COMMON TRANSACTION FORM
Internal Code For
Distributor Name & ARN Code                           Sub Broker ARN Code                                                                                         EUIN No.
                                                                                                 Employee / Sub Broker / Investor
Jitendra
Dhabaria                  ARN-20535                                                                                                                               E041715
      ■   I/We hereby confirm that the EUIN box has been intentionally left Blank by me/us as this transaction is executed without any Interaction or advice by
          the employee/relationship manager/sales Person of the above distributor/sub broker or notwithstanding the Advice of in-appropriateness, if any,
          provided by the Employee/relationship manager/sales person of the distributor/sub Broker.
Signature: ■                        First Holder                                                  Second Holder                                                    Third Holder
Investor Details
Unit Holder Name : Dr Hitesh Shah                                                                                        Folio No.: 40691025905
Mutual Fund Name : Reliance Mutual Fund
Purchase Request
I/we would like to purchase units worth Rs.
 Scheme Name:                                                                                                    Plan:                                 Option:
Cheque / DD No:                                                                                                  Cheque Date:
Bank Name:                                                                                                       Branch & City:
Redemption Request
I/we would like to redeem Rs.                                                                                    OR                                                                    Units.
Scheme Name:                                                                                       Plan:                            Option:
Switch Request
 I/we would like to Switch Rs.                                                                              OR All                                                                    Units.
 From Reliance Liquidity Fund-Growth                                                                        Plan: Regular                         Option: Growth
 To Reliance Mid & Small Cap Fund-Growth                                                                    Plan: Regular                         Option: Growth
PAN & KYC UPDATION (Please Tick) Enclosed herewith:                                              Photo Copy of Pan Card                       Photocopy of KYC
 PAN No. Details:            A M I P S 2 8 0 0 C
      OR
 PEKRN Details:
                                             First Holder                                        Second Holder                                         Third Holder
 DECLARATION:
 1. I/We am/are an eligible Investor as per the scheme related documents.
 2.  I/We confirm that I/We have read and understood the terms & contents of the offer Document(s) of the scheme(s) in which I/We are investing, as of the date of this investment.
 3.  I/We agree to abide and comply with the terms, conditions, rules and regulations of the Scheme.
 4. Upfront Commission shall be paid directly by the Investor to the AMFI registered Distributor based on the Investor's assessment of various factors including the service rendered by
     the distributor.
 5. The ARN holders has disclosed to me/us all the commissions (in the form of trail commission or any other mode), payable to him or them for the different competing Schemes of
     various mutual funds from amongst which the Scheme is being recommended to me/us.
 6. I/We hereby confirm that I/We have not been offered / communicated any Indicative Portfolio and/ Or any Indicative Yield by the Distributor for this investment.
Signature
  ■
                           First Holder                                                Second Holder                                                     Third Holder
Acknowledgment Slip:                                                                                               Folio / Account No.: 40691025905
Received From Mr/. Mrs/. M/s. Dr Hitesh Shah
Fund:                               Scheme Name:                                                              Plan:                                   Option:
                     Purchase         Redemption           Switch        Change of Address               Change of Bank Mandate                  Pan & KYC Updation