THIRD PARTY CHEQUES
Third Party Payment Declaration (Should be enclosed with each payment/SIP Enrolment)
Payments by: Parent/ Grand-Parents/ Related Persons Other than the Registered Guardian
Payments to: To a Minor Folio only; In consideration of: Natural love and affection or as gift only
Maximum Value: Not Exceeding Rs 50,000/- (each regular purchase or per SIP installment)
Application and Payment Details (All details below are mandatory, including relationship, PAN & KYC)
Folio No. Application Form No.
Beneficial Minor's Name:
Investment Amount in Rs.
Payment Cheque No. Dated D D M M Y Y Y Y
Cheque Drawn on Bank:
Cheque Drawn on A/c No.:
Declaration and Signatures:
Parent/Grand-Parents/Related Guardian of Minor,
Persons Other than the Registered as registered in the Folio
Guardian
Name
Relationship with Minor:
Income Tax PAN
KYC Acknowledgement Attached Attached
Mandatory for any amount Mandatory for any amount
Declaration I hereby declare and confirm the I confirm that I am the legal guardian of
minor stated above is the the Minor, registered in folio and have
beneficial owner of the investment no objection to receiving these funds on
details mentioned above and I am behalf of the minor.
providing the funds for these
investments on account of my
natural love and affection or as gift
from my bank account only.
Signature
Contact Number
THIRD PARTY CHEQUES
Banker's Certificate in case of Demand Draft / Pay Order / Any Other pre-funded instrument:
To whomsoever it may concern, we hereby confirm the following details regarding the instrument issued by us:
Instrument Details:
Instrument Type: Demand Draft Pay Order / Banker's Cheque
Instrument Number: Dated D D M M Y Y Y Y
Investment Amount in Rs.:
In Favour of / Favouring:
Payable At:
Details of Bank Account Debited for issuing the instrument:
Bank Account Number Account Type
Account Holder Details Name Income Tax PAN
1.
2.
3.
If the issuing bank branch is outside India:
We further declare that we are registered as a Bank/branch as mentioned below:
Under the Regulator Name of the Regulator
In the Country Country Name
Registration No. Registration Number
We confirm having carried out necessary Customer Due Diligence with regard to the Beneficiary and to the source of the funds received
from him, as per the standards of Anti-Money Laundering laws and other applicable relevant laws in our country.
Branch Manager/Declarant(s)
Name: _____________________________________________________________________ Signature:
Address: __________________________________________________________________
__________________________________________________________________
City: __________________________ State: ______________________________ Bank & Branch Seal
Postal code: ___________________ Country: ____________________________
Contact Number:
Important Note: It is clarified that the bankers certificate suggested above is recommendatory in nature, as there may be existing Bank
Letters/ Certificates/ Declarations, which will confirm to the spirit of the requirements, if all required details are mentioned in the certificate.
THIRD PARTY CHEQUES
Custodian on behalf of an FII or client Should be enclosed with each payment.
To whomsoever it may concern
Application and Payment Details (All details below are mandatory):
Folio No. Application Form No.
Beneficial Applicant/
Investor Name:
Investment Amount in Rs.
Payment Mode Cheque Funds Transfer RTGS NEFT
Payment Cheque/ UTR No.: Date D D M M Y Y Y Y
Payment from Bank:
Payment from A/c No.:
We further declare that we are registered as a Custodian with SEBI under Registration No: _________________________________
We confirm the beneficial owner as stated above and that this payment is issued by us in our capacity as Custodian to the Applicant/Investor.
The source of this payment is from funds provided to us by the Applicant/Investor.
Name of Declarant(s):
Income Tax PAN):
Address of Declarant(s): Signature of Declarant(s):
City: State:
Postal code: Country:
THIRD PARTY CHEQUES
Payment by Employer on behalf of Employee under Systematic Investments Plans through Payroll deductions
To whomsoever it may concern
We hereby declare that the application form no/s: ___________________________ for subscription of units in ________________________
________________________________________ (Name of the scheme / plan / option) is accompanied by Cheque No: ____________________
dated __________________ drawn on ____________________________________________________________________________________
(Name of the Bank / Branch).
We confirm that the beneficial owner(s) of the investment in these units is/are _____________________________________________
__________________________________________________ (Name of the Employee/s, with employee number/s), who is/are my/our
employee/s and am providing the funds for these investments through the payroll deduction.
Name of Declarant(s):
Income Tax PAN):
Address of Declarant(s): Signature of Declarant(s):
City: State:
Postal code: Country:
Signature of Beneficiary(ies)
