Common Application Form
Common Application Form
Common Application Form
Application No.
Form 1
ARN-3086
Upfront commission shall be paid directly by the investor to the AMFI registered distributor based on the investor's assessment of various factors including the service rendered by the distributor.
Title
Mr.
Ms.
M/s
KYC Acknowledgment* Name of the Guardian if minor / Contact Person for non individuals / PoA Holder name
For Investments "On behalf of Minor"(Refer Instruction 6) (^Attach mandatory documents as per instructions.) School Certificate/Mark sheet Birth Certificate Proof of Date of Birth Attached^ Passport Any other Court Appointed^ Father Mother Guardian named below is PoA PAN
City
City
State
Mobile +91
Pin Code
Tel (Office)
Tel (Resi)
Proprietor Other Professional
Status of Sole / 1st Applicant (Please P ) Resident Individual Trust Partnership Firm PIO Company Occupation (of 1st / Sole Applicant) Housewife Defence Service MICRO SIP (Refer instruction 5b.) Type of Supporting Document
HUF Specify
Retired
Minor
Society
FII
NRI
Business
Agriculture
Other
Specify
ID Document Number
Anyone or Survivor Single M/s
Title
Mr.
Ms.
(2nd applicant)
Enclose
KYC Acknowledgment*
Email ID
Name of 3rd Applicant (Should match with PAN Card) PAN
Enclose
Mobile +91
Title
Mr. Ms. M/s
(3rd applicant)
KYC Acknowledgment*
Email ID
Mobile +91
4. BANK ACCOUNT DETAILS FOR PAY-OUT (Mandatory. Refer instruction 4 and avail of Multiple Bank Registration Facility.)
Bank Name Bank A/c No.
Branch Address City IFSC Code (11 digit)* MICR Code (9 digit)* Pin
*Mentioned on your cheque leaf
A/c Type
Current
Savings
NRO
NRE
FCNR
Others Specify
5. DEBIT MANDATE (For Axis Bank account holders only. To be used to invest in one scheme at a time only. Refer instruction 3d.)
TO BE DETACHED BY THE REGISTRAR (KARVY) AND PRESENTED TO AXIS BANK CMS DEPARTMENT D D M M Y Y *To be processed in CMS software under client code AXISMF Date Application No. Name of the account holder(s) authorise you to debit my/our account no. I/ We
to pay for the purchase of Axis Income Saver amount of ` (in figures) Axis Triple Advantage Fund Axis Midcap Fund
` (in words)
Application No.
Form 1
ONE TIME LUMP SUM INVESTMENT (Do not submit SIP Auto Debit Form for lump sum investments) Payment mode Cheque DD RTGS NEFT
SCHEME 1
Debit Mandate^
SCHEME 2 SCHEME 3
(^Facility available for Axis Bank account holders only. Please fill in section 5. The Debit Mandate can be used to invest in one scheme at a time only.)
LUMPSUM
Investment amount (`) Cheque / DD / RTGS / NEFT No. Cheque / DD / RTGS / NEFT date Drawn on bank / branch name Pay-in bank account no. (For cheques only) Account type (Please P )
DD/MM/YY
DD/MM/YY
DD/MM/YY
Current NRO
Specify
FCNR
Current NRO
Specify
FCNR
Current NRO
Specify
FCNR
MICRO SIP INVESTMENT (Provide 'Type of Supporting Document' & 'ID Document Number' under section 2. Refer instruction 5b.)
(in figures) ` (in words)
Drawn On
Second and subsequent SIP Installment details Till you instruct Axis Mutual Fund to discontinue or SIP period
Preferred date for monthly debit (Pick any date except 29th, 30th and 31st of the month.) D SIP through post-dated cheques-Cheque Nos. From D
to* M M
*Please fill only if no. of installments have been specified. Otherwise leave blank.
To
Date From D D M M Y
Y To D
M M
SIP through Electronic Auto Debit (Please fill and attach the SIP Auto Debit Form along with this form)
7. NOMINATION DETAILS (Nomination is advisable. If you do not wish to nominate, tick here . Refer instructions.)
Name Nominee 1 Nominee 2 Nominee 3 Date of Birth Address Guardian Name
(in case Nominee is a Minor)
Total=100%
Second Applicant
Third Applicant