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New Fund Offer Opens: September 4, 2008
New Fund Offer Closes: October 1, 2008**
Scheme re-opens for continuous sale and re-purchase on: October 29, 2008.
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Please read the instructions carefully, before filling up the application form. Use this form If you are making the first time investment.
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1
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Name & Agent Code Sub-Agent Name & Code Bank/Branch Name & Serial No. Registrar Serial No. Date/Time of Receipt
NJ India Invest / ARN-0155 54934
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F I R S T N A M E M I D D L E N A M E
L A S T N A M E
PAN Attested PAN Proof enclosed KYC Compliant Status (Mandatory for Rs. 50,000 & above) (If yes, attach proof) : YES NO

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F I R S T N A M E M I D D L E N A M E
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PAN Attested PAN Proof enclosed KYC Compliant Status (Mandatory for Rs. 50,000 & above) (If yes, attach proof) : YES NO

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F I R S T N A M E M I D D L E N A M E
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PAN Attested PAN Proof enclosed KYC Compliant Status (Mandatory for Rs. 50,000 & above) (If yes, attach proof) : YES NO

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F I R S T N A M E M I D D L E N A M E
L A S T N A M E
PAN Attested PAN Proof enclosed KYC Compliant Status (Mandatory for Rs. 50,000 & above) (If yes, attach proof) : YES NO
#
Please mention the contact person in case of Non-indiviual

M
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Ho
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1
Anyone or Survivor
1
( Default)

Resident individual NRI/PIO Company / Body Corporate Trust Listed Company Partnership FIIs Bank / FI
S
t
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AOP / BOI Club / Society Minor NGO Defence Establishment Government Body HUF Others

Private Sector Service Public Sector / Government Service Business Professional Agriculturist Retired
O
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Housewife Student Forex Dealer Others
4
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(P.O. Box alone may not be sufficient)

City State Pin code

O
ve rse
a
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d
dr
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ss
# (mandatory for NRI/FII applicant). (P.O. Box alone may not be sufficient)

City Country Pin code

# Document proof for foreign address to be provided (self certified copy of bank account statement/Passbook will serve as proof of address. Incase the documents are in foreign language,
the same to be translated to English and certified by Govt. authorities in the country of residence or the Indian Embassy.
C
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1
App
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2
App
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r
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3Ap
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*Email ID compulsory for ECO Plan
5
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EMA
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5)(Investors in ECO Plan will be compulsorily communicated via Email only)

I/We wish to receive the following document via Account Statement News Letter Annual Report Other Statutory Information
e-mail in lieu of physical document(s) [Please (?
)]

A
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:

A
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KN
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DG
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L
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P(To be filled in by the investor)
Received from: Mr. / Ms. / M/s_______________________________________________ an application for allotment of Collection Centre’s Stamp &
Receipt Date and Time
units under Bharti AXA Equity Fund, Plan_________________________, Option _________________________
Cheque/DD No ________________________________________________________ Dated ____/____/________
Amount (Rs.) __________________ Drawn on Bank and Branch ______________________________________.
Checklist Investments Details Bank Mandate Attested PAN Card Copy KYC Details
Please note: All purchases are subject to realization of cheques/Demand Drafts.
 6
.
BAN
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A/c Type [please ?

] Saving Current NRO NRE FCNR
Bank Name
Account No
Branch City Pin
IFSC Code* (mandatory for credit via NEFT/RTGS) (11 Character code appearing on your cheque leaf.)

MICR Code* (9 Digit No. next to your Cheque Number)

(
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Direct credit facility is available for redemption/dividend proceeds for investors having HDFC Bank Account.
7
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SCH
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(R
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S
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:
Bharti AXA Equity Fund

I
n
ves
t
me
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In P
l
an O
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i
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id
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Op
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Su
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Lumpsum Regular Growth Dividend Bonus Regular Quarterly Reinvest Payout
Eco Growth Dividend Bonus Regular Quarterly Reinvest Payout
SIP (please fill the
Auto Debit Form) Institutional Growth Dividend Bonus Regular Quarterly Reinvest Payout
8
.
SYS
T
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MA
TI
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(
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(
Ref
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io
nN
o
8)
From Bharti AXA Liquid Fund (only for existing investors in Liquid Fund) To Bharti AXA Equity Fund
Plan Option Plan Option
Each Instalment Amount (In figures)
Frequency (please ?
) Monthly STP Date : 1st 7th 10th 15th 20th 25th Daily (On all Business Days only)
STP shall not be executed if amount is less than Rs. 1000 and Rs. 300 for monthly
Enrolment Period From D D M M Y Y Y Y To D D M M Y Y Y Y and daily options respectively.
9
.
DI
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RF
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(Please ? Re
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9)
This facility is applicable only for Dividend Payout option and the unit holder chooses to transfer amount of the dividend receivable by them into the Bharti AXA Liquid Fund only.

1
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Investment Amount DD Charges Net Amount
Cheque/DD No Cheque/DD Date Drawn on Bank
Branch Name A/c Type [please ?
] Saving Current NRO NRE FCNR
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1
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NOM
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11
)
I/We do hereby nominate the undermentioned Nominee to receive the Units alloted to my/our credit in my Folio 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/Trustees.
Nominee's Name Mr. Ms. Relationship (Mandatory In case of Minor) Date of Birth D D M M Y Y

F U L L N A M E
Name of Guardian (In case Nominee is a Minor (Other than the Applicant))

Mailing Address

City Pin

1
2
.
DEC
L
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NA
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I
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(
S)
(R
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(
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I/We have read and understood the contents of the Offer Document of the above Scheme of Bharti AXA Mutual Fund including the section on “Who cannot invest” and “Prevention of Money
Laundering”. I/We hereby apply for Allotment/Purchase of Units in the Scheme and agree to abide by the terms and conditions applicable thereto. I/We hereby declare that I/We am /are authorised to
make this investment and that the amount invested in the Scheme is through legitimate sources only and does not involve and is not designed for the purpose of any contravention or evasion of any Act,
Rules, Regulations, Notifications or Directions issued by any regulatory authority in India. I/We hereby authorise Bharti AXA Mutual Fund, its Investment Manager and its agents to disclose details of my
investment to my bank(s)/Bharti AXA Mutual Fund’s bank(s) and /or Distributor /Broker / Investment Advisor. I/We have neither received nor been induced by any rebate or gifts, directly or indirectly, in
making this investment. I/We declare that the information given in this application form is correct, complete and truly stated.
A ppli
c abl
e to N RI onl
y : I /We confirm that I am/we are Non-Resident of Indian Nationality/Origin and that I/We have remitted funds from abroad through
approved banking channels or from funds in my/our NRE/FCNR Account. I/We undertake that all additional purchases made under this Folio will also be from D A T E D D M M Y Y
funds received from abroad through approved banking channels or from funds in my/our NRE/FCNR Account.

S
I
GN
AT
U
RE
(
S)

Sole/1st applicant/Guardian/Authorised Signatory/POA 2nd applicant/Guardian/Authorised Signatory/POA 3rd applicant/Guardian/Authorised Signatory/POA

C
H
E
CK
L
IS
T
(Please submit the following documents with your application (where applicable). All documents should be
original/true copies Certified by a Director/Trustee /Company Secretary /Authorised signatory / Notary Public.)
D
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s I
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Resolution/ Authorisation to invest
List of authorised signatories with specimen signatures
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Memorandum & Articles of Association ?
Trust Deed ? E
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s
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a
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a-
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Bye-laws
Partnership Deed ?
Notorised POA ?
Bank confirmation of Non Resident Account
Type / FIRC/ Approval from FIPB ? C
a
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lu
sa
t
(
To
ll
Fr
ee
) A
l
t
er
na
t
eN
um
b
e
r
KYC Acknowledgement (If application for ?? ? ? ? ? ? ?
Rs. 50,000 or above)
PAN Card ?? ? ? ? ? ? ?
1
-
80
0-
10
32
-
26
30
2
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40
11
2
30
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 S
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ONF
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RM
(Application should be submitted atleast 30 days before the 1st Debit Clearing date)
For terms & conditions refer overleaf Application No:
1. DIST RIBU TOR INFO RM A TI
O N F
O
RO
F
FI
CE
US
E
ON
L
Y
Name & Agent Code Sub-Agent Name & Code Bank/Branch Name & Serial No. Registrar Serial No. Date/Time of Receipt

NJ India Invest / ARN-0155 54934

Please ?
any one only SIP Registration - by Existing Investor SIP Registration - by New Investor
(Please do not fill the Application Form) (Complete the Application Form compulsorily alongwith this form.)

2
.
IN
VE
S
T
OR
DE
T
A
IL
S
Folio No. / Application No. (For Existing Investor please mention Folio Number / For New Applicants please mention the Common Application Form Number)

Name of 1st Applicant /

Name of 2nd Applicant /

Name of 3rd Applicant /

Minor Name of Father/
Guardian in case of Minor
3
.
SI
PDE
T
A
IL
S(First SIP cheque and subsequent via Auto Debit Facility in select cities only)
Scheme Name Plan Option Dividend Option Frequency Dividend Sub Option
Regular Growth Dividend Bonus Regular Quarterly Reinvest Payout
Bharti AXA Equity Fund Eco Growth Dividend Bonus Regular Quarterly Reinvest Payout
Institutional Growth Dividend Bonus Regular Quarterly Reinvest Payout

Scheme Name Plan Option

Frequency (please ?
) Monthly SIP Date : 1st 7th 10th 15th 20th 25th Daily*
Instalment Amount (In figures) Enrolment Period From** D D M M Y Y Y Y To D D M M Y Y Y Y
Drawn on Bank /Branch Name
*Daily SIP is offered only for Account holders in any of the following Banks: HDFC Bank, AXIS Bank, Bank of Baroda (core banking branches only) and in any other bank as notified by AMC from time to time.
**Minimum SIP term should be for 6 months for monthly and daily SIP
4
.
PAR
T
I
CU
LA
R
SO
F
BA
N
KA
C
CO
U
NT
Name of 1st Account
Holder
Name of 1st Joint Holder

Name of 2nd Joint Holder

Name of Bank & Branch

City Pin

Account No. Account Type (Please ?

)

9 digit MICR Code (Mandatory) (This is 9 digit number next to the cheque number) Savings NRO
Please provide a copy of cancelled cheque
Current NRE
IFSC Code leaf from an Auto Debit eligible bank (Mandatory)
DECLARATION & SIGNATURE I/We hereby declare that the particulars given above are correct and express my willingness to make payments referred above to debit my/our account
directly or through participation in Auto Debit. If the transaction is delayed or not effected at all for reasons of incomplete or incorrect information, I / We would not hold the user institution responsible.
I / We will also inform AMC, about any changes in my/our bank account. I/We have read and agreed to the terms and conditions mentioned overleaf.

SIGNATURE (S)
(as in Bank
records)
Sole/1st applicant/Guardian/Authorised Signatory/POA 2nd applicant/Guardian/Authorised Signatory/POA 3rd applicant/Guardian/Authorised Signatory/POA
5
.
BAN
K
E
R’S
A
TT
E
ST
A
TI
ON
Certified that the signature of account holder and the Details of Bank account are Signature of authorised Official from Bank (Bank stamp and date)
correct as per our records

Signature verification request (To be retained by the Customers Bank)

The Branch Manager Date D D M M Y Y

Bank Branch
Sub : Mandate verification for A/c. No.
This is to inform you that I/We have registered for making payment towards my investments in Bharti AXA Equity Fund by debit to my /our above account directly or through ECS (Debit Clearing).
I/We hereby authorize to honour such payments and have signed and endorsed the Mandate Form.
Further, I authorize my representative (the bearer of this request) to get the above Mandate verified. Mandate verification charges, if any, may be charged to my/our account.
Thanking you,
Yours sincerely

SIGNATURE (S)
(as in Bank
records)
Sole/1st applicant/Guardian/Authorised Signatory/POA 2nd applicant/Guardian/Authorised Signatory/POA 3rd applicant/Guardian/Authorised Signatory/POA

ACKNOWLEDGEMENT SLIP Folio No. /

To be filled in by the Investor Application No.

(To be filled in by the First applicant/Authorized Signatory) :

Received from Name & address : _______________________________________________________________________________
an application for Purchase of Units alongwith Cheque SIP Auto Debit Facility For Rs.
All purchases are subject to realisation of cheques. Cheque Number Acknowledgement Stamp