ASSOCIATION OF MUTUAL FUNDS IN INDIA

ONE INDIABULLS CENTRE, TOWER 2, WING B, 701, 7TH FLOOR, 841 SENAPATI BAPAT MARG, ELPHINSTONE ROAD,MUMBAI - 400 013
REGISTRATION FORM FOR CORPORATE EMPLOYEE (REVISED) NAME OF THE APPLICANT FIRST NAME MIDDLE NAME LAST NAME GENDER MALE FEMALE DATE OF BIRTH D D / M M / Y Y Y Y NAME OF ORGANISATION EMPLOYED WITH ARN OF THE ORGANIZATION DATE OF APPOINTMENT D D / M M / Y Y Y DESIGNATION/ POSITION HELD BREIF DESCRIPTION OF RESPONSIBILITIES PERMANENT ACCOUNT NUMBER (PAN) (COPY TO BE ATTACHED) TEST DETAILS CERTIFICATE NUMBER DATE OF PASSING TEST D D / M M / Y Y Y FOR SENIOR CITIZENS REFRESHER COURSE/ CPE CERTIFICATE NO. DATE OF REFRESHER COURSE/ CPE D D / M M ADDRESS DETAILS OFFICE ADDRESS CITY STATE TELEPHONE NUMBER - OFF. RESIDENTIAL ADDRESS CITY STATE TELEPHONE NUMBER - RES. MOBILE NUMBER E-MAIL ID QUALIFICATIONS COURSE UNIVERSITY/INSTITUTE YEAR OF PASSING PAYMENT DETAILS DEMAND DRAFT NUMBER DD DATE DRAWN ON (Name of the Bank and Branch) SIGNATURE OF THE APPLICANT PIN CODE COUNTRY PIN CODE COUNTRY FAX

1.6*1.8cm W*H Two Colour Photographs

AMOUNT

PLACE DATE

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ATTESTED BY NAME OF THE AUTHORISED SIGNATORY DESIGNATION SIGNATURE OF AUTHORIZED SIGNATORY WITH COMPANY SEAL

LIST OF DOCUMENTS TO BE SUBMITTED ALONGWITH THE APPLICATION

DD of Rs. 5000/- in favour of 'ASSOCIATION OF MUTUAL FUNDS IN INDIA' payable at the location of the CAMS office to which the form is submitted. CERTIFIED COPY OF PASSING CERTIFICATE CORPORATE EMPLOYEE TWO STAMP SIZE COLOUR PHOTOGRAPH PAN crad copy Proof of Residential address (such as copy of Ration card/ latest bank statement/ landline telephone bill/ electricity bill)

ACKNOWLEDGEMENT

Received Registration Form from _____________________________ along with a Demand Draft No._______________ for Rs.__________(Rs._____________________________________) dated ___________________ being Fees for Registration with AMFI. Signature of the Receiver