Key Information Memorandum Cum Application Form for Reliance Fixed Horizon

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Express Building, 4th Floor, 14 - ‘E’ - Road, Opp. Churchgate Station, Churchgate, Mumbai - 400 020. App. No. FHF IX Sr 6
Broker / Agent Code Sub Broker / Sub Agent Code Date and Time of Receipt Registrar Serial No.

NJ India Invest / ARN-0155 54934

TO BE FILLED IN CAPITAL LETTERS. Pl. use one box for each letter, leaving one box blank between two words. Please tick whichever is applicable.
EXISTING FOLIO NO. Name of Sole / 1st applicant
APPLICANT INFORMATION
MODE OF HOLDING OCCUPATION STATUS INDIVIDUAL STATUS NON-INDIVIDUAL
(Tick whichever

Single Business Professional 1st Applicant Resident Indian NRI Partnership firm FIIs Society
is applicable)

Joint Service Retired AOP/BOI Banks FIs

Any one or 2nd Applicant Resident Indian NRI
survivor(s) Student Housewife Trust Company/Body Corporate
Former or Survivor 3rd Applicant Resident Indian NRI
(In case of minor with Others _________________ HUF Others _________________
Joint Applicant)

Name of Sole / 1st applicant/Minor/Karta of HUF/Non-Individual Mr. / Mrs. / Miss / Master / M/s. Date of Birth
D D M M Y Y Y Y
Name of Parent / Guardian in case of Minor / or Contact Person for Non-Individual applicants Mr
Mr.. Mr s.
Mrs. Miss
Miss Relation with Minor/Designation

Name of 2nd applicant Mr. Mrs. Ms Date of Birth*

D D M M Y Y Y Y

Name of 3rd applicant Mr. Mrs. Ms Date of Birth*

D D M M Y Y Y Y

PAN - Mandatory (Ref. Instruction No. 10)

PAN
1st applicant Attached Pan Proof [Are you KYC Compliant Please (9) Yes or No ]

PAN Pan Proof

2nd applicant Attached [Are you KYC Compliant Please (9) Yes or No ]

PAN
3rd applicant Attached Pan Proof [Are you KYC Compliant Please (9) Yes or No ]

DOCUMENTS TO BE ATTACHED (if applicable)

Memorandum & Articles of Association Resolution/Authorisation to invest. List of authorised signatories with speciment signature(s)
Trust Deed Bye-Laws Partnership deed Power of Attorney
CONTACT DETAILS
Mailing Address [Please provide complete address. P.O. Box alone is not adequate]
Add 1

Add 2

Add 3

City Country Pin

District State

Overseas Address* (Mandatory for NRI / FII Applicants) Address for Correspondence (for NRI Applicants only) Indian Foreign

City Country Zip

Tel. No. STD Code _________________________ Office ____________________________ Residence ___________________________ Fax ___________________________
Mobile No. _________________________________ E-mail Id. __________________________________________________________________________________________
E-MAIL COMMUNICATION
I/We wish to receive the following documents through e-mail in lieu of physical document(s):
Account Statement Newsletter Annual report / Abridged Accounts Any other information

ACKNOWLEDGEMENT
Received from _____________________________________________________________________________________________________ an application for allotment of Units
under Reliance Fixed Horizon Fund - IX - Series 6. App. No. FHF IX Sr 6

PLAN OPTION Switch from Reliance

Dividend Scheme : _________________________________________________
Institutional Growth
Payout Plan: __________________ Option: ____________________________
Dividend for Rs. _________________________ / _____________________ Units
Retail Growth Payout
Cheque / DD No. ___________________________________ Dated _______________________ Rs. _______________________
Drawn on ____________________________________________________________________________________________________ Signature, Date & Stamp

Acceptance of the Application is subject to the application being complete in all respects and submission of the relevant required documents.
 BANK ACCOUNT DETAILS MANDATORY (Refer Instruction No. 5)
A/c. type SB Current NRO NRE FCNR Account No. M A N D A T O R Y

Bank M A N D A T O R Y
Branch
Address M A N D A T O R Y
Branch
City M A N D A T O R Y PIN M A N D A T O R Y

I.F.S.C. Code M A N D A T O R Y 9 Digit MICR Code M A N D A T O R Y

RMF will endeavour to provide payment of Dividend / Redemption / Refund(If any) through ECS,NEFT, Cheque, Demand Draft or Direct Credit into investors bank account
wherever possible.

MODE OF PAYMENT / SUBSCRIPTION DETAILS MANDATORY (Refer Instruction No. 12)

Reliance Fixed Horizon Fund - IX - Series 6 Plans : Institutional Retail Options : Growth Dividend Payout

Instrument Details: Cheque DD No.: Dated:

Investment Amount Rs.

Drawn on ________________________________________________________________
Bank __________________________________
Branch ____________________________
City

Source of Funds: SB Current NRO NRE* FCNR* Rupee Draft purchased abroad* Other* Pl. Specify
* Please attach a photocopy of instrument or Account Debit Certificate from Bankers
Account No. ____________________________________________________

Swit ch Ov
witch er F
Over Frrom (Scheme) ________________________________________________________________________________________________________________
Plan: _________________________ Option: _________________________ Amount Rs. Or Units
Switch Over application to be submitted only at Designated Investor Service Centers of RMF

NOMINATION (Please see Instruction No. 15)

I/We ____________________________________________, ________________________________________ and _____________________________________________

(Unit holder 1) (Unit holder 2) (Unit holder 3)
do hereby nominate the person(s) more particularly described hereunder/and*/cancel the nomination made by me/us on the ________day of _______________________
in respect of the Units under Folio No. (* strike out which is not oapplicable)
Date Proportion (%) by which the
Name and Address of Nominee(s) Date of Name and Address of Guardian Signature of Guardian
of Birth units will be shared by each
(to be furnished in case the Nominee is a minor) Nominee (should aggregate to 100%)

DECLARATION & SIGNATURE/S (Refer Instruction No. 7) SIGNATURE/S

I/We would like to invest in Reliance Fixed Horizon Fund - IX - Series 6 subject to terms
Sole / 1st applicant
of the Scheme Information Document (SID) and subsequent amendments thereto. I/We Guardian
have read the instructions and the SID before filling the Application Form. I/We have Authorised Signatory
understood the details of the scheme and I/We have not received nor been induced by
any rebate or gifts, directly or indirectly, in making this investment.

APPLICABLE TO NRIs ONLY 2nd applicant

Authorised Signatory
I/We confirm that I am/We are Non-Resident of Indian Nationality/Origin and I/We
hereby confirm that the funds for subscription have been remitted from abroad through
normal banking channels or from funds in my/our Non-Resident External/Ordinary
Account/FCNR Account.
3rd applicant
Authorised Signatory

Place : _________________________________ Date : _____________________

CHECK LIST
Please ensure that:
Documents Companies Trust
rustss Societies Par tner
artner ship FIIs Investments through
tnership
Your Application Form is complete in all respect, Name, Address & Firms Constituted Attorney
contact details are mentioned in full, signed by all applicants. 1. Resolution/Authorisation to invest 9 9 9 9 9
Bank Account Details are entered completely and correctly. 2. List of Authorised Signatories with 9 9 9 9 9 9
Permanent Account Number (PAN) of all the applicants are manda- Specimen Signature(s)
tory.
3. Memorandum & Articles of Association 9
Please refer to instruction no. 10 for details.
4. Trust Deed 9
For investment of Rs. 50,000 or above, investor needs to be KYC
compliant. 5. Bye-Laws 9
Appropriate Option is ticked. 6. Partnership Deed 9
The Cheque / DD is drawn in favour of “Reliance Fixed Horizon Fund”, 7. Overseas Auditor’s Certificate 9
dated and duly signed. 8. Notarised Power of Attorney 9
Application Number is mentioned on the reverse of the Cheque / DD. 9. Proof of PAN 9 9 9 9 9 9
Documents as listed alongside are submitted along with the Applica-
tion (as applicable to your specific case). 10. KYC Compliant 9 9 9 9 9 9