport information, and travel history. For funds, it explains that mutual fund redemptions from the applicant's grandmother's account were the source, providing transaction records. It also attaches passport pages and describes the applicant's history of traveling between India and Qatar from 2007 to 2017 while living there. The letter aims to provide transparency around funding, identity, and residence to support the visa application.

Uploaded by

Inderpaal Singh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 95

Respected Madam, 03/11/2023

I have received communication regarding my student visa application – Application No:


22468304, Client No: 83112810 and I would like to clarify on the same.

1.Funds:
My grandmother’s IOB Account (Acc # 108301000006799) is the evidence of funds and the
source for the highlighted transactions are from mutual fund redemption,which is joint with her
spouse (Mr.Raghunathan)

25/09/2023 – Rs.5,72,356
25/09/2023 – Rs.1,44,701
25/09/2023 – Rs.6,06,728
25/09/2023 – Rs.6,06,728
26/09/2023 – Rs.1,20,372
26/09/2023 – Rs.1,60,997
26/09/2023 – Rs.5,72,371
26/09/2023 – Rs.1,44,705
Additional amount Rs.98,000 is also considered from this account for airfare expenses.

Earlier ,we had submitted consolidated transaction history, but for a better clarity ,I have
attached individual transaction history for each redemption reflecting the same amount.

These mutual funds have been held for a longer period and last year’s statement is attached as
its proof.

I have also provided the up to date bank statement of my grandmother’s IOB account, though
there are additions from other redemption ,the amount considered remains the same.

2.Passport:
I have had 4 passports from my childhood, of which the 3rd one was lost long back. Earlier with
my application I had submitted the scan copies of stamping pages of the passports ,now I have
attached all pages of my current and other 2 previous passports.

3.Travel History:
I had been a resident of Qatar from 2007 till 2017. I was on a family visa as my father was
working in Qatar. My Qatar ID number was 30135602239,during which we used to travel back
to my home town Chennai,Tamil Nadu, India for my school vacations.I did my schooling in Birla
Public School, Doha, Qatar from Class I to Class X (document submitted already)
The below are my trips to and from Doha, best of my knowledge.

India to Qatar 01/06/2007

Qatar to India 16/11/2007 - 24/12/2007 India to Qatar (holiday visit)

Qatar to India 13/03/2008 - 29/03/2008 India to Qatar (holiday visit)


Qatar to India 03/07/2008 - 30/09/2008 India to Qatar (holiday visit)
Qatar to India 13/11/2008 - 23/12/2008 India to Qatar (holiday visit)

Qatar to India 11/06/2009 - 01/10/2009 India to Qatar (holiday visit)


Qatar to india 01/12/2019 - 21/12/2009 India to Qatar (holiday visit)

Qatar to India 29/07/2010 - 08/09/2010 India to Qatar (holiday visit)


Qatar to India 25/11/2010 - 19/12/2010 India to Qatar (holiday visit)

Qatar to India 17/06/2011 - 12/12/2011 India to Qatar (holiday visit)

Qatar to India 05/07/2012 - 22/08/2012 India to Qatar (holiday visit)


Qatar to India 16/12/2012 - 02/01/2013 India to Qatar (holiday visit)

Qatar to India 04/07/2013 - 21/08/2013 India to Qatar (holiday visit)


Qatar to India 07/10/2013 - 21/10/2013 India to Qatar (holiday visit)
Qatar to India 23/12/2013 - 02/01/2014 India to Qatar (holiday visit)

Qatar to India 05/07/2014 - 20/08/2014 Qatar to India (holiday visit)

Qatar to India 22/01/2015 - 01/02/2015 India to Qatar (holiday visit)


Qatar to India 26/06/2015 - 30/07/2015 India to Qatar (holiday visit)

Qatar to Chennai 07/04/2017


Since my father returned to India, my resident permit was cancelled in 2017

Chennai to Qatar 17/10/2017 - 22/10/2017 Qatar to India(Visit Visa)

Chennai to Qatar 26/12/2018 - 02/01/2019 India to Qatar(Visit Visa)

I have attached my 10th standard transfer certificate and marksheet and the ticket copies of last
2-3 travels as the proof.

Hope this gives better clarity on my funding, passport and travel history. Please reach out to me
in case of further clarifications.
Warm Regards,
Inderpaal Singh Rathna Balaji
Mutual fund redemption statement for Rs.5,72,356.
Source of Funds
Due to security reasons last 4 digits of the account
which is linked to his mutual fund is mentioned
below the table,highted the same.

For any enquiries, please contact Investor Service Centre, HDFC Asset Management Company Ltd, 74, V Block, 5th Avenue, Near Ganga Sweets, Anna
Nagar, Chennai-600040, Tamil Nadu, Phones : 1800 3010 6767 / 1800 419 7676, Email : hello@hdfcfund.com

Page 1 of 2
Account Statement

Folio No. : 1 1 3 2 5 9 7 7 / 0 5 Statement Date : 03-Nov-2023

Mode of Holding : Anyone or Survivor


R Kanakavalli Tax Status : Individual

Old No 33 New No 12
Natumuthu Kumarappa Street Nmk Street
Mylapore
Chennai - 600004
Tamil Nadu , India
Joint 1 : K Raghunathan

Email : raghunathankanaka@gmail.com
Mobile No. : +919380633036

PAN/ PEKRN PAN-Aadhar linking CKYC No. KYC FATCA / CRS UBO

1st Unit Holder AVDPK8774B Successful Please provide Verified Complete Not applicable

2nd Unit Holder AGZPR3872L Successful Please provide Verified Complete Not applicable

3rd Unit Holder Not applicable Not Applicable Not applicable Not applicable Not applicable Not applicable

Guardian, I f any Not applicable Not Applicable Not applicable Not applicable Not applicable Not applicable

POA, I f any Not applicable Not Applicable Not applicable Not applicable Not applicable Not applicable

Nominee Details
Sr. No. Nominee Name Date of Birth Guardian Name ( in case of minor) Share ( % )
1 R Krishnan 31-Dec-1971 Not Applicable 100

8 5 1 2 / HDFC Small Cap Fund - Regular Plan - I DCW # Plan* - I NF1 7 9 KA1 SA9 UCC : MFHDFC0 5 0 0 , Option :
Payout
NAV Amount Price Number of Balance
Date Transaction Type
in I NR in I NR Units Units
Opening Balance as on 22/ 05/ 2018 0.000
22/05/2018 Switch-In - From HDFC Liquid Fund-Growth 26.803 377,013.22 26.803 14,066.083 14,066.083
27/03/2019 * * * ID C W P a id @ R s.2 .5 0 p e r u n it* * * 25.955 35,165.21
18/03/2021 * * * ID C W P a id @ R s.2 .5 0 p e r u n it* * * 27.378 32,528.21
* * * T D S o n C u m u la tiv e ID C W * * * 2,637.00
17/03/2022 * * * ID C W P a id @ R s.3 .5 0 p e r u n it* * * 34.051 44,308.29
* * * T D S o n C u m u la tiv e ID C W * * * 4,923.00
16/03/2023 * * * ID C W P a id @ R s.3 .0 0 p e r u n it* * * 33.860 37,978.25
* * * T D S o n C u m u la tiv e ID C W * * * 4,220.00
21/09/2023 Redemption - NEFT PAYOUT - via HDFCMFOnline - 40.691 (572,356.99) 40.691 (14,066.083) 0.000
HDFCR52023092590040431 , less STT
*** STT Paid *** (6.00)
Available Units to Redeem : 0.000
Market Value of Balance Units at NAV of 40.322 on 02/11/2023 (INR) : 0.00 Total Units Under Lien : 0.000
IDCW reinvested / paid (INR) : 149,979.96 Total IDCW reinvested / paid (INR) : 149,979.96
EISC-HDFCKANT-16.6.0-031123112611(I)-A16605--1119-NN

Primary Bank Account : SB XXXX6799 / Indian Overseas Bank / East Mada Street Mylapore / Chennai / Redemption / IDCW Payout Mode : Electronic
IOBA0001083
Advisor : ARN-137779 / Revathi
EUIN : E232917

I DCW-I ncome Distribution and Capital Withdrawal * Due to change in fundamental attributes of the Scheme w.e.f. May 23, 2018, the type of the Scheme has been changed to an
open-ended equity scheme predominantly investing in small cap stocks. Current Load Structure - Entry Load: Not Applicable; Exit Load: 1% if units are redeemed/ switched-out
within 1 year from the allotment date; No Exit Load if units are redeemed / switched-out after 1 year. The rate of exit load levied on units redeemed/ switched-out will be the rate
prevailing at the time of allotment of the units. For further details visit www.hdfcfund.com or contact any of our I nvestor Service Centre. GST I dentification Number :
27AAATH1809A1Z9

#I DCW - I ncom e Dist ribut ion cum Capit al W it hdraw al continued...


Page 2 of 2
Account Statement ( Folio No. : 11325977 / 05)
8 6 1 1 / HDFC Liquid Fund - Regular Plan - Grow th * - I NF1 7 9 KB1 HK0 UCC : MFHDFC0 0 0 4

NAV Amount Price Number of Balance


Date Transaction Type
in I NR in I NR Units Units
Opening Balance as on 09/ 05/ 2018 0.000
09/05/2018 Switch-In - From HDFC Prudence Fund-Dividend 3,434.8287 376,228.87 3,434.8287 109.534 109.534
21/05/2018 Switch Out - To HDFC Small Cap Fund - Regular DP 3,441.9742 (377,013.22) 3,441.9742 (109.534) 0.000
Available Units to Redeem : 0.000
Market Value of Balance Units at NAV of 4,560.9946 on 02/11/2023 (INR) 0.00
: Total Units Under Lien : 0.000
IDCW reinvested / paid (INR) : 0.00 Total IDCW reinvested / paid (INR) : 0.00
Primary Bank Account : SB XXXX6799 / Indian Overseas Bank / East Mada Street Mylapore / Chennai / Redemption Payout Mode : Electronic
IOBA0001083
Advisor : ARN-137779 / Revathi
EUIN : E232917

* Merger of erstwhile 'HDFC Liquid Fund Premium Plan into HDFC Liquid Fund, w.e.f, May 11, 2019, HDFC Liquid Fund, An open ended Liquid Scheme. Current Load Structure:
Entry Load: Not Applicable. Exit Load: Effective October 20, 2019, following graded exit load will be applicable if units are redeemed/ switched-out within 6 days from the date of
allotment: Day1 - 0.0070% ; Day2 - 0.0065% ; Day3 - 0.0060% ; Day4 - 0.0055% ; Day5 - 0.0050% ; Day6 - 0.0045% ; Day7 onwards - Nil. For further details visit
www.hdfcfund.com (under I nvestor Corner) or contact any of our I nvestor Service Centre. GST I dentification Number : 27AAATH1809A1Z9. On account of the change in face
value of units, the NAV and balance units in this scheme were adjusted with effect from August 30, 2015. This change did not affect the value of units held (subject to rounding
off).

Details regarding your primary Bank account and Email Id maybe masked to ensure security of information.
(#)switch-in will be processed based on the settlement cycle of the switch-out scheme.
This is a computer generated statement and does not require any signature.

Non Financial Transaction( s)


Date Transaction Type
01/02/2017 Address Updated from KRA Data
06/02/2017 Address Updated from KRA Data - 1st Joint Holder
23/05/2023 Form 15H Registration
23/05/2023 Registration of Nominee
19/09/2023 Change of Contacts
25/09/2023 Address Updated from KRA Data

EISC-HDFCKANT-16.6.0-031123112611(I)-A16605--1119-NN
Mutual fund redemption statement for Rs.1,44,701.81
Due to security reasons last 4 digits of the account
which is linked to his mutual fund is mentioned
below the table,highted the same.
For any enquiries, please contact Investor Service Centre, HDFC Asset Management Company Ltd, 74, V Block, 5th Avenue, Near Ganga Sweets, Anna
Nagar, Chennai-600040, Tamil Nadu, Phones : 1800 3010 6767 / 1800 419 7676, Email : hello@hdfcfund.com

Page 1 of 2
Account Statement

Folio No. : 1 1 3 2 5 3 2 0 / 3 6 Statement Date : 03-Nov-2023

Mode of Holding : Anyone or Survivor


R Kanakavalli Tax Status : Individual

Old No 33 New No 12
Natumuthu Kumarappa Street Nmk Street
Mylapore
Chennai - 600004
Tamil Nadu , India
Joint 1 : K Raghunathan

Email : raghunathankanaka@gmail.com
Mobile No. : +919380633036

PAN/ PEKRN PAN-Aadhar linking CKYC No. KYC FATCA / CRS UBO

1st Unit Holder AVDPK8774B Successful Please provide Verified Complete Not applicable

2nd Unit Holder AGZPR3872L Successful Please provide Verified Complete Not applicable

3rd Unit Holder Not applicable Not Applicable Not applicable Not applicable Not applicable Not applicable

Guardian, I f any Not applicable Not Applicable Not applicable Not applicable Not applicable Not applicable

POA, I f any Not applicable Not Applicable Not applicable Not applicable Not applicable Not applicable

Nominee Details
Sr. No. Nominee Name Date of Birth Guardian Name ( in case of minor) Share ( % )
1 R Krishnan 31-Dec-1971 Not Applicable 100

8 5 1 2 / HDFC Small Cap Fund - Regular Plan - I DCW # Plan* - I NF1 7 9 KA1 SA9 UCC : MFHDFC0 5 0 0 , Option :
Payout
NAV Amount Price Number of Balance
Date Transaction Type
in I NR in I NR Units Units
Opening Balance as on 22/ 05/ 2018 0.000
22/05/2018 Switch-In - From HDFC Liquid Fund-Growth 26.803 95,315.16 26.803 3,556.138 3,556.138
27/03/2019 * * * ID C W P a id @ R s.2 .5 0 p e r u n it* * * 25.955 8,890.35
18/03/2021 * * * ID C W P a id @ R s.2 .5 0 p e r u n it* * * 27.378 8,223.35
* * * T D S o n C u m u la tiv e ID C W * * * 667.00
17/03/2022 * * * ID C W P a id @ R s.3 .5 0 p e r u n it* * * 34.051 11,201.48
* * * T D S o n C u m u la tiv e ID C W * * * 1,245.00
16/03/2023 * * * ID C W P a id @ R s.3 .0 0 p e r u n it* * * 33.860 9,601.41
* * * T D S o n C u m u la tiv e ID C W * * * 1,067.00
21/09/2023 Redemption - NEFT PAYOUT - via HDFCMFOnline - 40.691 (144,701.81) 40.691 (3,556.138) 0.000
N268232654402247 , less STT
*** STT Paid *** (1.00)
Available Units to Redeem : 0.000
Market Value of Balance Units at NAV of 40.322 on 02/11/2023 (INR) : 0.00 Total Units Under Lien : 0.000
IDCW reinvested / paid (INR) : 37,916.59 Total IDCW reinvested / paid (INR) : 37,916.59
EISC-HDFCKANT-16.6.0-031123112653(I)-A16605--1119-NN

Primary Bank Account : SB XXXX6799 / Indian Overseas Bank / East Mada Street Mylapore / Chennai / Redemption / IDCW Payout Mode : Electronic
IOBA0001083
Advisor : ARN-137779 / Revathi
EUIN : E232917

I DCW-I ncome Distribution and Capital Withdrawal * Due to change in fundamental attributes of the Scheme w.e.f. May 23, 2018, the type of the Scheme has been changed to an
open-ended equity scheme predominantly investing in small cap stocks. Current Load Structure - Entry Load: Not Applicable; Exit Load: 1% if units are redeemed/ switched-out
within 1 year from the allotment date; No Exit Load if units are redeemed / switched-out after 1 year. The rate of exit load levied on units redeemed/ switched-out will be the rate
prevailing at the time of allotment of the units. For further details visit www.hdfcfund.com or contact any of our I nvestor Service Centre. GST I dentification Number :
27AAATH1809A1Z9

#I DCW - I ncom e Dist ribut ion cum Capit al W it hdraw al continued...


Page 2 of 2
Account Statement ( Folio No. : 11325320 / 36)
8 6 1 1 / HDFC Liquid Fund - Regular Plan - Grow th * - I NF1 7 9 KB1 HK0 UCC : MFHDFC0 0 0 4

NAV Amount Price Number of Balance


Date Transaction Type
in I NR in I NR Units Units
Opening Balance as on 09/ 05/ 2018 0.000
09/05/2018 Switch-In - From HDFC Prudence Fund-Dividend 3,434.8287 95,116.86 3,434.8287 27.692 27.692
21/05/2018 Switch Out - To HDFC Small Cap Fund - Regular DP 3,441.9742 (95,315.16) 3,441.9742 (27.692) 0.000
Available Units to Redeem : 0.000
Market Value of Balance Units at NAV of 4,560.9946 on 02/11/2023 (INR) 0.00
: Total Units Under Lien : 0.000
IDCW reinvested / paid (INR) : 0.00 Total IDCW reinvested / paid (INR) : 0.00
Primary Bank Account : SB XXXX6799 / Indian Overseas Bank / East Mada Street Mylapore / Chennai / Redemption Payout Mode : Electronic
IOBA0001083
Advisor : ARN-137779 / Revathi
EUIN : E232917

* Merger of erstwhile 'HDFC Liquid Fund Premium Plan into HDFC Liquid Fund, w.e.f, May 11, 2019, HDFC Liquid Fund, An open ended Liquid Scheme. Current Load Structure:
Entry Load: Not Applicable. Exit Load: Effective October 20, 2019, following graded exit load will be applicable if units are redeemed/ switched-out within 6 days from the date of
allotment: Day1 - 0.0070% ; Day2 - 0.0065% ; Day3 - 0.0060% ; Day4 - 0.0055% ; Day5 - 0.0050% ; Day6 - 0.0045% ; Day7 onwards - Nil. For further details visit
www.hdfcfund.com (under I nvestor Corner) or contact any of our I nvestor Service Centre. GST I dentification Number : 27AAATH1809A1Z9. On account of the change in face
value of units, the NAV and balance units in this scheme were adjusted with effect from August 30, 2015. This change did not affect the value of units held (subject to rounding
off).

Details regarding your primary Bank account and Email Id maybe masked to ensure security of information.
(#)switch-in will be processed based on the settlement cycle of the switch-out scheme.
This is a computer generated statement and does not require any signature.

Non Financial Transaction( s)


Date Transaction Type
01/02/2017 Address Updated from KRA Data
01/02/2017 Address Updated from KRA Data - 1st Joint Holder
23/05/2023 Form 15H Registration
23/05/2023 Registration of Nominee
19/09/2023 Change of Contacts
25/09/2023 Address Updated from KRA Data

EISC-HDFCKANT-16.6.0-031123112653(I)-A16605--1119-NN
TATA MUTUAL FUND
Mulla House Ground Floor Homi Mody Street Mumbai - 400001

Account Statement

Mutual fund redemption statement for Rs.6,06,728.44


Folio Number : 4341177 / 77 Due to security reasons last 4 digits of the account
which is linked to his mutual fund is mentioned
R Kanakavalli below the table,highted the same.
Old No 33 New No 12
Natumuthu Kumarappa Street Nmk Street
Mylapore
Chennai - 600004
Tamil Nadu, India

Work : Please provide


Home : 9380633036
Mobile : +919380633036
Email : raghunathankanaka@gmail.com

Statement Date : 03-Nov-2023

FOLIO DETAILS
Folio Number : 4341177 / 77 CKYC KIN Old Folio Number :
Unit Holder : R Kanakavalli
Second Holder : K Raghunathan Tax Status : Individual
Third Holder : Mode Of Holding : Anyone or Survivor
Guardian :
NOMINATION NAME PERCENTAGE RELATIONSHIP GUARDIAN
Nominee 1 : Please provide
Nominee 2 :
Nominee 3 :
R E G IS TE R E D BAN K AC C O U N T(S ) (masked for security reasons) IFSC Code R TG S Payout Mode
First : SB/XXXXXXXXXXX6799/Indian Overseas Bank/East Mada Street/Chennai IOBA0001083 IOBA0001083 NEFT/RTGS PAYOUT

PAN / PEKRN KYC Supplementary KYC FATCA / CRS UBO PAN Validation Status PAN Aadhaar Seeding

1st Unit Holder ******774B Verified Complete Available Not applicable Valid Successful

2nd Unit Holder ******872L Verified Complete Available Not applicable Valid Successful

3rd Unit Holder

Guardian,If any

As you are aware, the last date to link the Aadhaar and Permanent Account Number (PAN) has been extended by the Government of India, until 30 Jun 2023. You are requested to
ignore this communication if you have already linked your Aadhar and PAN. In case the same has not been linked yet please click on the link
https://eportal.incometax.gov.in/iec/foservices/#/pre-login/bl-link-aadhaar

S ince Inception to 03-NOV-2023


T ransaction D etails

TBAFG Tata Balanced Advantage Fund - R egular P lan - G rowth-


NAV as on 02/11/2023 : 16.6425
IS IN :IN F 277K010S 4
EISC-STASLIM-16.6.0-031123135024(I)-A16605--1124

Value Amount Price NAV Number of Balance


Transactions Type
Date in INR in INR in INR Units Units

29/07/2021 Purchase - ARN-137779 499,975.00 13.8702 13.8702 36,046.704 36,046.704


Gross Amount: Rs.500000/-; Stamp Duty charges Levied 25.00
21/09/2023 Redemption - NEFT/RTGS PAYOUT - via Online - (606,728.44) 16.8319 16.8319 (36,046.704) 0.000
HDFCR52023092590045614 , less STT
*** STT Paid *** (6.07)

Current Unit Balance : 0.000 Market Value as on 02/11/2023 : 0.00 Intermediary Name : Revathi
Intermediary Code : ARN-137779
Redemption Payout : NEFT/RTGS PAYOUT Sub Broker ARN :
EUIN : E232917
Bank Details : SB XXXXXXXXXXX6799 / Indian Overseas Bank / East Mada Street / IFSC : IOBA0001083
A llotm ent of units w ould be subject to realization of credit.C urrent Load S tructure : E ntry Load: N .A . E xit Load: 1% of the applicable N A V , if redeem ed on or before expiry of 90 days
from the date of allotm ent.S w itch-in w ill be processed based on the settlem ent cycle of the sw itch-out schem e. This schem e is to be considered as E quity oriented for taxation
purpose.

# IDCW - Incom e D istribution cum C a pita l W ithdra w a l Page : 1 / 4


Call: 022-62827777. SMS: TMF To 57575. E-mail: enq_t@camsonline.com
TATA MUTUAL FUND
Mulla House Ground Floor Homi Mody Street Mumbai - 400001

Account Statement

Folio Number : 4341177 / 77 Old Folio Number :

Unit Holder : R Kanakavalli

TVF1D T ata V alue F und S eries 1 - R egular P lan - ID C W # - IS IN :IN F 277K010H7 NAV as on 19/07/2021 : 13.5486

Value Amount Price NAV Number of Balance


Transactions Type
Date in INR in INR in INR Units Units

13/07/2018 Purchase - NFO 200,000.00 10.0000 10.0000 20,000.000 20,000.000


19/07/2021 Amount Paid on Maturity - NEFT/RTGS PAYOUT - (270,969.29) 13.5486 13.5486 (20,000.000) 0.000
HDFCR52021072354478247 , less STT
*** STT Paid *** (2.71)

Current Unit Balance : 0.000 Market Value as on 19/07/2021 : 0.00 Intermediary Name : Revathi
IDCW Option : Pay IDCW Intermediary Code : ARN-137779
Redemption Payout : NEFT/RTGS PAYOUT Sub Broker ARN :
IDCW Payout : NEFT/RTGS PAYOUT EUIN : E232917
Bank Details : SB XXXXXXXXXXX6799 / Indian Overseas Bank / East Mada Street / IFSC : IOBA0001083
C urrent Load S tructure : E ntry Load : N .A . E xit load : N il - 1103 days M aturity , M aturity date (Last N A V date) : 19-Jul-2021. Listed on B S E . Trading in U nits through the stock
exchange w ill be perm itted only in electronic form and not in physical form .

Non Financial Transaction(s)


Date Transaction Type

13/07/2018 Address Updated from KRA Data


22/05/2023 Registration of Nominee Rejected
20/09/2023 Change of Contacts
23/09/2023 Address Updated from KRA Data

EISC-STASLIM-16.6.0-031123135024(I)-A16605--1124

# IDCW - Incom e D istribution cum C a pita l W ithdra w a l


Page : 2 / 4
Call: 022-62827777. SMS: TMF To 57575. E-mail: enq_t@camsonline.com
Additional P urchase / S witch / R edemption Form

1 INVESTOR DETAILS
Folio Number. 4341177 CAN Intermediary ARN-137779 - #+919600107729

Mode of Holding Anyone or Survivor Status Individual EUIN E232917

1st Holder Name R Kanakavalli PAN ******774B

2nd Holder Name K Raghunathan PAN ******872L

3rd Holder Name PAN

Guardian PAN

2 INTERMEDIARY DETAILS
Intermediary Name / Code Sub-Broker / Bank Branch Code Sub-Broker ARN Code EUIN Code

I/W e hereby confirm that the EUIN box has been intentionally left blank by m e/us as this is an “execution-only” transaction without any interaction or advice by the Interm ediary or personnel.
Upfront com m ission shall be paid directly by the investor to the Interm ediaries based on the investor's assessm ent of various factors including the service rendered by the interm ediary.

Sole / 1 st Applicant Signature / Thumb 2 nd Applicant Signature / 3 rd Applicant Signature /


Impression Thumb Impression Thumb Impression
3 ADDITIONAL PURCHASE DETAILS
From Scheme / Plan / Option

Payment Mode : OTM facility (Registered in Folio) Cheque / DD Fund Transfer RTGS / NEFT

Gross Amount (A) DD Charges(if any) (B) Net Amount


(A - B)
Bank A/C No. A/C Type Dated D D / M M / Y Y Y Y

Drawn on Bank Cheque/DD/


UTR No.
Branch Branch City

4 SWITCH DETAILS
From Scheme / Plan / Option

To Scheme / Plan / Option

Amount ( ) OR Units OR All units


(in Figure) (in Figure)

5 REDEMPTION DETAILS
From Scheme / Plan / Option

Amount ( ) OR Units OR All units


(in Figure) (in Figure)
R E D E M P T IO N BAN K AC C O U N T D E T AILS : F or Inve stors w ho ha ve re giste re d for M ultiple B a nk A ccounts fa cility in the a bove folio (please strike off the section
if not used) The redemption should be processed into the following bank account as per the payout mechanism indicated by me/us:

Bank Name

A/c No. IFSC Code


N ote : If the bank account mentioned above is different from those already registered in your folio OR If the bank account details are not filled above, the redemption will be
processed into the “ Default” bank account registered for the aforesaid folio.
EISC-STASLIM-16.6.0-031123135024(I)-A16605--1124

6 DECLARATION AND SIGNATURES


I / We have read , understood and hereby agree to comply with the terms and conditions of the scheme related documents including the Key Information Memorandum and request
for Purchase /Redem ption/Switch of Units of the Schem e(s ) of Tata Mutual Fund (‘Fund’) indicated in the application form . I/W e will indemnify the Fund , A M C , Trustee, RTA and
other intermediaries in case of any dispute regarding the eligibility,validity and authorization of m y /our transactions . I/We shall not hold AMC /mutual Fund or it’s RTA for not being
able to process my request due to incomplete information provided by me. The Intermediary has disclosed to me/us all the com m issions (in the form of trail commission or any other
m ode), 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/W e hereby confirm
that I/W e have not been offered/com m unicated any indicative portfolio and/or any indicative yield by the Fund/A M C /its interm ediary for this investm ent.

Date:

Sole / 1 st Applicant Signature / Thumb 2 nd Applicant Signature / 3 rd Applicant


Signature /
Impression Thumb Impression Thumb Impression

ACKNOWLEDGEMENT SLIP

Received request from Mr./Ms./M/s. Folio No.

for purchase of switch-in of redemption (details overleaf)

Page : 3 / 4
IN S TR U C TIO N S
Call: 1800 209 0101 • SMS: TMF To 57575 • E-mail: enq_t@camsonline.com

1. GENERAL INSTRUCTIONS: iii. The Folio number / PAN and Name of the Applicant should be written by the Investor on
The Unit balance(s ) is/are subject to realization of Cheque / D D the reverse of the cheques and bank drafts accom panying the transaction form.
i.
accom panying the Purchase Request & PAN Validation.
ii. This Account Statem ent is subject to quality check. iv. The first unit holder should be one of the bank account holders in the pay-in bank
account. Purchase application through Cheque/D D /RTGS/NEFT/Funds transfer
iii. This Account Statement is a record of your transactions of the Units held in Tata
requests should necessarily mention the pay-in bank account details i.e. account
Mutual Fund (TM F).
number and bank, branch name of the bank account used for issuing the payments to
iv. Kindly review this statement and contact the Investor Service Centres / 022- the fund. If this is not evidenced on the payment cheque/funds transfer/RTGS/NEFT
62827777 / enq_t@cam sonline.com prom ptly if there is any discrepancy. C ontents request, or in case of demand drafts, unit holder should attach necessary supporting
of this statement will be considered correct if no error is reported within 30 days of documents as required by TMF,like bank certificate, bank passbook copy or statem ent
receipt of the statem ent. to prove that the funds are from a bank account held by first unit holder only. If the
v. For more information about our product, services and processes , visit our website documents are not subm itted with the application, the fund reserves the right to reject
w w w .tatam utualfund.com . the application or call for additional details . Investors are advised to visit
vi. Please quote your Folio Number in all future correspondence, please use the w w w .tatam utualfund.com for details on documents, restrictions on third party
transaction forms enclosed along with this account statement for additional paym ents or approach any of the AM C offices.
purchase, switch and redem ption.
vii. The Statement of Additional Information (SAI), Schem e Inform ation Docum ent
v. In case of discrepancies in the amount received from the investor and the amount
(S ID ) and Key Information Memorandum (K IM ) of the schemes and information mentioned in the application form the application units will be allotted for the amount
about our product, services and processes are available on received in our bank account.
w w w .tatam utualfund.com .
vi. Units will be allotted subject to realization of paym ent proceeds.
viii. Investors need to read the SAI , S ID , K IM , Addenda, KIM and Instructions therein
and below mentioned instructions carefully before filling up the transaction form s. vii. ADDITIONAL PURCHASE THROUGH OTM FACILITY: Investors m aking paym ent
through OTM facility registered in their folio , should tick the relevant box and need not
attach any cheque . If more than one bank account is registered in the folio under OTM
ix. Transaction Charges:
facility, investors should mention the bank account number and bank name where they
In accordance with SEBI circular No. C ir/ IM D / D F /13/ 2011 dated August 22,2011,
wish the debit to happen . If the same is not mentioned or is not registered, default bank
Tata Asset Management Private Limited / Mutual Fund will deduct transaction
mandate under OTM facility will be considered to debit the purchase amount.
Charges from the purchase/ subscription amount received from the investors
investing through a valid Intermediary Holder i .e. Intermediaries (provided the
Interm ediary has opted to receive the transaction Charges).Transaction Charge of 3. SWITCHES:
R s. 100 per purchase / subscription of Rs. 10,000 and above are deductible (per i. Investors can split the sw itch-out amount in more than one scheme, subject to m eeting
Scheme Plan - Option) from the purchase / subscription amount and payable to the the m inim um am ount criterion of the switch-in schem es.
Interm ediary. The balance amount shall be invested. ii. Sw itch –outs to more than one scheme can be in terms of Amount Only.
Transaction Charges shall not be deducted: iii. If amount to be switched is insufficient in the Switch-out scheme then the balance
available free units in the scheme will be switched subject to the minimum application
where the Intermediary of the investor has not opted to receive any Transaction am ount of the Switch –in Scheme(s ).
a.
Charges iv. S w itch-out of ‘All Units ’ option can be selected for switch -in to a single scheme only .
for purchases / subscriptions / total commitment amount in case of SIP of an The switch -in scheme should be mentioned in the section 5 without mentioning the
b.
amount less than Rs. 10,000/-; am ount.
c. for transactions other than purchases / subscriptions relating to new inflows i.e. 4. REDEMPTIONS:
through Switches / Systematic Transfers / Dividend Transfers/ Dividend i. The Redemption form can be used for redemption requests upto 7 schem es within the
Reinvestment, etc.; sam e folio.
for purchases / subscriptions made directly with the Fund (i.e. not through any
ii. The Redemption form has to be filled with the scheme details within a folio. Investors
d. need to specify the name of the scheme (s ), plan, option and units/am ount they wish to
Intermediary); and
redeem. In case the details are not mentioned, transactions are liable for rejection.
e. for purchases / subscriptions routed through Stock Exchange(s).
x. All transactions must be signed in accordance with the mode of holding opted by the iii. For redemption of All units, investors need to specify by selecting the "All Units" option.
investor. If the redemption request specifies both i.e. unit and amount ,the units mentioned shall
xi. All transactions will be accepted subject to verification of mandatory information / be considered for the transaction . If there is no sufficient am ounts/ units, the balance
documents. available free units in the respective account will be redeemed.
xii. Investors shall note that KYC is mandatory and they need to comply with the 'Know Your
Client' requirements as applicable from time to time. For more information on KYC, iv. Redemption may not be processed if folio number and full scheme name including plan
please visit our website www.tatamutualfund.com. Applications are liable to be rejected and option is not mentioned. Investors need to ensure that either of amount or units is
without any intimation to the applicants, if required KYC compliance is not completed by mentioned in the redemption request. TMF offers a facility to register multiple bank
all the applicants/unit holders. accounts and designate one of the bank account as "Default Bank Account". D efault
xiii. Do not overwrite. For any corrections/changes if made in the transaction forms, the Bank Account will be used for all redemptions payouts unless investor specifies one of
investors shall enter the correct details pursuant to cancellation of incorrect details and the existing registered bank account in the redemption request for receiving redemption
authenticate the corrected details by counter- signing against the changes. Applications proceeds.
with any such changes not counter- signed by the applicants are liable for rejection.
v. Proceeds of any redemption request will be sent only to a bank account that is already
registered and validated in the folio at the time of redemption transaction processing .
xiv. Applications complete in all respects, may be submitted out at any of our branch/ Investors may choose to mention any of the existing registered bank accounts with
authorized centre of AMC & Registrar. redemption request for receiving redemption proceeds. If registered bank account is
xv. Application received at any of our branch/authorized centre of AMC/Registrar would be not mentioned, default bank account will be used. If a new and unregistered bank
time stamped on receipt to evidence time of receipt of the application. An mandate is provided with a specific redemption request (with or without necessary
acknowledgement may be issued across the counter confirming the date & time of supporting docum ents ) such bank account will not be considered for payment of
receipt of the application. Investors are advised to retain the acknowledgement slip till redemption proceeds. Tata Asset management Private Ltd OR Tata mutual Fund will
they receive a confirmation of processing of their transaction. not be liable for any loss arising to the investors due to the credit of redemption
proceeds into any of the bank accounts registered with us for the aforesaid folio
xvi. Subject to applicable regulations and provisions in the Scheme Information Document of
the scheme(s) the date and time stamp would be considered for determining applicable
EISC-STASLIM-16.6.0-031123135024(I)-A16605--1124

NAV for the transactions. vi. Redemption requests should not be accompanied with requests for Change of Bank
xvii. Applications incomplete in any respect are liable to be rejected. Tata Asset Management Account D etails . If the Change of Bank Account Detail request is received along with
Private Limited (the AMC) / Tata Trustee Company Private Limited (Trustee) have Redemption requests only the redemption request will be processed and the
absolute discretion to reject any such Application Forms. redemption proceeds will be credited to the last registered bank mandate & the request
for Change of bank mandate will be rejected.New bank accounts can only be registered
2. PURCHASES:
using the designated "Bank Account Registration Form /Multiple Bank Account
i. Investors need to indicate their choice of Scheme, Plan and Option for which
Registration Form ". In case the investor needs to add/alter the existing bank mandate
subscription is made at the time of filling up the Transaction Form. In case of ambiguity
he should carry out the same 10 business days prior to date of redemption.
default options will apply.
ii. Investors can invest in more than one scheme with one cheque/ payment instrument.
This facility is for administrative convenience only. For investment in more than one vii. Investor holding units in the Depository Account, need to submit the redemption
request to Depository Participant/ Interm ediary.
scheme a single cheque/DD amounting to the total value of investment must be drawn in
favour of "Tata Mutual Fund" dated, signed and crossed 'A/c Payee only.' For investment 5. REGISTRAR:
in single scheme cheque must be drawn in favour of "Name of the Scheme". C omputer Age M anagement S ervices Limited. : New No . 10 (Old No. 178), M .G.R .
Salai, N ungam bakkam , Chennai - 600 034.
E-m ail: enq_t@cam sonline.com

Acknowledgement Slip (to be filled by the investor)


Purchase Cheque No. Dated Bank A/c. No.
Sn. Switch-in/Redemption Scheme/Plan/Option Units / Amount Sn. Switch-in/Redemption Scheme/Plan/Option Units / Amount
1. 5.
2. 6.
3. 7.
4.

Page : 4 / 4
TATA MUTUAL FUND
Mulla House Ground Floor Homi Mody Street Mumbai - 400001

Account Statement

Folio Number : 4348964 / 93


Mutual fund redemption statement for Rs.6,06,728.44
K Raghunathan Due to security reasons last 4 digits of the account
OLD NO 33 NEW 12 which is linked to his mutual fund is mentioned
NATU MUTHU KUMARAPA STREET below the table,highted the same.
MYLAPORE
CHENNAI - 600004
Tamil Nadu, India

Work : Please provide


Home : Please provide
Mobile : +919380633036
Email : raghunathankanaka@gmail.com

Statement Date : 03-Nov-2023

FOLIO DETAILS
Folio Number : 4348964 / 93 CKYC KIN Old Folio Number :
Unit Holder : K Raghunathan
Second Holder : R Kanakavalli Tax Status : Individual
Third Holder : Mode Of Holding : Anyone or Survivor
Guardian :
NOMINATION NAME PERCENTAGE RELATIONSHIP GUARDIAN
Nominee 1 : R Krishnan 100% Not Provided NA
Nominee 2 :
Nominee 3 :
R E G IS TE R E D BAN K AC C O U N T(S ) (masked for security reasons) IFSC Code R TG S Payout Mode
First : SB/XXXXXXXXXXX6799/Indian Overseas Bank/East Mada Street/Chennai IOBA0001083 IOBA0001083 NEFT/RTGS PAYOUT

PAN / PEKRN KYC Supplementary KYC FATCA / CRS UBO PAN Validation Status PAN Aadhaar Seeding

1st Unit Holder ******872L Verified Complete Available Not applicable Valid Successful

2nd Unit Holder ******774B Verified Complete Available Not applicable Valid Successful

3rd Unit Holder

Guardian,If any

As you are aware, the last date to link the Aadhaar and Permanent Account Number (PAN) has been extended by the Government of India, until 30 Jun 2023. You are requested to
ignore this communication if you have already linked your Aadhar and PAN. In case the same has not been linked yet please click on the link
https://eportal.incometax.gov.in/iec/foservices/#/pre-login/bl-link-aadhaar

S ince Inception to 03-NOV-2023


T ransaction D etails

TBAFG Tata Balanced Advantage Fund - R egular P lan - G rowth-


NAV as on 02/11/2023 : 16.6425
IS IN :IN F 277K010S 4
EISC-STASLIM-16.6.0-031123135048(I)-A16605--1124

Value Amount Price NAV Number of Balance


Transactions Type
Date in INR in INR in INR Units Units

29/07/2021 Purchase - ARN-137779 499,975.00 13.8702 13.8702 36,046.704 36,046.704


Gross Amount: Rs.500000/-; Stamp Duty charges Levied 25.00
21/09/2023 Redemption - NEFT/RTGS PAYOUT - via Online - (606,728.44) 16.8319 16.8319 (36,046.704) 0.000
HDFCR52023092590041666 , less STT
*** STT Paid *** (6.07)

Current Unit Balance : 0.000 Market Value as on 02/11/2023 : 0.00 Intermediary Name : Revathi
Intermediary Code : ARN-137779
Redemption Payout : NEFT/RTGS PAYOUT Sub Broker ARN :
EUIN : E232917
Bank Details : SB XXXXXXXXXXX6799 / Indian Overseas Bank / East Mada Street / IFSC : IOBA0001083
A llotm ent of units w ould be subject to realization of credit.C urrent Load S tructure : E ntry Load: N .A . E xit Load: 1% of the applicable N A V , if redeem ed on or before expiry of 90 days
from the date of allotm ent.S w itch-in w ill be processed based on the settlem ent cycle of the sw itch-out schem e. This schem e is to be considered as E quity oriented for taxation
purpose.

# IDCW - Incom e D istribution cum C a pita l W ithdra w a l Page : 1 / 4


Call: 022-62827777. SMS: TMF To 57575. E-mail: enq_t@camsonline.com
TATA MUTUAL FUND
Mulla House Ground Floor Homi Mody Street Mumbai - 400001

Account Statement

Folio Number : 4348964 / 93 Old Folio Number :

Unit Holder : K Raghunathan

TVF1D T ata V alue F und S eries 1 - R egular P lan - ID C W # - IS IN :IN F 277K010H7 NAV as on 19/07/2021 : 13.5486

Value Amount Price NAV Number of Balance


Transactions Type
Date in INR in INR in INR Units Units

13/07/2018 Purchase - NFO 200,000.00 10.0000 10.0000 20,000.000 20,000.000


19/07/2021 Amount Paid on Maturity - NEFT/RTGS PAYOUT - (270,969.29) 13.5486 13.5486 (20,000.000) 0.000
HDFCR52021072354467832 , less STT
*** STT Paid *** (2.71)

Current Unit Balance : 0.000 Market Value as on 19/07/2021 : 0.00 Intermediary Name : Revathi
IDCW Option : Pay IDCW Intermediary Code : ARN-137779
Redemption Payout : NEFT/RTGS PAYOUT Sub Broker ARN :
IDCW Payout : EUIN : E232917
Bank Details : SB XXXXXXXXXXX6799 / Indian Overseas Bank / East Mada Street / IFSC : IOBA0001083
C urrent Load S tructure : E ntry Load : N .A . E xit load : N il - 1103 days M aturity , M aturity date (Last N A V date) : 19-Jul-2021. Listed on B S E . Trading in U nits through the stock
exchange w ill be perm itted only in electronic form and not in physical form .

Non Financial Transaction(s)


Date Transaction Type

13/07/2018 Address Updated from KRA Data


22/05/2023 Registration of Nominee
20/09/2023 Change of Contacts
22/09/2023 Address Updated from KRA Data

EISC-STASLIM-16.6.0-031123135048(I)-A16605--1124

# IDCW - Incom e D istribution cum C a pita l W ithdra w a l


Page : 2 / 4
Call: 022-62827777. SMS: TMF To 57575. E-mail: enq_t@camsonline.com
Additional P urchase / S witch / R edemption Form

1 INVESTOR DETAILS
Folio Number. 4348964 CAN Intermediary ARN-137779 - #+919600107729

Mode of Holding Anyone or Survivor Status Individual EUIN E232917

1st Holder Name K Raghunathan PAN ******872L

2nd Holder Name R Kanakavalli PAN ******774B

3rd Holder Name PAN

Guardian PAN

2 INTERMEDIARY DETAILS
Intermediary Name / Code Sub-Broker / Bank Branch Code Sub-Broker ARN Code EUIN Code

I/W e hereby confirm that the EUIN box has been intentionally left blank by m e/us as this is an “execution-only” transaction without any interaction or advice by the Interm ediary or personnel.
Upfront com m ission shall be paid directly by the investor to the Interm ediaries based on the investor's assessm ent of various factors including the service rendered by the interm ediary.

Sole / 1 st Applicant Signature / Thumb 2 nd Applicant Signature / 3 rd Applicant Signature /


Impression Thumb Impression Thumb Impression
3 ADDITIONAL PURCHASE DETAILS
From Scheme / Plan / Option

Payment Mode : OTM facility (Registered in Folio) Cheque / DD Fund Transfer RTGS / NEFT

Gross Amount (A) DD Charges(if any) (B) Net Amount


(A - B)
Bank A/C No. A/C Type Dated D D / M M / Y Y Y Y

Drawn on Bank Cheque/DD/


UTR No.
Branch Branch City

4 SWITCH DETAILS
From Scheme / Plan / Option

To Scheme / Plan / Option

Amount ( ) OR Units OR All units


(in Figure) (in Figure)

5 REDEMPTION DETAILS
From Scheme / Plan / Option

Amount ( ) OR Units OR All units


(in Figure) (in Figure)
R E D E M P T IO N BAN K AC C O U N T D E T AILS : F or Inve stors w ho ha ve re giste re d for M ultiple B a nk A ccounts fa cility in the a bove folio (please strike off the section
if not used) The redemption should be processed into the following bank account as per the payout mechanism indicated by me/us:

Bank Name

A/c No. IFSC Code


N ote : If the bank account mentioned above is different from those already registered in your folio OR If the bank account details are not filled above, the redemption will be
processed into the “ Default” bank account registered for the aforesaid folio.
EISC-STASLIM-16.6.0-031123135048(I)-A16605--1124

6 DECLARATION AND SIGNATURES


I / We have read , understood and hereby agree to comply with the terms and conditions of the scheme related documents including the Key Information Memorandum and request
for Purchase /Redem ption/Switch of Units of the Schem e(s ) of Tata Mutual Fund (‘Fund’) indicated in the application form . I/W e will indemnify the Fund , A M C , Trustee, RTA and
other intermediaries in case of any dispute regarding the eligibility,validity and authorization of m y /our transactions . I/We shall not hold AMC /mutual Fund or it’s RTA for not being
able to process my request due to incomplete information provided by me. The Intermediary has disclosed to me/us all the com m issions (in the form of trail commission or any other
m ode), 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/W e hereby confirm
that I/W e have not been offered/com m unicated any indicative portfolio and/or any indicative yield by the Fund/A M C /its interm ediary for this investm ent.

Date:

Sole / 1 st Applicant Signature / Thumb 2 nd Applicant Signature / 3 rd Applicant


Signature /
Impression Thumb Impression Thumb Impression

ACKNOWLEDGEMENT SLIP

Received request from Mr./Ms./M/s. Folio No.

for purchase of switch-in of redemption (details overleaf)

Page : 3 / 4
IN S TR U C TIO N S
Call: 1800 209 0101 • SMS: TMF To 57575 • E-mail: enq_t@camsonline.com

1. GENERAL INSTRUCTIONS: iii. The Folio number / PAN and Name of the Applicant should be written by the Investor on
The Unit balance(s ) is/are subject to realization of Cheque / D D the reverse of the cheques and bank drafts accom panying the transaction form.
i.
accom panying the Purchase Request & PAN Validation.
ii. This Account Statem ent is subject to quality check. iv. The first unit holder should be one of the bank account holders in the pay-in bank
account. Purchase application through Cheque/D D /RTGS/NEFT/Funds transfer
iii. This Account Statement is a record of your transactions of the Units held in Tata
requests should necessarily mention the pay-in bank account details i.e. account
Mutual Fund (TM F).
number and bank, branch name of the bank account used for issuing the payments to
iv. Kindly review this statement and contact the Investor Service Centres / 022- the fund. If this is not evidenced on the payment cheque/funds transfer/RTGS/NEFT
62827777 / enq_t@cam sonline.com prom ptly if there is any discrepancy. C ontents request, or in case of demand drafts, unit holder should attach necessary supporting
of this statement will be considered correct if no error is reported within 30 days of documents as required by TMF,like bank certificate, bank passbook copy or statem ent
receipt of the statem ent. to prove that the funds are from a bank account held by first unit holder only. If the
v. For more information about our product, services and processes , visit our website documents are not subm itted with the application, the fund reserves the right to reject
w w w .tatam utualfund.com . the application or call for additional details . Investors are advised to visit
vi. Please quote your Folio Number in all future correspondence, please use the w w w .tatam utualfund.com for details on documents, restrictions on third party
transaction forms enclosed along with this account statement for additional paym ents or approach any of the AM C offices.
purchase, switch and redem ption.
vii. The Statement of Additional Information (SAI), Schem e Inform ation Docum ent
v. In case of discrepancies in the amount received from the investor and the amount
(S ID ) and Key Information Memorandum (K IM ) of the schemes and information mentioned in the application form the application units will be allotted for the amount
about our product, services and processes are available on received in our bank account.
w w w .tatam utualfund.com .
vi. Units will be allotted subject to realization of paym ent proceeds.
viii. Investors need to read the SAI , S ID , K IM , Addenda, KIM and Instructions therein
and below mentioned instructions carefully before filling up the transaction form s. vii. ADDITIONAL PURCHASE THROUGH OTM FACILITY: Investors m aking paym ent
through OTM facility registered in their folio , should tick the relevant box and need not
attach any cheque . If more than one bank account is registered in the folio under OTM
ix. Transaction Charges:
facility, investors should mention the bank account number and bank name where they
In accordance with SEBI circular No. C ir/ IM D / D F /13/ 2011 dated August 22,2011,
wish the debit to happen . If the same is not mentioned or is not registered, default bank
Tata Asset Management Private Limited / Mutual Fund will deduct transaction
mandate under OTM facility will be considered to debit the purchase amount.
Charges from the purchase/ subscription amount received from the investors
investing through a valid Intermediary Holder i .e. Intermediaries (provided the
Interm ediary has opted to receive the transaction Charges).Transaction Charge of 3. SWITCHES:
R s. 100 per purchase / subscription of Rs. 10,000 and above are deductible (per i. Investors can split the sw itch-out amount in more than one scheme, subject to m eeting
Scheme Plan - Option) from the purchase / subscription amount and payable to the the m inim um am ount criterion of the switch-in schem es.
Interm ediary. The balance amount shall be invested. ii. Sw itch –outs to more than one scheme can be in terms of Amount Only.
Transaction Charges shall not be deducted: iii. If amount to be switched is insufficient in the Switch-out scheme then the balance
available free units in the scheme will be switched subject to the minimum application
where the Intermediary of the investor has not opted to receive any Transaction am ount of the Switch –in Scheme(s ).
a.
Charges iv. S w itch-out of ‘All Units ’ option can be selected for switch -in to a single scheme only .
for purchases / subscriptions / total commitment amount in case of SIP of an The switch -in scheme should be mentioned in the section 5 without mentioning the
b.
amount less than Rs. 10,000/-; am ount.
c. for transactions other than purchases / subscriptions relating to new inflows i.e. 4. REDEMPTIONS:
through Switches / Systematic Transfers / Dividend Transfers/ Dividend i. The Redemption form can be used for redemption requests upto 7 schem es within the
Reinvestment, etc.; sam e folio.
for purchases / subscriptions made directly with the Fund (i.e. not through any
ii. The Redemption form has to be filled with the scheme details within a folio. Investors
d. need to specify the name of the scheme (s ), plan, option and units/am ount they wish to
Intermediary); and
redeem. In case the details are not mentioned, transactions are liable for rejection.
e. for purchases / subscriptions routed through Stock Exchange(s).
x. All transactions must be signed in accordance with the mode of holding opted by the iii. For redemption of All units, investors need to specify by selecting the "All Units" option.
investor. If the redemption request specifies both i.e. unit and amount ,the units mentioned shall
xi. All transactions will be accepted subject to verification of mandatory information / be considered for the transaction . If there is no sufficient am ounts/ units, the balance
documents. available free units in the respective account will be redeemed.
xii. Investors shall note that KYC is mandatory and they need to comply with the 'Know Your
Client' requirements as applicable from time to time. For more information on KYC, iv. Redemption may not be processed if folio number and full scheme name including plan
please visit our website www.tatamutualfund.com. Applications are liable to be rejected and option is not mentioned. Investors need to ensure that either of amount or units is
without any intimation to the applicants, if required KYC compliance is not completed by mentioned in the redemption request. TMF offers a facility to register multiple bank
all the applicants/unit holders. accounts and designate one of the bank account as "Default Bank Account". D efault
xiii. Do not overwrite. For any corrections/changes if made in the transaction forms, the Bank Account will be used for all redemptions payouts unless investor specifies one of
investors shall enter the correct details pursuant to cancellation of incorrect details and the existing registered bank account in the redemption request for receiving redemption
authenticate the corrected details by counter- signing against the changes. Applications proceeds.
with any such changes not counter- signed by the applicants are liable for rejection.
v. Proceeds of any redemption request will be sent only to a bank account that is already
registered and validated in the folio at the time of redemption transaction processing .
xiv. Applications complete in all respects, may be submitted out at any of our branch/ Investors may choose to mention any of the existing registered bank accounts with
authorized centre of AMC & Registrar. redemption request for receiving redemption proceeds. If registered bank account is
xv. Application received at any of our branch/authorized centre of AMC/Registrar would be not mentioned, default bank account will be used. If a new and unregistered bank
time stamped on receipt to evidence time of receipt of the application. An mandate is provided with a specific redemption request (with or without necessary
acknowledgement may be issued across the counter confirming the date & time of supporting docum ents ) such bank account will not be considered for payment of
receipt of the application. Investors are advised to retain the acknowledgement slip till redemption proceeds. Tata Asset management Private Ltd OR Tata mutual Fund will
they receive a confirmation of processing of their transaction. not be liable for any loss arising to the investors due to the credit of redemption
proceeds into any of the bank accounts registered with us for the aforesaid folio
xvi. Subject to applicable regulations and provisions in the Scheme Information Document of
the scheme(s) the date and time stamp would be considered for determining applicable
EISC-STASLIM-16.6.0-031123135048(I)-A16605--1124

NAV for the transactions. vi. Redemption requests should not be accompanied with requests for Change of Bank
xvii. Applications incomplete in any respect are liable to be rejected. Tata Asset Management Account D etails . If the Change of Bank Account Detail request is received along with
Private Limited (the AMC) / Tata Trustee Company Private Limited (Trustee) have Redemption requests only the redemption request will be processed and the
absolute discretion to reject any such Application Forms. redemption proceeds will be credited to the last registered bank mandate & the request
for Change of bank mandate will be rejected.New bank accounts can only be registered
2. PURCHASES:
using the designated "Bank Account Registration Form /Multiple Bank Account
i. Investors need to indicate their choice of Scheme, Plan and Option for which
Registration Form ". In case the investor needs to add/alter the existing bank mandate
subscription is made at the time of filling up the Transaction Form. In case of ambiguity
he should carry out the same 10 business days prior to date of redemption.
default options will apply.
ii. Investors can invest in more than one scheme with one cheque/ payment instrument.
This facility is for administrative convenience only. For investment in more than one vii. Investor holding units in the Depository Account, need to submit the redemption
request to Depository Participant/ Interm ediary.
scheme a single cheque/DD amounting to the total value of investment must be drawn in
favour of "Tata Mutual Fund" dated, signed and crossed 'A/c Payee only.' For investment 5. REGISTRAR:
in single scheme cheque must be drawn in favour of "Name of the Scheme". C omputer Age M anagement S ervices Limited. : New No . 10 (Old No. 178), M .G.R .
Salai, N ungam bakkam , Chennai - 600 034.
E-m ail: enq_t@cam sonline.com

Acknowledgement Slip (to be filled by the investor)


Purchase Cheque No. Dated Bank A/c. No.
Sn. Switch-in/Redemption Scheme/Plan/Option Units / Amount Sn. Switch-in/Redemption Scheme/Plan/Option Units / Amount
1. 5.
2. 6.
3. 7.
4.

Page : 4 / 4
Mutual fund redemption statement for Rs.1,20,372 and
Rs.1,60,997.Due to security reasons last 4 digits of the account which
is linked to his mutual fund is mentioned below the table,highted the
Account Statement
same.

Page 1 of 3
investor.line@mutualfunds.hsbc.co.in 1800 200 2434 / 1800 4190 200 assetmanagement.hsbc.com/in
Folio Number : 4631292 / 16 Statement Date : 03-Nov-2023
R Kanakavalli (First Holder) Total Units : 0.00
Investment Overview
Total Valuation : INR Total Valuation : INR
Mode of Holding : Anyone or Survivor
Old No 33 New No 12 Tax Status : Individual
Natumuthu Kumarappa Street Nmk Street 2 nd Unit Holder : K Raghunathan
Mylapore 3 rd Unit Holder : None
Chennai - 600004
Nominee : OPTED OUT
Tamil Nadu
India
Off : - Res : 9380633036
Mobile : XXXXXXXXX3036 Guardian :-
EMAIL : XXXXXXXXXXXXXnaka@gmail.com POA :-
CAN : N/A Statement Preference : By Email
IDCW Option : Pay IDCW

INVESTOR TYPE PAN PAN VERIFIED KYC COMPLIANT CKYC-KIN FATCA/UBO SUPPLEMENTARY PAN AADHAR
KYC LINKING STATUS
Complied/Not
First Holder AVDPK***** Yes Yes Not Provided Complied Successful
applicable
Complied/Not
Second Holder AGZPR***** Yes Yes Not Provided Complied Successful
applicable

HSBC Midcap Fund - Regular IDCW# (Formerly known as L&T Midcap Fund - NAV as on 02/11/2023 : INR 57.0983
IDCW# )
ISIN - INF917K01239

EISC-CCSHAKTI-16.6.0-031123130152(I)-A16605--1042
Date Transaction Type Amount Price NAV Number of Balance
(INR) (INR) (INR) Units Units
Opening Balance as on 23/08/2019 0.000
23/08/2019 Purchase 80,000.00 37.370 37.3700 2,140.755 2,140.755
23/08/2019 ***IDCW Payout @ Rs.2.87757809 per unit*** 6,160.19 37.3700
26/08/2020 ***IDCW Payout @ Rs.1.50 per unit*** 3,211.13 39.9600
26/08/2021 ***IDCW Payout @ Rs.3.50 per unit*** 6,743.64 55.0900
*** TDS on Cumulative IDCW *** 749.00
26/08/2022 ***IDCW Payout @ Rs.3.75 per unit*** 7,224.83 54.2400
*** TDS on Cumulative IDCW *** 803.00
26/05/2023 ***Registration of Nominee Rejected***
25/08/2023 ***IDCW Payout @ Rs.5.00 per unit*** 9,633.78 59.6460
*** TDS on Cumulative IDCW *** 1,070.00
19/09/2023 ***Change of Contacts***
22/09/2023 Redemption - ELECTRONIC PAYMENT - CITIN23427948893 , less (120,372.17) 56.2294 56.2294 (2,140.755) 0.000
STT
*** STT Paid *** (1.20)
23/09/2023 ***Address Updated from KRA Data***

Unit Balance : 0.00 Cost Value : INR 0.00

Market Value as on 02/11/2023 : INR 0.00 Available Units for Redemption : 0.000

IDCW for the period : 32,973.57 IDCW since inception : 32,973.57 Units under Lien : 0.000 Payout Mode : Electronic

Bank Details : SB XXXXXXXXXXX6799 / Indian Overseas Bank / CHENNAI-EAST MADA STREET / Chennai IFSC Code : IOBA0001083

MICR Code : 600020057 Your Broker/Dealer is : ARN-137779 / Revathi Sub-Broker (ARN Code) : -
EUIN : E232917 Sub-Broker Code : -

Exit Load :If the units redeemed or switched out are upto 10% of the units purchased or switched in (the limit) within 1 year from the date of allotment Nil. If units redeemed or switched out are
over and above the limit within 1 year from the date of allotment 1%. If units are redeemed or switched out on or after 1 year from the date of allotment Nil. A switch-out or a withdrawal under
SWP may also attract an Exit Load like any Redemption.No Exit load will be chargeable in case of switches made between different options of the Scheme.No Exit load will be chargeable in
case of Units allotted on account of dividend reinvestments, if any.

HSBC Small Cap Fund - Regular IDCW# (Formerly known as L&T Emerging
Businesses Fund IDCW # ) NAV as on 02/11/2023 : INR 36.3672
ISIN - INF917K01QB9
Date Transaction Type Amount Price NAV Number of Balance
(INR) (INR) (INR) Units Units
Opening Balance as on 08/06/2018 0.000
08/06/2018 Purchase 100,000.00 22.598 22.5980 4,425.170 4,425.170
09/06/2018 ***Address Updated from KRA Data***
26/10/2018 ***IDCW Payout @ Rs.1.32811296 per unit*** 5,877.13 19.7680

#IDCW - Income Distribution cum Capital Withdrawal

... continued on next page


Page 2 of 3

HSBC Small Cap Fund - Regular IDCW# (Formerly known as L&T Emerging
Businesses Fund IDCW # ) NAV as on 02/11/2023 : INR 36.3672
ISIN - INF917K01QB9
Date Transaction Type Amount Price NAV Number of Balance
(INR) (INR) (INR) Units Units
Opening Balance as on 08/06/2018 0.000
23/10/2019 ***IDCW Payout @ Rs.1.06249037 per unit*** 4,701.70 17.4510
22/10/2021 ***IDCW Payout @ Rs.1.50 per unit*** 5,973.76 31.2030
*** TDS on Cumulative IDCW *** 664.00
21/10/2022 ***IDCW Payout @ Rs.1.85 per unit*** 7,367.56 32.3730
*** TDS on Cumulative IDCW *** 819.00
25/05/2023 ***IDCW Payout @ Rs.3.00 per unit*** 11,947.51 33.4612
*** TDS on Cumulative IDCW *** 1,328.00
22/09/2023 Redemption - ELECTRONIC PAYMENT - CITIN23427948853 , less (160,997.58) 36.383 36.3826 (4,425.170) 0.000
STT
*** STT Paid *** (1.61)

Unit Balance : 0.00 Cost Value : INR 0.00

Market Value as on 02/11/2023 : INR 0.00 Available Units for Redemption : 0.000

IDCW for the period : 35,867.66 IDCW since inception : 35,867.66 Units under Lien : 0.000 Payout Mode : Electronic

Bank Details : SB XXXXXXXXXXX6799 / Indian Overseas Bank / CHENNAI-EAST MADA STREET / Chennai IFSC Code : IOBA0001083

MICR Code : 600020057 Your Broker/Dealer is : ARN-137779 / Revathi Sub-Broker (ARN Code) : -
EUIN : E232917 Sub-Broker Code : -

Exit Load :If the units redeemed or switched out are upto 10% of the units purchased or switched in (the limit) within 1 year from the date of allotment Nil. If units redeemed or switched out are
over and above the limit within 1 year from the date of allotment 1%. If units are redeemed or switched out on or after 1 year from the date of allotment Nil. A switch-out or a withdrawal under

EISC-CCSHAKTI-16.6.0-031123130152(I)-A16605--1042
SWP may also attract an Exit Load like any Redemption.No Exit load will be chargeable in case of switches made between different options of the Scheme.No Exit load will be chargeable in
case of Units allotted on account of dividend reinvestments, if any.

#IDCW - Income Distribution cum Capital Withdrawal


... continued on next page
To locate your nearest Investor Service Centre of AMC / CAMS please visit the Contact Us section www.assetmanagement.hsbc.co.in/en/mutual-funds or www.camsonline.com

Folio Number : 4631292 / 16


Particulars PAN No KYC Compliant Last Transacted
: ARN-137779/Revathi
R Kanakavalli (First Holder) AVDPK***** Yes Broker Code

Sub-Broker (ARN Code) :


Mode of Holding : Anyone or Survivor EUIN : E232917

Scheme HSBC Plan :

^Sub-Option Growth Reinvestment Payout of IDCW ^IDCW Frequency Daily Weekly Fortnightly Monthly Quarterly Semi-Annual Annual
of IDCW
ADDITIONAL PURCHASE REQUEST Cheque/Transfer
Cheque/Transfer
Date Date
I / We would like to purchase Units of the above mentioned Scheme for Rs. (amount in figures) transferred via RTGS or Funds Transfer or
Cheque/DD No. Drawn on bank A/c. No.
To your Bank A/c. No. A/c. Type Current Savings NRO NRE FCNR Others

SWITCH REQUEST (From scheme as above) Please check exit load, if applicable.
I / We wish to switch All Units OR No. of Units OR Amount Rs.
To Scheme HSBC Plan Option
^Sub-Option Growth Reinvestment Payout of IDCW ^IDCW Frequency Daily Weekly Fortnightly Monthly Quarterly Semi-Annual Annual
of IDCW
Sole / First Unitholder Guardian Second Unitholder Third Unitholder
PAN (Mandatory)
Documents attached to avoid Third Party Payment Rejection where applicable: Third Party Declarations Bank Certificate for Pre-funded Instruments.
^ In case the option(s) offered are not ticked or incorrectly ticked, the default option(s) will be applicable as per SID and SAI.
In case the Additional Purchase amount is Rs. 10,000 or more and your Distributor has opted to receive Transaction Charges Rs. 100/- will be deducted from the purchase amount and paid to the Distributor. Units will be
issued against the balance amount invested . I / We have read and understood the terms and contents of the Scheme Information Documents including addenda, Key Information Memorandum and load structure (s) of the
respective Scheme (s) and Statement of Additional Information of HSBC Mutual Fund. I / We hereby apply to the Trustee of HSBC Mutual Fund for allotment of Units of the Scheme(s) of HSBC Mutual Fund, as
indicated and agree to abide by the terms, conditions, rules and regulations of the relevant Scheme(s). I / We have not received nor been induced by any rebate or gifts, directly or indirectly, in making this investment. The
ARN Holder 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 whcih 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 HSBC Mutual Fund / HSBC Asset
Management Company Limited / its distributor for this investment. I / We am / are authorised to undertake this transaction.

X X X

SIGNATURE(S) First Account Holder / Regd. POA Holder Second Account Holder / Regd. POA Holder Third Account Holder / Regd. POA Holder
In case of joint holding, the request should be signed by all the unitholders

... continued on next page


Page 3 of 3

IMPORTANT INSTRUCTIONS 12. Please note that certain critical information will be obtained from the KRA database and
overwritten in AMC records. Eg: Address, DOB and where email and mobile number is not
1. Please fill in details in English and in BLOCK CAPITALS in Black or Blue ink. available in the folio.
13. Any non-financial or static details change request received with a financial transaction will be
2. If you have filled both side of the transaction slip, it is mandatory to sign both sides, failing
rejected. In such cases, only the financial transaction will be processed. For e.g. incase of a
which only the signed side will be processed.
redemption transaction, the same will be processed and the proceeds shall be credited to the
3. PAN and KYC are mandatory for all investors, POA holders and Guardians. registered bank account without considering the change of bank details received along with such
redemption request.
4. Completed Transaction Slip should be submitted to HSBC or CAMS Investor Service Centres. 14. In order to avoid any instances of mis-selling, please provide the EUIN of the Sub-Broker
Please visit our website www.assetmanagement.hsbc.co.in for an updated list of Official Points code/Main ARN code as applicable in case if your transaction is advisory in nature. In case of
of Acceptance of HSBC Mutual Fund. Please visit www.camsonline.com for an updated list of execution mode, please provide the declaration.
CAMS.
15. In case of Direct Application, please write as "Direct" against Broker Code.Any correction of the
5. This Account Statement is record of your transaction in the Units of the Scheme(s) of HSBC code requires authentication. Any corrections in the request to be counter-signed by the unit
Mutual Fund. This is a non-transferable document. The unit balance shown overleaf is subject to holder(s).
realisation of cheque, fulfilment of regulatory requirements, fulfilment of requirements of the
scheme related documents / Addendum(s) and furnishing necessary information to the 16. Please refer to the SID/SAI/KIM for details on Transaction Charges, Third Party validation,
satisfaction of the Mutual Fund. Kindly quote your Folio No. and Plan / Scheme name in all Stamp Duty Charges.
future correspondence. 17. Redemption request:
a. Please specify scheme details and the amount /number of units you wish to redeem . If
6. All cheques and bank drafts must be drawn in the name of Scheme as specified in the Scheme your redemption request specifies both amount and units for redemption, then the
related documents and crossed "Account Payee Only". A separate cheque / bank draft / fund amount will be considered.
transfer letter must accompany each Application. All purchase are subject to realisation of
instruments. b. In case an investor has purchased Units on more than one Business Day (either under
the Initial Offer Period or through subsequent purchases) the Units purchased first will
7. Any request must be signed by all joint holders in case mode of operation as specified by the be deemed to have been redeemed first i.e. on a First-In-First-O ut basis.
unitholder(s) is joint.
8. For details and risk factors applicable to the scheme / Plans, Please refer to the scheme related c. A redemption will be processed only for the amount which has been realized. If the
documents. Investors are deemed to have read and understood the terms and conditions of the balance in the scheme/plan/option after taking into account the redemption is below
scheme related documents and addenda of the scheme in which they are transacting, as of the the minimum redemption size (either in amount or in units whichever is less), the
date of the transaction. entire balance would be redeemed and paid out.
9. Please verify the details mentioned on this statement . In case of any discrepancy you
d. To safeguard investors against fraudulent action on their investments, where
may write to enq_o@camsonline.com or investor.line@hsbc.co.in or contact us at the
redemption request is received together with a request for change of address and / or
number mentioned below . Contents of this statement will be considered correct, if no
change in bank details. the AMC may release the payment only after completing
discrepancy is reported within 30 days of receipt of this statement.
necessary additional checks.
18. Switch Request:
10. HSBC Mutual Fund is not responsible for errors or delay in processing your request due to the a. Please specify the exact source, target scheme names for the switch and
errors in the information provided. All transaction processing is subject to final verification.
amount/number of units you wish to switch.

EISC-CCSHAKTI-16.6.0-031123130152(I)-A16605--1042
11. The Proof of address AND PAN Card (OR Any other Proof of Identity for PAN exempt cases b. If your switch request specifies both amount and units, then the amount will be
only). Copies of all documents submitted should be self-attested & accompanied by originals for considered.
verification (OR) they should be attested by a KYD complied distributor or personnel/entities
authorized for attesting as per KYC guidelines. All KYC comliant folios/clients are requested to c. f the balance in the source scheme / plan / option, after taking into account the switch
submit change of address request along with the Supporting documents as outlined under is below the minimum redemption size (either in amount or in units whichever is less),
uniform KYC guidelines. the entire balance in the source scheme will be switched to the target scheme

Contact us at SMS your request to HSBC Mutual Fund


Contact us at our following customer service toll free numbers or write an email to: Latest NAV : Send SMS as HSBCMF NAV <Scheme Code> to 56767
investor.line@m utualfunds.hsbc.co.in Example:
Example: HSBCMF NAV CAMS
F03 O VAL 123456
Investor & Online related queries : 1800-4190-200 / 1800-200-2434 Valuation Service : Send SMS as HSBCMF VAL <folio_number> to 56767
Example: HSBCMF VAL 123456
Investor (Dialing from abroad) : +91 44 39923900
Annual Report :
Useful Links for self service options For Electronic Copy: Send SMS as HSBCMFARE <folio_number> to 567678080
To Invest online or Update your Bank details or Nominee : Example: HSBCMFARE 123456
v isit: https://invest.assetmanagement.hsbc.co.in For Physical Copy: Send SMS as HSBCMFARP <folio_number> to 567678080
Use our 24 x 7 Chatbot : “ASKME” for any queries or service request : Example: HSBCMFARP 123456
v isit: https://invest.assetmanagement.hsbc.co.in
Half Yearly Portfolio:
To update your Personal details like PAN & Email ID : For Electronic Copy: Send SMS as HSBCMFHPE <folio_number> to 567678080
v isit: https://new.camsonline.com
Example: HSBCMFHPE 123456
Join us on WhatsApp For Physical Copy: Send SMS as HSBCMFHPP <folio_number> to 567678080
W hatsApp @ 9326929294 for financial and non-financial transactions, Account statement, Example: HSBCMFHPP 123456
etc.
SMS charges applicable as per the rates fixed for such services by your mobile phone
Missed Call Service operator.
You can give a missed call to 9212900020 to get the total valuation via SMS and a statement
on your registered email ID
To locate your nearest Investor Service Centre of AMC / CAMS please visit the Contact Us section www.assetmanagement.hsbc.co.in/en/mutual-funds or www.camsonline.com
Folio Number : 4631292 / 16
Particulars PAN No KYC Compliant
Last Transacted
AVDPK***** Yes
: ARN-137779/Revathi
R Kanakavalli (First Holder) Broker Code

Sub-Broker (ARN Code) :


Mode of Holding : Anyone or Survivor EUIN : E232917

Folio No.
REDEMPTION REQUEST Please check exit load, if applicable.
I / We would like to redeem from the below mentioned Scheme
All Units OR No. of Units OR Amount Rs. (in words) Rs.
Scheme HSBC Plan
Option ^Sub-Option Growth Reinvestment of IDCW Payout of IDCW

^IDCW Frequency Daily Weekly Fortnightly Monthly Quarterly Semi-Annual Annual


^ In case the option(s) offered are not ticked or incorrectly ticked, the default option(s) will be applicable as per SID and SAI.

For investors who have registered for Multiple Bank Accounts facility in the above folio. (Please strike off this section if not used)
The redemption should be processed into the following bank account as per the payout mechanism indicated by me / us. (This bank account has already been registered in the folio)

Name of the Bank: Account No. : Account Type :

Important Note : If the bank account mentioned above is different from those already registered in your folio OR if the bank account details are not filled above, the redemption will be processed into the “Default”
bank account registered for the aforesaid folio. HSBC Mutual Fund or HSBC Asset Management Company Ltd. will not be liable for any loss arising to the unitholder(s) due to the credit of redemption proceeds into any
of the bank accounts registered with us for the aforesaid folio.
I / We have read and understood the contents of the Scheme Information Document and Statement of Additional Information. Key Information Memorandum, Addendums and Instructions issued of respective Scheme
(s) of HSBC Mutual Fund. I / We hereby apply to the Trustee of HSBC Mutual Fund for units of the Scheme(s) and agree to abide by the terms and conditions, rules and regulations of the relevant Scheme(s). I / We
have neither received nor been induced by any rebate or gifts, directly or indirectly in making this investment.
X X X
SIGNATURE(S) First Account Holder / Regd. POA Holder Second Account Holder / Regd. POA Holder Third Account Holder / Regd. POA Holder
In case of joint holding, the request should be signed by all the unitholders
For any enquiries, please contact Investor Service Centre, HDFC Asset Management Company Ltd, 74, V Block, 5th Avenue, Near Ganga Sweets, Anna
Nagar, Chennai-600040, Tamil Nadu, Phones : 1800 3010 6767 / 1800 419 7676, Email : hello@hdfcfund.com

Page 1 of 2
Account Statement

Folio No. : 1 1 3 2 3 2 0 6 / 7 3 Statement Date : 03-Nov-2023

Mode of Holding : Anyone or Survivor


K Raghunathan Tax Status : Individual

OLD NO 33 NEW 12
NATU MUTHU KUMARAPA STREET
MYLAPORE Mutual fund redemption statement for Rs.1,44,705.37
CHENNAI - 600004 Due to security reasons last 4 digits of the account
Tamil Nadu , India which is linked to his mutual fund is mentioned
Joint 1 : R Kanakavalli below the table,highted the same.
Email : raghunathankanaka@gmail.com
Mobile No. : +919380633036

PAN/ PEKRN PAN-Aadhar linking CKYC No. KYC FATCA / CRS UBO

1st Unit Holder AGZPR3872L Successful Please provide Verified Complete Not applicable

2nd Unit Holder AVDPK8774B Successful Please provide Verified Complete Not applicable

3rd Unit Holder Not applicable Not Applicable Not applicable Not applicable Not applicable Not applicable

Guardian, I f any Not applicable Not Applicable Not applicable Not applicable Not applicable Not applicable

POA, I f any Not applicable Not Applicable Not applicable Not applicable Not applicable Not applicable

Nominee Details
No nominee Opted

8 5 1 2 / HDFC Small Cap Fund - Regular Plan - I DCW # Plan* - I NF1 7 9 KA1 SA9 UCC : MFHDFC0 5 0 0 , Option :
Payout
NAV Amount Price Number of Balance
Date Transaction Type
in I NR in I NR Units Units
Opening Balance as on 22/ 05/ 2018 0.000
22/05/2018 Switch-In - From HDFC Liquid Fund-Growth 26.803 95,315.16 26.803 3,556.138 3,556.138
27/03/2019 * * * ID C W P a id @ R s.2 .5 0 p e r u n it* * * 25.955 8,890.35
18/03/2021 * * * ID C W P a id @ R s.2 .5 0 p e r u n it* * * 27.378 8,223.35
* * * T D S o n C u m u la tiv e ID C W * * * 667.00
17/03/2022 * * * ID C W P a id @ R s.3 .5 0 p e r u n it* * * 34.051 11,201.48
* * * T D S o n C u m u la tiv e ID C W * * * 1,245.00
16/03/2023 * * * ID C W P a id @ R s.3 .0 0 p e r u n it* * * 33.860 9,601.41
* * * T D S o n C u m u la tiv e ID C W * * * 1,067.00
22/09/2023 Redemption - NEFT PAYOUT - via HDFCMFOnline - 40.692 (144,705.37) 40.692 (3,556.138) 0.000
N269232656154189 , less STT
*** STT Paid *** (1.00)
Available Units to Redeem : 0.000
Market Value of Balance Units at NAV of 40.322 on 02/11/2023 (INR) : 0.00 Total Units Under Lien : 0.000
IDCW reinvested / paid (INR) : 37,916.59 Total IDCW reinvested / paid (INR) : 37,916.59
Primary Bank Account : SB XXXX6799 / Indian Overseas Bank / Eastmada / Chennai / IOBA0001083 Redemption / IDCW Payout Mode : Electronic
EISC-HDFCKANT-16.6.0-031123112442(I)-A16605--1119-NN

Advisor : ARN-137779 / Revathi


EUIN : E232917

I DCW-I ncome Distribution and Capital Withdrawal * Due to change in fundamental attributes of the Scheme w.e.f. May 23, 2018, the type of the Scheme has been changed to an
open-ended equity scheme predominantly investing in small cap stocks. Current Load Structure - Entry Load: Not Applicable; Exit Load: 1% if units are redeemed/ switched-out
within 1 year from the allotment date; No Exit Load if units are redeemed / switched-out after 1 year. The rate of exit load levied on units redeemed/ switched-out will be the rate
prevailing at the time of allotment of the units. For further details visit www.hdfcfund.com or contact any of our I nvestor Service Centre. GST I dentification Number :
27AAATH1809A1Z9

8 6 1 1 / HDFC Liquid Fund - Regular Plan - Grow th * - I NF1 7 9 KB1 HK0 UCC : MFHDFC0 0 0 4

NAV Amount Price Number of Balance


Date Transaction Type
in I NR in I NR Units Units
Opening Balance as on 09/ 05/ 2018 0.000
09/05/2018 Switch-In - From HDFC Prudence Fund-Dividend 3,434.8287 95,116.86 3,434.8287 27.692 27.692

#I DCW - I ncom e Dist ribut ion cum Capit al W it hdraw al continued...


Page 2 of 2
Account Statement ( Folio No. : 11323206 / 73)
8 6 1 1 / HDFC Liquid Fund - Regular Plan - Grow th * - I NF1 7 9 KB1 HK0 UCC : MFHDFC0 0 0 4

NAV Amount Price Number of Balance


Date Transaction Type
in I NR in I NR Units Units

21/05/2018 Switch Out - To HDFC Small Cap Fund - Regular DP 3,441.9742 (95,315.16) 3,441.9742 (27.692) 0.000
Available Units to Redeem : 0.000
Market Value of Balance Units at NAV of 4,560.9946 on 02/11/2023 (INR) 0.00
: Total Units Under Lien : 0.000
IDCW reinvested / paid (INR) : 0.00 Total IDCW reinvested / paid (INR) : 0.00
Primary Bank Account : SB XXXX6799 / Indian Overseas Bank / Eastmada / Chennai / IOBA0001083 Redemption Payout Mode : Electronic
Advisor : ARN-137779 / Revathi
EUIN : E232917

* Merger of erstwhile 'HDFC Liquid Fund Premium Plan into HDFC Liquid Fund, w.e.f, May 11, 2019, HDFC Liquid Fund, An open ended Liquid Scheme. Current Load Structure:
Entry Load: Not Applicable. Exit Load: Effective October 20, 2019, following graded exit load will be applicable if units are redeemed/ switched-out within 6 days from the date of
allotment: Day1 - 0.0070% ; Day2 - 0.0065% ; Day3 - 0.0060% ; Day4 - 0.0055% ; Day5 - 0.0050% ; Day6 - 0.0045% ; Day7 onwards - Nil. For further details visit
www.hdfcfund.com (under I nvestor Corner) or contact any of our I nvestor Service Centre. GST I dentification Number : 27AAATH1809A1Z9. On account of the change in face
value of units, the NAV and balance units in this scheme were adjusted with effect from August 30, 2015. This change did not affect the value of units held (subject to rounding
off).

Details regarding your primary Bank account and Email Id maybe masked to ensure security of information.
(#)switch-in will be processed based on the settlement cycle of the switch-out scheme.
This is a computer generated statement and does not require any signature.

Non Financial Transaction( s)


Date Transaction Type
01/02/2017 Address Updated from KRA Data
01/02/2017 Address Updated from KRA Data - 1st Joint Holder
23/05/2023 Form 15H Registration
23/05/2023 Registration of Nominee Rejected
20/09/2023 Change of Contacts
22/09/2023 Address Updated from KRA Data

EISC-HDFCKANT-16.6.0-031123112442(I)-A16605--1119-NN
For any enquiries, please contact Investor Service Centre, HDFC Asset Management Company Ltd, 74, V Block, 5th Avenue, Near Ganga Sweets, Anna
Nagar, Chennai-600040, Tamil Nadu, Phones : 1800 3010 6767 / 1800 419 7676, Email : hello@hdfcfund.com

Page 1 of 2
Account Statement

Folio No. : 1 1 3 2 3 3 0 8 / 5 8 Statement Date : 03-Nov-2023

Mode of Holding : Anyone or Survivor


K Raghunathan Tax Status : Individual

OLD NO 33 NEW 12
NATU MUTHU KUMARAPA STREET
MYLAPORE
Mutual fund redemption statement for Rs.5,72,371.03
CHENNAI - 600004 Due to security reasons last 4 digits of the account
Tamil Nadu , India which is linked to his mutual fund is mentioned
Joint 1 : R Kanakavalli below the table,highted the same.

Email : raghunathankanaka@gmail.com
Mobile No. : +919380633036

PAN/ PEKRN PAN-Aadhar linking CKYC No. KYC FATCA / CRS UBO

1st Unit Holder AGZPR3872L Successful Please provide Verified Complete Not applicable

2nd Unit Holder AVDPK8774B Successful Please provide Verified Complete Not applicable

3rd Unit Holder Not applicable Not Applicable Not applicable Not applicable Not applicable Not applicable

Guardian, I f any Not applicable Not Applicable Not applicable Not applicable Not applicable Not applicable

POA, I f any Not applicable Not Applicable Not applicable Not applicable Not applicable Not applicable

Nominee Details
No nominee Opted

2 1 1 1 / HDFC Asset Allocator Fund of Funds Regular I DCW # * - I NF1 7 9 KC1 BE5 , Option : Payout

NAV Amount Price Number of Balance


Date Transaction Type
in I NR in I NR Units Units
Opening Balance as on 05/ 05/ 2021 0.000
Gross NFO Purchase 200,000.00
Less: Stamp Duty 10.00
05/05/2021 Net Purchase 10.00 199,990.00 10.00 19,999.000 19,999.000
25/10/2023 Redemption - NEFT PAYOUT - HDFCR52023102798969376 13.61 (272,186.39) 13.6100 (19,999.000) 0.000
Available Units to Redeem : 0.000
Market Value of Balance Units at NAV of 13.71 on 02/11/2023 (INR) : 0.00 Total Units Under Lien : 0.000
IDCW reinvested / paid (INR) : 0.00 Total IDCW reinvested / paid (INR) : 0.00
Redemption / IDCW Payout Mode : Electronic
Primary Bank Account : SB XXXX6799 / Indian Overseas Bank / East Mada St / Chennai / IOBA0001083

Advisor : ARN-137779 / Revathi


EUIN : E232917

An open ended Fund of Funds scheme investing in equity oriented, debt oriented and gold ETFs schemes. Current Load Structure: Entry Load: Not Applicable. Exit Load:
Redemption/ Switch-out upto 15% of the units from the date of allotment: NI L. Units in excess of 15% : within 1 Year of allotment - 1% . The rate of exit load levied on units
redeemed will be the rate prevailing at the time of allotment of the units. For further details, visit www.hdfcfund.com (under I nvestor Corner) or contact any of our I nvestor
Service Centre. GST I dentification Number: 27AAATH1809A1Z9
EISC-HDFCKANT-16.6.0-031123112242(I)-A16605--1119-NN

8 5 1 2 / HDFC Small Cap Fund - Regular Plan - I DCW # Plan* - I NF1 7 9 KA1 SA9 UCC : MFHDFC0 5 0 0 , Option :
Payout
NAV Amount Price Number of Balance
Date Transaction Type
in I NR in I NR Units Units
Opening Balance as on 22/ 05/ 2018 0.000
22/05/2018 Switch-In - From HDFC Liquid Fund-Growth 26.803 377,013.22 26.803 14,066.083 14,066.083
27/03/2019 * * * ID C W P a id @ R s.2 .5 0 p e r u n it* * * 25.955 35,165.21
18/03/2021 * * * ID C W P a id @ R s.2 .5 0 p e r u n it* * * 27.378 32,528.21
* * * T D S o n C u m u la tiv e ID C W * * * 2,637.00
17/03/2022 * * * ID C W P a id @ R s.3 .5 0 p e r u n it* * * 34.051 44,308.29
* * * T D S o n C u m u la tiv e ID C W * * * 4,923.00
16/03/2023 * * * ID C W P a id @ R s.3 .0 0 p e r u n it* * * 33.860 37,978.25

#I DCW - I ncom e Dist ribut ion cum Capit al W it hdraw al continued...


Page 2 of 2
Account Statement ( Folio No. : 11323308 / 58)
8 5 1 2 / HDFC Small Cap Fund - Regular Plan - I DCW # Plan* - I NF1 7 9 KA1 SA9 UCC : MFHDFC0 5 0 0 , Option :
Payout
NAV Amount Price Number of Balance
Date Transaction Type
in I NR in I NR Units Units

* * * T D S o n C u m u la tiv e ID C W * * * 4,220.00
22/09/2023 Redemption - NEFT PAYOUT - via HDFCMFOnline - 40.692 (572,371.03) 40.692 (14,066.083) 0.000
HDFCR52023092690445225 , less STT
*** STT Paid *** (6.00)
Available Units to Redeem : 0.000
Market Value of Balance Units at NAV of 40.322 on 02/11/2023 (INR) : 0.00 Total Units Under Lien : 0.000
IDCW reinvested / paid (INR) : 149,979.96 Total IDCW reinvested / paid (INR) : 149,979.96
Redemption / IDCW Payout Mode : Electronic
Primary Bank Account : SB XXXX6799 / Indian Overseas Bank / East Mada St / Chennai / IOBA0001083

Advisor : ARN-137779 / Revathi


EUIN : E232917

I DCW-I ncome Distribution and Capital Withdrawal * Due to change in fundamental attributes of the Scheme w.e.f. May 23, 2018, the type of the Scheme has been changed to an
open-ended equity scheme predominantly investing in small cap stocks. Current Load Structure - Entry Load: Not Applicable; Exit Load: 1% if units are redeemed/ switched-out
within 1 year from the allotment date; No Exit Load if units are redeemed / switched-out after 1 year. The rate of exit load levied on units redeemed/ switched-out will be the rate
prevailing at the time of allotment of the units. For further details visit www.hdfcfund.com or contact any of our I nvestor Service Centre. GST I dentification Number :
27AAATH1809A1Z9

Details regarding your primary Bank account and Email Id maybe masked to ensure security of information.
(#)switch-in will be processed based on the settlement cycle of the switch-out scheme.
This is a computer generated statement and does not require any signature.

8 6 1 1 / HDFC Liquid Fund - Regular Plan - Grow th * - I NF1 7 9 KB1 HK0 UCC : MFHDFC0 0 0 4

NAV Amount Price Number of Balance


Date Transaction Type
in I NR in I NR Units Units
Opening Balance as on 09/ 05/ 2018 0.000
09/05/2018 Switch-In - From HDFC Prudence Fund-Dividend 3,434.8287 376,228.87 3,434.8287 109.534 109.534
21/05/2018 Switch Out - To HDFC Small Cap Fund - Regular DP 3,441.9742 (377,013.22) 3,441.9742 (109.534) 0.000
Available Units to Redeem : 0.000
Market Value of Balance Units at NAV of 4,560.9946 on 02/11/2023 (INR) 0.00
: Total Units Under Lien : 0.000
IDCW reinvested / paid (INR) : 0.00 Total IDCW reinvested / paid (INR) : 0.00
Redemption Payout Mode : Electronic
Primary Bank Account : SB XXXX6799 / Indian Overseas Bank / East Mada St / Chennai / IOBA0001083

Advisor : ARN-137779 / Revathi


EUIN : E232917

* Merger of erstwhile 'HDFC Liquid Fund Premium Plan into HDFC Liquid Fund, w.e.f, May 11, 2019, HDFC Liquid Fund, An open ended Liquid Scheme. Current Load Structure:
Entry Load: Not Applicable. Exit Load: Effective October 20, 2019, following graded exit load will be applicable if units are redeemed/ switched-out within 6 days from the date of
allotment: Day1 - 0.0070% ; Day2 - 0.0065% ; Day3 - 0.0060% ; Day4 - 0.0055% ; Day5 - 0.0050% ; Day6 - 0.0045% ; Day7 onwards - Nil. For further details visit
www.hdfcfund.com (under I nvestor Corner) or contact any of our I nvestor Service Centre. GST I dentification Number : 27AAATH1809A1Z9. On account of the change in face
value of units, the NAV and balance units in this scheme were adjusted with effect from August 30, 2015. This change did not affect the value of units held (subject to rounding
off).

Details regarding your primary Bank account and Email Id maybe masked to ensure security of information.
(#)switch-in will be processed based on the settlement cycle of the switch-out scheme.
This is a computer generated statement and does not require any signature.

Non Financial Transaction( s)


Date Transaction Type
01/02/2017 Address Updated from KRA Data
01/02/2017 Address Updated from KRA Data - 1st Joint Holder
23/05/2023 Form 15H Registration
EISC-HDFCKANT-16.6.0-031123112242(I)-A16605--1119-NN

23/05/2023 Registration of Nominee Rejected


20/09/2023 Change of Contacts
22/09/2023 Address Updated from KRA Data

#
I DCW - I ncom e Dist ribut ion cum Capit al W it hdraw al
All pages of all passport copies
Proof for qatar stay

Scanned by CamScanner
some of the ticket copies for qatar visit

BOARDING PASS

Mr Inderpaal Singh Rathna Balaji


Flight Class Of Travel Seat Boarding Gate

QR 0528 ECONOMY 45D 18:45


Departure From Destination Departure Date Departure Time
Doha Chennai 05 Jul 2014 19:45

E-Ticket No:
1572341603578

Seq No. 71 Generated on 04 Jul 2014 22:33 Doha Local Time

Important Information:
• Please proceed to the departure level and approach the fast bag drop counters to check-in your luggage.
• Carry on baggage for First and Business Class passengers, 2 pieces weighing no more than 7 kgs each.
• Carry on baggage for Economy Class passengers, 1 piece weighing no more than 7 Kgs.
• We cannot guarantee any particular seat as we may need to change it for operational, safety or security reasons, even after you
have boarded the aircraft.

Free checked baggage per passenger


• Adults and Children : Not to exceed 40 kg and a maximum dimension of 406 cm (length + height + width).

Mr Inderpaal Singh Rathna Balaji


Flight Class Of Travel Seat

QR 0528 ECONOMY 45D


AGENT COPY

Departure Date Seq No. 71


05 Jul 2014
Online Check-in Confirmation
You have successfully checked in your flight.This is not a boarding pass.

Mr Inderpaal Singh Rathna Balaji


Flight Class Of Travel Seat

QR 0529 ECONOMY 25E


Departure From Destination Departure Date Departure Time
Chennai Doha 20 Aug 2014 04:05

Booking Reference ETicket No Status


8U2JYN 1572341603578 Checked In

Free checked baggage allowance per passenger


• Adults and Children : 40 kg

Airport Contact Important Information


For any enquiries on flight, please contact the airport office
below • Please arrive at the Airport Terminal no later than 2 hours
Qatar Airways Sales Office before departure.
#576 Moh Building 1st Floor • You will be required to present your travel documents and
credit card used to make your online booking at the airport check-
Anna Salai Teynampet in counter to get a boarding pass.
Chennai 600 006 • Carry on baggage for First and Business Class passengers, 2
Chennai pieces weighing no more than 7 kgs each.
+91 124 4566000 • Carry on baggage for Economy Class passengers, 1 piece
weighing no more than 7 Kgs.
• Liquid and Gel not permitted more than 100 ML.
• We cannot guarantee any particular seat as we may need to
change it for operational, safety or security reasons, even after you
have boarded the aircraft .
Generated On Thu, 15 Jan 2015 07:13 GMT

Dear Valued Customer, Reservation Details


Booking Reference :- X4WEQJ
Thank you for choosing Qatar Airways.

Passengers
• Mr Balaji Singh Rathna
• Mrs Revathi Balaji Singh
• Mr Inderpaal Singh Rathna Balaji
• Master Surender Singh Rathna Balaji

Flight / Operated By Departs / Arrives Class Special Services

QR 0528 Doha (DOH), Hamad International Airport Economy(S) • Mr Balaji Singh Rathna
Qatar Airways Thu, 22 Jan 2015 18:55 Window Seat
• Mrs Revathi Balaji Singh
Chennai / Madras (MAA), Chennai International Airport
Window Seat
Fri, 23 Jan 2015 01:45 +1 Day(s) • Mr Inderpaal Singh Rathna Balaji
Window Seat
• Master Surender Singh Rathna Balaji
Window Seat

QR 0529 Chennai / Madras (MAA), Chennai International Airport Economy(V) • Mr Balaji Singh Rathna
Qatar Airways Sun, 1 Feb 2015 03:15 Window Seat
• Mrs Revathi Balaji Singh
Doha (DOH), Hamad International Airport
Window Seat
Sun, 1 Feb 2015 05:40 • Mr Inderpaal Singh Rathna Balaji
Window Seat
• Master Surender Singh Rathna Balaji
Window Seat

• To qualify for the fare quoted to you, please purchase your E-ticket before 08:52 AM on Thursday, 15 January 2015

• All Fares, taxes and other charges are subject to change without prior notice.

Office Details : DOHQR0700, QATAR AIRWAYS DOH CC, +974 4023 0000

NOTICE
• Flight(s) calculated average CO2 emissions is 1,642.06 KG/PERSON. SOURCE: ICAO CARBON EMISSIONS CALCULATOR

Note: Please keep this document for your reference. Your official E-Ticket will be issued once payment and ticketing has been completed.
For change in reservations please contact your nearest Qatar Airways office. Please refer to qatarairways.com/contact for details.

Note: Carriage is subject to Qatar Airways full Conditions of Carriage that is available at qatarairways.com/legal or on request from your nearest Qatar Airways Office.
03/11/2023, 21:02 Gmail - Fw: Your IndiGo Itinerary - QLLBRA

Inderpaal Singh Rathna Balaji <inpalsin@gmail.com>

Fw: Your IndiGo Itinerary - QLLBRA


Balaji Singh.R <balajisingh@wintracklimited.com> 14 September 2019 at 16:51
To: revathi <revathi@wintracklimited.com>, inpalsin <inpalsin@gmail.com>

From: IndiGo <reservations@customer.goindigo.in>


Sent: Sat, 14 Sep 2019 14:18:48 GMT+0300
To: <balajisingh@wintracklimited.com>
Subject: Your IndiGo Itinerary - QLLBRA

Email Itinerary

s PNR/Booking Ref.: QLLBRA s

Status Date of Booking* Payment Status

CONFIRMED 14Sep19 11:16:59 (UTC) Approved

*Booking Date reflects in UTC (Universal Time Coordinated), all other timings mentioned are as per Local Time.

IndiGo Passenger(s) Flight Status

1. Mr. Balaji singh Rathna

IndiGo Flight(s)

Flight
From Number Check-in/Bag drop
Date Departs To (Terminal) Arrives Via
(Terminal) (Aircraft closes
type)

6E 1706 Chennai
26 Sep 19 Doha 14:25 13:10 21:20
(A321) (T3)
6E 1707
01 Oct 19 Chennai (T4) 00:30 23:15 Doha 02:25
(A320)

Seats and Additional Services

DOH s MAA MAA s DOH


Passenger name Seat Services Purchased Seat Services Purchased

Mr. Balaji singh


4C 15B
Rathna

Travel and Baggage Information

DOH s MAA MAA s DOH

Fare Type : Return Fare Fare Type : Return Fare


Please do reach the airport 3 hours before flight Please do reach the airport 3 hours before flight
departure. departure.

https://mail.google.com/mail/u/0/?ik=ed2bb6d880&view=pt&search=all&permmsgid=msg-f:1644649593592488563&simpl=msg-f:1644649593592… 1/3
03/11/2023, 21:02 Gmail - Fw: Your IndiGo Itinerary - QLLBRA

Boarding gates close 25 minutes prior to the scheduled Boarding gates close 25 minutes prior to the scheduled
departure time. departure time.
Check-in counters close 75 minutes prior to the Check-in counters close 75 minutes prior to the
scheduled departure time. scheduled departure time.
Check-in baggage allowance: 30kg Check-in baggage allowance: 30kg
Hand Baggage Allowance: 7kg Hand Baggage Allowance: 7kg
Partial cancellation is not allowed. Partial cancellation is not allowed.
Click here for ‘Ok to Board’ information

For Your Benefits

s s

Terms & Conditions

• As per Indian regulations, Click here for conditions of carriage. You can also visit www.goindigo.in.

• For details on the ‘Passenger Charter’ issued by the Ministry of Civil Aviation (MoCA), Click here.

For your information

s s

Have you purchased 6E Top-ups for hassle-free travel?

s s s s

Pre-book additional Pre-book your favourite Priority check-in and Get Travel Assistance and
baggage on your booking snack combo on-board priority baggage handling protect your travel starting
starting ₹1900/5 kg. Add starting ₹200. Add Now! service starting ₹400. Add ₹159. Add Now!
Now! Now!

Fare Summary Personal contact information

Airfare Charges QAR 1,071.00 Home Phone : 974*66276984

G4 QAR 35.00 Email : balajisingh@wintracklimited.com

Passenger Service Charge QAR 7.00 Update Contact details

Airport Fee QAR 40.00

Fiscal Tax QAR 10.00

ASF QAR 22.00

Passenger Service Charge QAR 7.00

User Development Fee QAR 4.00

Convenience Fee QAR 38.00

Seat Fee QAR 27.00

Total Fare QAR 1,261.00

Interglobe Aviation ltd.(IndiGo), Global Business Park, Gurgaon, Haryana, India. Call +91 9910383838
or +91 124 6613838

https://mail.google.com/mail/u/0/?ik=ed2bb6d880&view=pt&search=all&permmsgid=msg-f:1644649593592488563&simpl=msg-f:1644649593592… 2/3

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