UTI Applicaiton Form
UTI Applicaiton Form
2022/
OPEN-ENDed EQUITY AND HYBRID SCHEMES
(OCBs are not allowed to invest in units of any of the schemes of UTI MF)
TIME STAMP
Registrar Sr. No.
(Please read instructions carefully before filling the form and use BLOCK LETTERS only) [Fields Marked with (*) must be Mandatorily filled in] Ê
DISTRIBUTOR INFORMATION (only empanelled Distributors/Brokers will be permitted to distribute Units) (refer instruction ‘h’) BDA / CA Code
ARN/RIA Code^ Name of Financial Advisor Sub ARN Code Sub Code/ M O Code EUI No.@ UTI RM No.
Bank Branch Code
^ By mentioning RIA code, I/we authorise you to share with the Investment Adviser the details of my/our transactions.
Upfront commission shall be paid directly by the investor to the AMFI / NISM certified UTI MF registered Distributors based on the investors’ assessment of
various factors including the service rendered by the distributor.
@ I/We confirm that the EUIN box is intentionally left blank by me/us as this is an “execution-only” transaction without any interaction or advice by the
distributor personnel concerned or notwithstanding the advice of in-appropriateness, if any, provided by such distributor personnel and the distributor
has not charged any advisory fees for this transaction. ( Please tick and sign below when EUIN box is left blank) (refer instruction ‘w’).
Ê
Signature of 1st Applicant / Guardian Signature of 2nd Applicant Signature of 3rd Applicant
TRANSACTION CHARGES TO BE PAID TO THE DISTRIBUTOR (Please tick any one of the below) (Refer Instruction ‘i’)
I AM A FIRST TIME INVESTOR IN MUTUAL FUNDS I AM AN EXISTING INVESTOR IN MUTUAL FUNDS
OR
` 150 will be deducted as transaction charges per Subscription of ` 10,000 and above ` 100 will be deducted as transaction charges per Subscription of ` 10,000 and above
Existing Unit Holder information : If you have an existing Folio No. with PAN & KYC validation, mention your Folio No. :
APPLICANT’S PERSONAL DETAILS Mr. Ms. Mrs. M/s * Denotes Mandatory Fields
Name of First Applicant
F I R S T M I D D L E
L a s t Date of Birth d d m m y y y y Mandatory for minors
Date of birth will be taken as per the KYC record (Not applicable for minor child)
Name in full of the Father (OR) Mother / Guardian (In case of minor) $$ / Contact person for institutional applicants
Mr. Ms. Mrs.
F I R S T M I D D L E L A S T
$$ Proof of date of birth and proof of relationship with minor to be attached or else sign the declaration on the reverse (Refer instruction ‘f ’).
*PAN/PEKRN$ OF 1ST APPLICANT/FATHER/MOTHER/GUARDIAN Enclosed PAN/PEKRN CARD/ID PROOF COPY
First Applicant’s Address (Do not repeat the name) Name & Address of resident relative in India (for NRIs) (P.O. Box No. is not sufficient)
Village/Flat/Bldg./Plot*
Street/Road/Area/Post
City/Town* State Pin*
Overseas Address (Overseas address is mandatory for NRI / FPI applicants in addition to mailing address in India)
City*
State Country* Zip/Pin*
*PAN/PEKRN$ OF 2 APPLICANT
nd
Enclosed PAN/PEKRN CARD/ID PROOF COPY
payment details (Refer Instruction ‘y’) (Please ensure that the cheque complies to the CTS 2010 standard)
IFS Code
City Pin*
(this is a 11-digit number)
Account No.
Unitholding Option Physical Mode Demat Mode (if Demat account details are provided below, units will be allotted, by default, in Electronic Mode only)
DEMAT ACCOUNT DETAILS - Please ensure that the sequence of names as mentioned in the application form matches with that of the account held with any one
of the Depository Participant. Demat Account details are compulsory if demat mode is opted above
National Depository Name _________________________________ Central Depository Name ___________________________________________________
Securities Depository
Depository DP ID No. Services Target
Limited Beneficiary (India) ID No.
Account No. Limited
Enclosures : Client Master List (CML) Transaction cum Holding Statement Delivery Instruction Slip (DIS)
Friend in nEed details In case UTI MF is unable to communicate with me/us at my / our registered address, I / we authorize UTI MF to correspond
with the following person to ascertain my/our updated contact details. (refer instruction - k)
Name F I R S T M I D D L E L A S T
Address:
[Please attach self attested copy of PAN/Passport (proof of photo identity) along with application form]
Note : IDCW - Income Distribution cum Capital Withdrawal
GENERAL INFORMATION - Please () wherever applicable
STATUS: Resident Individual Minor through guardian HUF Partnership Trust
Sole Proprietorship Society / Club Body Corporate AOP BOI
FPI NRI Foreign Nationals## Listed Company LLP
Unlisted ‘Not for Profit’^^ Company Other Unlisted Company PIO
Others (Please specify) ________________________________________________________________________________________
^^ ‘Not for Profit’ Company as defined under Companies Act (Act of 1956/2013).
##
Overseas Corporate Bodies (OCBs) are not allowed to invest in units of any of the schemes of UTI MF
details under fatca (Foreign Tax Compliance Act) and CRS (Common Reporting Standard) (Refer instruction ‘z’)
Information to be provided by all Applicants in the same sequence of Names as given in this Application form
Are you a tax resident of any country other than India ?
If No, please tick here: First Applicant Second Applicant Third Applicant
If Yes, please fill in the Particulars in the prescribed Form for FATCA/CRS and attach it with this Application Form.
ACKNOWLEDGEMENT
(To be filled in by the Applicant)
[UTI-LTEF (Tax Saving) is eligible for deduction under section 80C Sr. No. 2022/
of the Income Tax Act, 1961]
Received from Mr / Ms / M/s
(scheme name)
An application under
along with Cheque /DD /NEFT/RTGS
$ $
dated
Ref. No./Unique Serial No. (For Cash)
Drawn on (Bank) Stamp of UTI AMC Office/
Authorised Collection Centre
for ` (in figures)
$
Cheques and drafts are subject to realisation.
NOMINATION DETAILS (Please ) (please sign if you do not wish to nominate)
I/We hereby nominate the undermentioned Nominee to receive the amounts to my / our credit in the event of my / our death. I/We also understand
that all payments and settlements made to such Nominee and signature of the Nominee acknowledging receipt thereof, shall be a valid discharge by
the AMC / Mutual Fund / Trustee.
Ê Investors who wish to nominate two or three persons may fill in the separate form prescribed for the same and attach it with this application form.
I / We hereby confirm that I / We do not wish to appoint any nominee(s) for my mutual fund units held in my / our mutual fund folio and understand the issues
Sign.
here involved in non appointment of nominee(s) and further are aware that in case of death of all the account holder(s), my / our legal heirs would need to submit all
the requisite documents issued by Court or other such competent authority, based on the value of assets held in the mutual fund folio.
Ê
Signature of 1st Applicant / Guardian Signature of 2nd Applicant Signature of 3rd Applicant
OPTION FOR DESPATCH OF STATEMENT OF ACCOUNT (SoA) / AbridgeD Annual Report (aaR)∞
Applicable to NRIs
SoA in Physical Form At my Overseas address as mentioned above
AAR in Physical Form To be dispatched to my resident relative’s address in India as mentioned above
Ê ∞ On providing email-id investors shall receive scheme wise annual report or an abridged summary thereof/ account statements/ transaction confirmation, communication of change of address, change of bank details etc. through email only.
First *Mobile No. Tel. (R) STD CODE Tel. (O) STD CODE
Applicant
Details *E-mail _________________________________________________________ Alternate E-mail _________________________________________________________
*If the Mobile Number or Email ID belongs to a family member please fill-in below details of the family member.
Relationship Relationship
PAN PAN
Signature of 1st Applicant / Guardian / POA^^ Signature of 2nd Applicant / POA^^ Signature of 3rd Applicant / POA^^
Name of 1st Authorised Signatory Name of 2nd Authorised Signatory Name of 3rd Authorised Signatory
____________________________________ __________________________________ ___________________________________
Designation ___________________________ Designation __________________________ Designation _________________________
^^Power of Attorney (POA) Registration No._________________________(if already registered) (refer instruction ‘ab’)
Notes :
1. If the application is incomplete and any other requirement is not fulfilled, the application is liable to be rejected.
2. Consolidated Account Statement (CAS) will be sent within 10 days of the following month of the transaction.
3. Please ensure that all KYC Compliance Proof and PAN details are given, failing which your application will be rejected. PAN not
applicable for Micro SIP.
4. All communication relating to issue of Statement of Account, Change in name, Address or Bank particulars, Nomination, Redemption, Death
Claims etc., may please be addressed to the Registrar :
M/s Kfin Technologies Limited; Unit : UTIMF, Selenium Tower B, Plot Nos. 31 & 32, Financial District ,Nanakramguda, Serilingampally Mandal,
Hyderabad - 500032 | India Board: 040-6716 2222, Fax no: 040-6716 1888, Email: uti@kfintech.com
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Registration of SIP
Renewal of SIP
Micro SIP
ARN / RIA EUIN Sub ARN Code Sub Code MO Code UTI RM No.
Salary Saving SIP
Change in Bank Details
Upfront commission shall be paid directly by the investor to the AMFI / NISM certified UTI MF registered distributors based on the investors’ assessment of various factors including the service rendered by the distributor. I/We confirm that
the EUIN box is intentionally left blank by me/us as this is an “execution-only” transaction without any interaction or advice by the distributors personnel concerned or not withstanding the advice of in-appropriateness, if any, provided by
such distributor personnel and the distributor has not charged any advisory fees for this transaction.
APPLICANT DETAILS APPLICATION NO./FOLIO NO. +
Name of Sole / 1st Holder / Beneficiary Child
Name of Guardian (in case of Minor)
PAN DETAILS (If not registered in the folio already)
First Applicant/Guardian Second Applicant Third Applicant
SIP DETAILS
SIP Period SIP Step Up
Instalment
Scheme Name, Plan, Option SIP Date Frequency Regular Perpetual Amount
Amount In Multiple of ` 500/- Frequency
(MM/YY) (MM/YY)
5000 Daily
10000 Weekly From From Half Yearly
D D
25000 Monthly
To To 1 2 9 9 Yearly
OR `
Quarterly
5000 Daily
10000 Weekly From From Half Yearly
D D
25000 Monthly
To To 1 2 9 9 Yearly
OR `
Quarterly
5000 Daily
10000 Weekly From From Half Yearly
D D
25000 Monthly
To To 1 2 9 9 Yearly
OR `
Quarterly
Amount in the mandate to bank should be equal or more than this total amount. Total `
1st Unit Holder / Guardian 2nd Unit Holder 3rd Unit Holder
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Depository Depository
Central National
participant Name participant Name
Depository Securities
Securities Target ID Depository DP ID No.
Limited Limited Target ID
Proof enclosed (Any one) Client Master List (CML) Transaction cum Holding Statement Cancelled Delivery Instruction Slip (DIS)
Registration of SIP
Renewal of SIP
For Post Dated Cheque (Only CTS - 2010 compliant cheques are allowed) Micro SIP
ARN / RIA EUIN Sub ARN Code Sub Code MO Code UTI RM No. Salary Saving SIP
DETAILS OF SIP (For “DIRECT PLAN“ please tick here & write the Scheme Name, Plan/Option below)
SIP / Micro SIP Date (Please tick) 01 07 15 25 Frequency : Monthly Quarterly Post Dtd. Chq. Amt. (`)
Mandatory Enclosure (if 1st instalment is not by cheque) Bank cancelled cheque Copy of cheque
I/We have attached PAN card/Document copies of all applicants.
1st Unit Holder / Guardian 2nd Unit Holder 3rd Unit Holder