Professional Documents
Culture Documents
GUARDIAN (in case Sole / First Applicant is a minor) Mr Ms Mrs Dr Status (Please )
Resident Individual
lNRI on Repatriation Basis
NRI on Non-Repatriation Basis
HUF
First Name Middle Name Last Name Proprietorship
Partnership Firm
CONTACT PERSON (in case of Non-individual applicants) Mr Ms Mrs Dr Private Limited Company
Public Limited Company
Mutual Fund
Mutual Fund FOF Scheme
Name Designation Body Corporate
Registered Society
SECOND APPLICANT (Joint Holder 1) Mr Ms Mrs Dr PF/Gratuity/Pension/
Superannuation Fund
TrustAOP / BOI
Foreign Institutional Investor
First Name Middle Name Last Name Others _________________
(Please specify)
THIRD APPLICANT (Joint Holder 2) Mr Ms Mrs Dr Occupation (Please )
(Mandatory)
Business
First Name Middle Name Last Name Manufacturing Trading
Service
MODE OF OPERATION (where there are more than one applicants) Government Non-Government
First Holder only Anyone or Survivor Joint Professional
Medicine Finance
Engineering Legal
PAN* Sole / First Applicant Second
d Applicant Third Applicant Retired
Housewife
Enclosed Student
(please ) PAN Proof or Form 60 / 61 / 49A PAN Proof or Form 60 / 61 / 49A PAN Proof or Form 60 / 61 / 49A
Agriculture
Others _________________
* Mandatory for all Investors (Indian & NRI) irrespective of. the investment amount. (Please specify)
RESIDENTIAL ADDRESS (Mandatory)
To be filled by Applicant
R
ACKNOWLEDGEMENT SLIP
Received from Mr./Ms.
an application for allotment of Units in the following Scheme: Appl. CA
R
Scheme
No. Dated DD/MM/YYYY Rs.
Plan
Bank & Branch
Option
Official Acceptance Point Stamp & Sign
Please retain this slip duly acknowledged by the Official Acceptance Point till you receive your Account Statement.
3. BANK ACCOUNT DETAILS (MANDATORY) [Refer Guideline 3]
Name of Bank DIRECT CREDIT
T
We offer a Direct Credit Facility with the following banks for paying out Dividend and
Branch Redemption Proceeds to you faster.
• ABN AMRO Bank • Deutsche Bank • IDBI Bank
(Clearing Circle) • AXIS Bank • HDFC Bank • IndusInd Bank
City • Centurion Bank of Punjab • HSBC • Kotak Mahindra Bank
• Citibank • ICICI Bank • Standard Chartered Bank
Account No. • Corporation Bank
MICR Code If your bank account is with any of these banks, we will directly credit your dividend/
This is the 9 digit No. next to your Cheque No. redemption proceeds into the same.
If, however, you wish to receive a cheque payout, please tick the box
Account Type : Current Savings NRO NRE FCNR Others alongside.
4. INVESTMENT DETAILS [Refer Guideline 4]
Payment Detail
Sl. Plan/Option/ Amount Net Amount
Scheme Name Cheque/
No. Sub-option Invested (Rs.) Paid (Rs.) Bank and Branch
DD No.
1.
Less DD Charges
2.
Less DD Charges
3.
Less DD Charges
If you are an NRI Investor, please indicate source of funds for your investment (Please )
NRE NRO FCNR Others (Please specify)
5. NOMINATION DETAILS (to be filled in by Individual(s) applying Singly or Jointly) [Refer Guideline 5]
I / We _______________________________________________________________________ and ____________________________________________________ do hereby nominate the
undermentioned Nominee to receive the Units to my/our credit in Account No./Application No. _____________________ 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.
DETAILS OF NOMINEE DETAILS OF GUARDIAN (to be furnished in case Nominee is a Minor)
(Strike off if this section is not applicable to you)
NAME Date of Birth
DD / MM / YYYY NAME
ADDRESS ADDRESS
We are at your service on 1800-222-626 from 9.30 a.m. to 6.30 p.m. (Monday to Friday)
91/92, 9th Floor, Sakhar Bhavan 230,
Nariman Point, Mumbai 400 021
( 022 6638 4444
+ mutual@kotak.com
" www.kotakmutual.com
I/We here by declare that the particulars given above are correct and express my / our willingness to make payments referred above through paticipation in ECS (Debit Clearing /Direct Debit). If,
the transaction is delayed or not effected at all for reasons of incomplte or incorrect information, I / We will not hold Kotak Mahindra Mutual Fund responsible. I/We will also inform Kotak
Mahindra Mutual Fund, about any chages in my bank account immediately. I/We have read and agreed to the terms and conditions mentioned overleaf.
BANKER’S ATTESTATION
(Mandatory if your First SIP Investment is through a Demand Draft / Pay Order)
Certified that the signature of account holder and the details of Bank Account are correct as per our records
I/We have read and understood the contents of the offer Documnts(s) of the above referred Scheme(s) of Kotak Mahindra Mutual Fund. I / We hereby apply for allotment / purchase of Units in the Scheme(s)
indicated as above and agree to abide by the terms and conditions applicable thereto. I / We hereby declare that I / We authorized to make this investment in the above mentioned Scheme(s) and that the
amount invested in the Scheme(s) is through legitimate sources only and is not designed for the purpose of any contravention or evasion of any Act, Rules, Regulations, Notifications or Directions of the
provisions of Income Tax Act, Anti Money Laundering Act, Anti Corruption Act or any other applicable lwas enacted by the Government of India from time to time. I / We hereby authorize Kotak Mahindra
Mutual Fund, its Investment Manager and its agents to disclose details of my investment to my / our Investment Advisor and / or banks. I /We have neither received nor been induced by any rebate or gifts,
directly, in making this investment.
Authorisation of Bank Account Holder : This is to inform that I/We have registered for RBI’s Electronic Clearing Service (Debit Clearing / Direct Debit) & that my/our payment towards my/our
investment in Kotak Mahindra mutual Fund shall be made from my/our below account with your bank.I/We authorise the representative carrying this ECS (Debit Clearing / Direct Debit)
Mandate Form to get it verified & executed.
* Please ensure utmost care while filling the highlighted column. The form may get rejected in case the details are incomplete.
Kotak Liquid
Tax Saver.)
30
Refer to Section “SIP AutoDebit: Terms and & Conditions” for location wise dates available for SIP Auto Debit.
Should be
Submitted 30 days prior the next Auto Debit date.
10.
Agra | Ahmedabad | Allahabad | Amritsar | Aurangabad | Bangalore | Baroda | Bhilwara | Bhopal | Bhubaneshwar | Calicut | Chandigarh | Chennai
Cochin | Coimbatore | Dehradun | Delhi | Erode | Gorakhpur | Guwahati | Gwalior | Hubli | Hyderabad | Indore | Jabalpur | Jaipur | Jalandhar | Jammu
Jamshedpur | Jodhpur | Kanpur | Kolhapur | Kolkata | Lucknow | Ludhiana | Madurai | Mangalore | Mumbai | Mysore | Nagpur | Nasik | Panjim | Patna
Pune | Raipur | Rajkot | Ranchi | Salem | Sholapur | Surat | Trichur | Trichy | Trivandrum | Udaipur | Varanasi | Vijaywada | Vizag
Direct Debit Facility is available across all the branches of Kotak Mahindra Bank, UTI Bank & IDBI Bank.
th
7 Scheme Name : same as metioned on the 1st cheque
30
If your
158, 4th Floor, Rayala Towers, Anna Salai, Chennai 600 002.
Star Kid Facility (SKF)#
Official Acceptance Point
Mandatory
Date of Birth*
Mandatory
DD/MM/YYYY
PAN & KYC Permanent Account Number KYC Compliance Status* Completed Age**
o
PAN Proof # oYes o No
(# Please attach PAN card copy) / (* KYC Acknowledgment letter copy is Mandatory for Investment > Rs. 50,000)
E-Mail Id
The tenure of the Star Kid Facility Age completed (23 yrs - 30 yrs) Age completed (31 yrs-35 yrs) Age completed (36 yrs-40 yrs) Age completed (41 yrs-45 yrs)
o
5 years o10 years o15 years o 20 years o 5 years o
10 years o 15 years o5 years o 10 years o 5 years
(Completed 45 years not eligible)
Are you currently covered under SKF ? If Yes, Please Mention your Folio number
Star Kid Facility Auto - Debit Mandate
o o
st
Nomination (Nominee should be the child of the 1 holder) Mandatory
Name Date of Birth
M A N D A T O R Y D D / M M / Y Y Y Y
I/We here by declare that the particulars given above are correct and express my / our willingness to make payments referred above through paticipation in
ECS (Debit Clearing /Direct Debit). If, the transaction is delayed or not effected at all for reasons of incomplte or incorrect information, I / We will not hold
Kotak Mahindra Mutual Fund responsible. I/We will also inform Kotak Mahindra Mutual Fund, about any changes in my bank account immediately. I/We
have read and agreed to the terms and conditions mentioned overleaf.
BANKER’S ATTESTATION
(Mandatory if your First SKF Investment is through a Demand Draft / Pay Order)
Certified that the signature of account holder and the details of Bank Account are correct as per our records
I/We have read and understood the contents of the offer Documnts(s) of the above referred Scheme(s) of Kotak Mahindra Mutual Fund. I / We hereby apply for allotment / purchase of Units in the Scheme(s) indicated as above
and agree to abide by the terms and conditions applicable thereto. I / We hereby declare that I / We authorized to make this investment in the above mentioned Scheme(s) and that the amount invested in the Scheme(s) is
through legitimate sources only and is not designed for the purpose of any contravention or evasion of any Act, Rules, Regulations, Notifications or Directions of the provisions of Income Tax Act, Anti Money Laundering Act,
Anti Corruption Act or any other applicable laws enacted by the Government of India from time to time. I / We hereby authorize Kotak Mahindra Mutual Fund, its Investment Manager and its agents to disclose details of my
investment to my / our Investment Advisor and / or banks. I /We have neither received nor been induced by any rebate or gifts, directly, in making this investment. I/We have understood all terms of life cover being offered with
SKF and tender my agreement for the same. I also confirm that my DOB / Age details provided above are correct and I/We understand and authorise Kotak Mahindra Old Mutual Life Insurance Limited. to take any action
including rejection of claim if the DOB / Age details are found to be incorrect at the time of claim. I/We also understand that the life cover provided with SKF shall only continue as long as I/We continue with SIP payment without
any interruption and that the cover shall come to an end immediately on my defaulting on two SIPs.
* If the 1st holders age is less than 23 years or greater than 45 years then he will not be eligible for the Star Kid Facility and this will be rejected.
** The insurance cover provided under SKF facility is subject to correct submission of DOB / Age. The insurance company reserves the right to take appropriate action, including rejection of claim, in case the DOB / Age
is found to be incorrect at the point of claim.
Authorisation of Bank Account Holder : This is to inform that I/We have registered for RBI’s Electronic Clearing Service (Debit Clearing / Direct Debit) & that my/our payment
towards my/our investment in Kotak Mahindra mutual Fund shall be made from my/our below account with your bank.I/We authorise the representative carrying this ECS (Debit
Clearing / Direct Debit) Mandate Form to get it verified & executed.
Declaration of Good Health (DOGH)
INSTRUCTIONS FOR FILLING THIS FORM
§
This form should be filled and completed by the applicant ONLY if he/she is in good health and can therefore submit to all the statements/avowals contained herein. This Declaration of
Good Health should not be submitted where the applicant is not in good health.
§
The applicant must disclose all material facts. In case of any doubt as to whether a fact is material or not the fact should be disclosed. As the statements in this Declaration constitute
warranties, complete and accurate information must be given.
§
Where the applicant signs this form in any vernacular language, the scribe portion given in the last paragraph must be compulsorily filled. Any such form wherein the scribe portion is not
completed will not be valid, and no benefit accruing pursuant to this Declaration (including insurance benefit) will be provided in such cases. Provision for nominee details has been
provided herein. In the event of cover being extended, benefits in respect of a member shall be released in favour of his / her nominee.
Details of Appointee
Full Name Title Surname First Name Middle Name
Maiden Name (In case Title Surname First Name Middle Name
Married female nominee)
Father’s name Surname First Name Middle Name
Nationality Date of Birth D D M M Y Y Y Y
Permanent Address:
#
Further Declaration where Scribe is involved (compulsory for all declarations signed in any vernacular language)
I __________________________________ (full name of scribe) have explained to the applicant the contents of this Form and that if any untrue statement is contained herein, the applicant, and/or the
heirs, executors, administrators, assignees of the applicant shall not be entitled to receive any benefits, including, inter alia, benefits under any insurance policy procured on the faith of this Form.
Place: Date:
#
Signature / Thumb impressions of the applicant Name & Signature of the Scribe
KOTAK MAHINDRA MUTUAL FUND Computer Age Management Services Pvt. Ltd.
5A-5th Flr, Bakhtawar 158, Rayala Towers, 4th Floor,
229, Nariman Point Anna Salai,
Mumbai - 400 021 Chennai - 600 002.
( 022-6638 4400 ( 044 - 2852 1596
+
mutual@kotak.com "
www.kotakmutual.com +
enq_k@camsonline.com "
www.camsonline.com