ASSOCIATION OF MUTUAL FUNDS IN INDIA

One Indiabulls centre, Tower 2, Wing B, 701, 7th Floor, 841, Senapati Bapat Marg,
Elphinstone Road, Mumbai - 400013

REGISTRATION FORM FOR EMPLOYEE

1.6 *1.8cm W *
H Two Colour
Photographs
GENDER

PhotographsW
XH
Two color

NAME OF THE APPLICANT

FIRST NAME

MIDDLE NAME

LAST NAME

GENDER

DATE OF BIRTH

NAME OF ORGANISATION EMPLOYED WITH

ARN OF THE ORGANIZATION

DATE OF APPOINTMENT

DESIGNATION/ POSITION HELD

BREIF DESCRIPTION OF RESPONSIBILITIES

PERMANENT ACCOUNT NUMBER (PAN)

(PAN card copy to be attached)

TEST/ CPE DETAILS (NISM-Series-V-A: Mutual Fund Distributors Certification Examination /NISM Series-V-A:
Mutual Fund Distributors Continuing Professional Education

NISM PASSING/ CPE CERTIFICATE NUMBER

DATE OF PASSING TEST/ ATTENDING CPE

ADDRESS DETAILS

OFFICE ADDRESS

CITY

PIN CODE

STATE

COUNTRY

TELEPHONE NUMBER OFF.

FAX

RESIDENTIAL ADDRESS

CITY

PIN CODE

STATE

COUNTRY

TELEPHONE NUMBER RES.

MOBILE NUMBER

E-MAIL ID
QUALIFICATIONS
COURSE

UNIVERSITY/INSTITUTE

YEAR OF PASSING

PAYMENT DETAILS
DEMAND DRAFT NUMBER

DEMAND DRAFT DATE

AMOUNT

DRAWN ON (Name of the Bank and Branch)

SIGNATURE OF THE APPLICANT

PLACE

DATE

ATTESTED BY AUTHORIZED SIGNATORY

NAME OF AUTHORISED SIGNATORY

DESIGNATION

SIGNATURE OF THE AUTHORISED SIGNATORY WITH COMPANY STAMP:

LIST OF DOCUMENTS TO BE SUBMITTED ALONGWITH THE APPLICATION

DEMAND DRAFT OF Rs. 1500/- IN FAVOUR OF ASSOCIATION OF MUTUAL
FUNDS IN INDIA PAYABLE AT THE LOCATION OF THE CAMS OFFICE TO WHICH
THE FORM IS SUBMITTED.
TWO STAMP SIZE COLOUR PHOTOGRAPHS

CORPORATE EMPLOYEE

PAN CARD COPY

CERTIFIED COPY OF PASSING CERTIFICATE
Employee can also submit a self attested copy of mark-sheet along with the
application form, provided the mark-sheet contains candidate's photo and PAN.
Mark-sheet is accepted only up to two months from date of exam and thereafter
one has to submit a self attested copy of passing certificate.
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.
_________________ dated_______________ for Rs.__________ (Rs. ____________________________________
_____________________________________) being Fees for Registration with AMFI.

(SIGNATURE OF THE RECEIVER)