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L&T Common Application With SIP
L&T Common Application With SIP
App. No.
Time Stamp
Please refer to the general instructions for assistance and complete all sections in English. For legibility, please use BLOCK LETTERS in black or dark ink.
Distributor/RIA Code Sub-Distributor ARN Sub-Distributor Code EUIN Branch Code
R. R.LAHORI EUIN - E054671
ARN-53115
Transaction Charges: SEBI (Mutual Fund) Regulations allow deduction of transaction charges of Rs. 100/- from your investment for payment to your distributor if your distributor has opted to receive
transaction charges for investments sourced by him. The transaction charges deductible are Rs. 150/- if you are investing in Mutual Funds for the first time. If you are making a SIP Investment, the transaction
charges would be deducted over 3-4 instalments. No transaction charges would be levied if you are not investing through a Distributor or your investment amount is less than Rs.10,000/-.
If this is the first time, you are investing in any mutual fund, please tick here
Investor’s Declaration where EUIN is not furnished: I/We confirm that the EUIN box has been intentionally left blank by me/us as this is an “execution only” transaction without any interaction or advice by
the employee/relationship manager/sales person of the above distributor and/or notwithstanding the advice of inappropriateness, if any, provided by the employee/relationship manager/sales person of distributor
and the distributor has not charged any advisory fees on this transaction.
1. EXISTING UNIT HOLDER’S INFORMATION (If you hold a Folio with L&T Mutual Fund, please furnish the below information and move to Investment & Payment Information section.)
Name of Sole/1st Unit Holder Mr. Ms. M/s First Name Middle Name Last Name Folio No.
Name of 1st/Sole Applicant Mr. Ms. M/s First Name Middle Name Last Name
Name Mr. Ms. M/s First Name Middle Name Last Name
Relationship with Minor Applicant Proof of Date of Birth Proof of the Relationship with minor
Natural Guardian Birth Certificate Copy Passport Copy Birth Certificate Copy Passport Copy Court Appointment Order
3. DETAILS OF OThER APPLICANT(S) (Please note that where the sole/1st applicant is a minor, no joint holders are allowed)
Name of 2nd Applicant Mr. Ms. M/s First Name Middle Name Last Name
Name of 3rd Applicant Mr. Ms. M/s First Name Middle Name Last Name
Correspondence Address
Tel (R) (ISD) (STD) Tel (O) (ISD) (STD) Fax (ISD) (STD)
Non Resident Indian Individual (NRI) – Repatriable Partnership Firm Limited Liability Partnership (LLP) Gratuity Fund
Non Resident Indian Individual (NRI) –Non Repatriable Public Ltd. Co. Financial Institutions Overseas Corporate Body
Minor (Resident Indian) Foreign Portfolio Investor (FPI) Non Govt. Organization (NGO)
Private Ltd. Co.
Foreign Institutional Investor (FII) Association of Persons(AOP)/Body
Minor (NRI - Repatriable)
Body Corporate of Individuals(BOI)
Minor (NRI – Non Repatriable) FPI - Category I
Unlisted Company Bank
FPI - Category II
Hindu Undivided Family (HUF) – Indian
Government Body Pension and Retirement Fund
FPI - Category III
Hindu Undivided Family (HUF) – NRI - Repatriable Global Development Network
NPS Trust Insurance Company
Hindu Undivided Family (HUF) – NRI – Non- Others
Repatriable Provident Fund / EPF / PF Trust Defence Establishment
Are you a Non Profit Organization
Person of Indian Origin (PIO) Mutual Fund Society (NPO) Yes No
7. Mode of Holding
Please ü Sole/1st Holder only Any one or Survivor* Joint
(If the mode of operation is not specified, for folios opened with more than one applicant, the mode of operation would be taken as “Any one or Survivor”)
If your investment is being made by a Constituted Attorney on your behalf, please furnish the below details and enclose a original notarised copy of the Power of Attorney for
registering the same:
POA Holder’s Name Mr. Ms. First Name Middle Name Last Name
PoA for Sole / First Applicant Second Applicant Third Applicant E-mail Id
This is only acknowledgment of receipt of application and will be processed as per the contents filled in the application, subject to realisation of cheque and furnishing of mandatory
information/ documents.
Note: Effective February 1, 2021, units will be allotted only upon receipt of subscription amount by the Fund House for utilisation irrespective of any scheme
category/investment amount. Net Asset Value (NAV) will be applied based on realization of funds for all purchases including systematic transactions registered
prior or post February 1, 2021. Please retain this slip till you receive your account statement.
call 1800 4190 200 or 1800 2000 400 email investor.line@lntmf.co.in www.ltfs.com
Please note our lines are open from 9 am to 6 pm, Monday to Friday and 9 am to 1 pm on Saturday
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10. Investment & payment information (Please ensure that the cheque complies to the Cts 2010 standards)
1. Investment Type (ü) Lumpsum SIP Multi-Scheme Lumpsum Multi-Scheme SIP (Please fill Multi-Scheme SIP investment form)
Micro SIP (For SIP/Micro SIP, please fill SIP Investment Form)
For Lumpsum & Sip Investment (Please issue cheque favouring scheme name)
Scheme Name L&T Option (ü) Growth* IDCW@ Payout IDCW@ Reinvestment Bonus^
IDCW@ Frequency (üwherever applicable) Daily Weekly Monthly* Quarterly Annual^ Semi-Annual^
For Multi-Scheme SIP/Multi-Scheme Lumpsum (Please issue cheque favouring L&T MF Multi-Scheme SIP and L&T MF Multi Scheme Lumpsum respectively)
Total Investment Amount (`) DD Charges (if applicable `) Net Amount (`)
Scheme 1 : L&T Option (ü) Growth* IDCW@ Payout IDCW@ Reinvestment Bonus^
Scheme 2 : L&T Option (ü) Growth* IDCW@ Payout IDCW@ Reinvestment Bonus^
Scheme 3 : L&T Option (ü) Growth* IDCW@ Payout IDCW@ Reinvestment Bonus^
If One Time Mandate, Please fill, Unique Mandate Reference Number (UMRN)
11. kyc details (Mandatory. If left blank the application is liable to be rejected)
categories First Applicant/ Guardian Second Applicant Third Applicant
Below 1 lac 1-5 Lacs Below 1 lac 1-5 Lacs Below 1 lac 1-5 Lacs
Gross Annual 5-10 Lacs 10-25 Lacs 5-10 Lacs 10-25 Lacs 5-10 Lacs 10-25 Lacs
Income 25 Lacs - 1 crore > 1 Crore 25 Lacs - 1 crore > 1 Crore 25 Lacs - 1 crore > 1 Crore
(For Individuals Net-worth in (Mandatory for Non-Individuals) Net-worth Net-worth
and Non
Individuals) (`) as on (`) as on (`) as on
D D / M M / Y Y Y Y (Not older than 1 year) D D / M M / Y Y Y Y (Not older than 1 year) D D / M M / Y Y Y Y (Not older than 1 year)
Private Sector Service Retired Private Sector Service Retired Private Sector Service Retired
Public Sector Service Student Public Sector Service Student Public Sector Service Student
Occupation
Details Government Service Forex Dealer Government Service Forex Dealer Government Service Forex Dealer
(For Individuals Business Agriculturist Business Agriculturist Business Agriculturist
only) Professional Housewife Professional Housewife Professional Housewife
Others Please specify Others Please specify Others Please specify
Others I am politically Exposed Person I am politically Exposed Person I am politically Exposed Person
(For Individuals I am Related to Politically Exposed Person I am Related to Politically Exposed Person I am Related to Politically Exposed Person
only) Not Applicable Not Applicable Not Applicable
Additional KYC Details for Non-Individuals
Is the company a Listed Company or Subsidiary of Listed Company or Controlled by a Listed Company YES NO
Others
(If No, please attach Ultimate Beneficiary Ownership Declaration mandatorily)
(For Non-
If the Entity involved/providing any of the following services: YES (Please ü from below) NO
Individuals only)
Gaming/Gambling/Lottery/Casino Services Foreign Exchange/ Money Changer Services Money Lending/Pawning
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12. INFORMATION REqUIRED FOR TAx REPORTINg (Mandatory. If left blank the application is liable to be rejected)
I am a tax resident of India and not a resident of any other country Yes No
If No, please mandatorily enclose the FATCA & CRS Declaration for Individual Investors.
FOR NON-INDIvIDUALS: Please mandatorily enclose the FATCA, CRS & UBO Declaration for Non Individuals with all the sections filled.
13. NOMINATION DETAILS (Please note that where the sole/1st applicant is a minor, no nomination is allowed)
(Please ü) I/We wish to Nominate I/We do not wish to Nominate
I/We do hereby nominate the person(s) named below to receive the units allotted to my/our credit in my/our folio in the event of my/our death. I/We also understand that all
payments and settlements made to Nominee(s), and signature(s) of the Nominee(s) acknowledging receipt thereof, will be noted as be a valid discharge by the AMC/Mutual Fund/
Trustee. This instruction supercedes all previous nominations made by me/us in respect of the folio indicated above.
Particulars 1st Nominee 2nd Nominee 3rd Nominee
Name
Address
City
State
Country
Pincode
Allocation %
Signature of Guardian
(if nominee is minor) (mandatory)
Signature of Nominee
Date: D D M M Y Y Y Y
(X) (X)
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SIP & SIP-TOP UP REGISTRATION / RENEWAL
R. R. LAHORI
ARN- Distributor / RIA / PMRN Code# ARN- Sub-Distributor Code E EUIN -EUIN
E054671
No. Internal Code for Sub-broker/ Employee
ARN-53115
#By mentioning RIA / PMRN code, I/we authorize you to share with the Investment Adviser the details of my/our transactions in the scheme(s) of IDFC Mutual Fund.
Declaration for “execution-only” transaction (only where EUIN box is left blank) (Refer Instruction No. XIII). – I/We hereby confirm that the EUIN box has been Signature of First / Sole Applicant /
intentionally left blank by me/ us as this is an “execution-only” transaction without any interaction or advice by the employee/relationship manager/sales person of the Guardian / Authorised Signatory
above distributor or notwithstanding the advice of in-appropriateness, if any, provided by the employee/relationship manager/sales person of the distributor and the
distributor has not charged any advisory fees on this transaction.
TRANSACTION CHARGES I am a first time investor in mutual funds (` 150 will be deducted) OR I am an existing investor in mutual funds (` 100 will be deducted)
(Please ü any one of the below) (Refer Instruction No. S) Applicable for transactions routed through a distributor who has 'opted in' for transaction charges. Upfront commission shall be paid directly by the investor to the AMFI registered distributor based on the
investors’ assessment of various factors including service rendered by the distributor.
Please Tick (ü) SIP Registration SIP Renewal SIP with Top-up Registration SIP - Change in Bank Details Please mention relevant SIP details below and also
in the IDFC Common Mandate (IDFC OTM).
UNIT HOLDER INFORMATION
Existing Folio Number PAN
SYSTEMATIC INVESTMENT PLAN DETAIL (SIP DETAIL) ^Default Top-up option Yearly
Monthly SIP Date
(Except 29th, 30th & 31st) D D (Default 10th) SIP Period From M M Y Y Y Y To M M Y Y Y Y OR 1 2 2 0 9 9
SIP TOP-UP (Optional) (Refer J (viii)) Registration for this facility is Frequency Half Yearly Yearly^ Amount ` in figures (The Top-up amount should be Rs. 500 and multiples of Rs. 500 thereafter)
subject to the investor's bankers accepting the mandate for this registration.
INITIAL SIP INSTALLMENT PAYMENT THROUGH (Please provide cheque for initial SIP Amount and fill below OTM for subsequent SIP installments.)
My existing OTM registered to be used for initial & subsequent SIP instalments (OR)
DEMAT ACCOUNT DETAILS (Applicable ONLY for investors who are willing to hold their investment in DEMAT form)
NSDL: Depository Participant (DP) ID (NSDL only) Beneficiary Account Number (NSDL only) CDSL: Depository Participant (DP) ID (CDSL only)
I/ We have read, understood and agree to comply with the terms and conditions of the Statement of Additional Information, Scheme Information Documents and Key Information Memorandum of the Scheme(s), Foreign Account Tax
Compliance Act and Common Reporting Standards, statutory requirements prescribed by SEBI, AMFI, Prevention of Money Laundering Act, 2002 (PMLA), Privacy Policy of IDFC Asset Management Company Limited available on the
website of IDFC Mutual Fund www.idfcmf.com and all applicable rules and regulations and hereby confirm that I/We have not received nor been induced by any rebate or gifts, directly or indirectly, to make this investment. I/We hereby
declare that I/we do not have any existing Micro SIPs which together with the current application will result in a total investments exceeding Rs. 50,000 in a year. The ARN holder has disclosed to me/us all the commissions (in the form of
trail commission or any other mode), payable to him for the different competing Schemes of various Mutual Funds from amongst which the Scheme is being recommended to me/us. For NRIs / PIOs / FPIs only: I / We confirm that I am / we
are Non Resident Indians / Person(s) of Indian Origin / Foreign Portfolio Investors but not (i) United States persons as per applicable Regulations or (ii) residents of Canada, and I / we have remitted funds from abroad through approved
banking channels or from funds in my / our Non-Resident External / Non-Resident Ordinary / FCNR Account maintained in accordance with applicable RBI guidelines.
I/We hereby provide my/our consent to IDFC Asset Management Company Limited (“IDFCAMC”) for (i) collecting, storing and usage of personal information for the purposes of processing my/our application and providing the services to
which I/we have subscribed and for the purposes of meeting legal and regulatory requirements; (ii) validating/authenticating with Unique Identification Authority of India (“UIDAI”) by itself or through its Registrar and Transfer Agent
(“RTA”); and (ii) downloading and updating my/our Aadhaar number(s) and associated demographic information (including updated information) in my/our accounts/folios under IDFC Mutual Fund, based on my/our Income Tax
Permanent Account Number (“PAN”) in accordance with the Aadhaar Act, 2016, PMLA and rules & regulations made thereunder and applicable SEBI guidelines. I/We hereby further authorise IDFC AMC for sharing/disclosing of the
Aadhaar number(s) and associated demographic information (including any updated information) by itself or through its RTA, depository participants, and asset management companies of other SEBI registered mutual funds, and their
RTAs, for the purpose of updating the same in my/our accounts/folios based on my/our PAN.
an amount of Rupees `
FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented DEBIT TYPE Fixed Amount Maximum Amount
PAN /
Application No. Mobile No. +91
Reference Email ID
I agree for the debit mandate processing charges by the bank whom I am authorizing to debt my account as per latest schedule for charges of the bank.
(X) (X)
• This is to confirm the declaration has been carefully read, understood & made by me/us. I am authorizing the user entity/corporate to debit my account, based on the instructions as agreed & signed by me.
• I have understood that I am authorised to cancel/amend this mandate by appropriately communicating the cancellation/ammendent request to the user entitly/corporate or the bank where I have authorised the debit.