Application Form For Tata Mutual Fund

Mulla House, Ground Floor, M. G. Road, Fort, Mumbai - 400 001

ALL THE DETAILS REQUESTED IN THE FORM ARE MANDATORY FOR EACH OF THE APPLICANTS

1. Advisor / Distributor Information Refer Sec. B

ARN / RIA ^ Code Sub-Broker ARN Code Sub-Broker / Bank Branch Code EUIN Code

Internal Code OR Declaration for “execution-only” transaction – I/We hereby 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 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.
In case the subscription amount is ` 10,000 or more and your Distributor has opted to receive transaction charges, ` 150/- (for First time mutual fund investor) or ` 100/- (for investor
other than First time mutual fund investor) will be deducted from the subscription amount and paid to the distributor. Units will be issued against the balance amount invested. Upfront
commission shall be paid directly by the investor to the AMFI registered Distributors based on the investors’ assessment of various factors including the service rendered by the distributor.
^ By mentioning RIA code, I / we authorize you to share with the SEBI Registered Investment Adviser (RIA) the details of my / our transactions in the schemes(s) of Tata Mutual Fund

Sole / 1st Applicant Signature / 2nd Applicant Signature / 3rd Applicant Signature /
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2. Applicant’s Information Refer Sec. A, C & J

The Name of the Applicants should be as mentioned in the PAN and the KYC acknowledgement. There can be upto 3 holders. No joint holders allowed
with 1st applicant as a minor. Any applicants should not be a resident of Canada or a person who falls within the definition of the term “U.S. Person”
under the US Securities Act of 1933 and corporations or other entities organised under the laws of the U.S. For Investors New to Tata Mutual Fund,
mention the C-KYC No. Incase C-KYC No. is not available kindly complete the Know Your Client (KYC) form attached herewith.

Ist Applicant’s Details Folio No.

The first applicant >> Mr. Ms. M/s. C-KYC PAN / PEKRN
will be the primary
holder and all
correspondence will be Name
sent to him/her.
Only the first holder
can be a minor.
Existing Investors may Date of Birth (DOB) In case of Minor: Proof of DOB: Birth certificate School leaving certificate
mention the Folio no.
and proceed to Sec. 4. D D / M M / Y Y Y Y Passport Others ………….............
Investors to ensure
that PAN is linked to Residence Phone (prefix STD Code) Office Phone (prefix STD Code)
Aadhaar. Extn

Mobile No. Mobile belongs to

Self Parent Sibling Custodian
Spouse Child Guardian PMS POA
Email Email belongs to
Self Parent Sibling Custodian
Spouse Child Guardian PMS POA

I hereby authorise TMF, TAMPL and/or its authorized service provider(s) to communicate Mutual Fund scheme related matters/documents and other
information related to the investment products either through call, SMS, email, whatsApp or such other means overriding any NDNC registration.
On providing email-id investors shall receive the scheme wise annual report or an abridged summary thereof/ account statements/ statutory and other documents by email.
However, if the investors wish to receive physical copy of the scheme wise annual report or an abridged summary thereof [Please tick (Tick Mark)] Yes No

Contact Person - Designation (Non Individual Investors) / Power of Attorney (POA) / Proprietor / Guardian details (minor applicant)
POA / Proprietor / PAN / PEKRN
Guardian Details Mr. Ms.

Name

For Non Individual >> Entity Identifier (LEI) Number Mandatory for Transaction Value of INR 50 crore and above

To be filled by >> Relationship with the Minor Applicant Proof of Relationship

Guardian Mother Father Legal Guardian Birth certificate School leaving certificate Passport Others ………............
Mobile No. Date of Birth C-KYC
D D / M M / Y Y Y Y
Tax Status
Resident Individual Sole Proprietorship Public Limited Company Limited Liability Partnership Overseas Citizen of India
NRI-Repatriation Hindu Undivided Family Trust Body of Individuals Foreign National Resident in India
NRI-Non-Repatriation Partnership Body Corporate Society / Club / NGO Person of Indian Origin
Minor - Resident Individual Private Limited Company Non Profit Organization Others (Please specify) ......... ...................................
Minor - NRI
3. Contact Details Refer Sec. D
Mailing address is >>
required for initial
communication. We
will overwrite this
address with the 1st City
Applicants address
as per the KRA
PIN State Country
records

% %
Acknowledgement Slip

Received from Mr./Ms./M/s. ___________________________________________________________________________ PAN _____________________________________ ` _________________________________

for purchase in _______________________________________________________________________________________________________________________Subject to verification and realisation.
Overseas address
Mandatory for Non-
Resident Individuals
and Overseas
Investors in addition
to the mailing City
address.

State ZIP Code Country

4. Payout Bank Account Details Refer Sec. G

The bank account details provided below will be held on record and considered as default bank mandate to pay redemption
proceeds and IDCW payouts (if applicable).
This must be an Account number A/C type Savings Current NRO
Indian account. The
1st applicant should NRNR NRE
be a holder in this
account. MICR IFSC for RTGS IFSC for NEFT

Bank Name and Branch

Branch City PIN State

5. Investment Scheme Details Refer Sec. F & Product Labels

Amount Allocation Lumpsum Lumpsum + SIP

Plan
Scheme Name >> (select >> Regular Direct
any one)

Option >> Sub Option >>

IDCW Payout
Option >> IDCW Reinvest IDCW Payout
(Select Anyone)

6. Investment Instrument Details Refer Sec. E

Mode of Payment Cheque Funds Transfer RTGS NEFT

The name of the >> Amount (`) (A) Dated Cheque / DD No.
first applicant
should be available D D / M M / Y Y Y Y
on the investment
Cheque. Account Number A/C type Savings Current NRO
NRNR NRE
Cheque/ DD to be
drawn in favour Bank Details Same as above [Please () if yes] Different from above [Please () if it is different from above and fill in
of ‘Name of the the Bank details below]
Scheme’ Name of Bank and Branch

Branch City Mandatory Enclosures (Please tick () (if the first instalment is not through cheque)
Cheque copy Bank Statement Banker’s Attestation

7. Joint Applicant’s Details Refer Sec. H & I

Mode of Holding Single Joint Any one or Survivor (Default)

II
nd
Applicant’s Details Investors to ensure that PAN is linked to Aadhaar.

Mr. Ms. Status C-KYC PAN / PEKRN

Resident Individual NRI
Name Date of Birth
D D / M M / Y Y Y Y

Mobile No. Mobile belongs to

Self Parent Sibling Custodian
Spouse Child Guardian PMS POA
Email Email belongs to
Self Parent Sibling Custodian
Spouse Child Guardian PMS POA
% %
Cheque Details Acknowledgement Slip
Cheque/DD No. _______________________ dated ______________________ A/c. No. __________________________________ Bank ______________________________
Call (022) 6282 7777 (Monday to Saturday 9:00 am to 5:30 pm) Subject to realisation.
IIIrd Applicant’s Details Investors to ensure that PAN is linked to Aadhaar.

Mr. Ms. Status C-KYC PAN / PEKRN

Resident Individual NRI
Name Date of Birth

D D / M M / Y Y Y Y

Mobile No. Mobile belongs to

Self Parent Sibling Custodian
Spouse Child Guardian PMS POA
Email Email belongs to
Self Parent Sibling Custodian
Spouse Child Guardian PMS POA

8. Know Your Customer (KYC) Details Refer Sec. J

CATEGORIES FIRST APPLICANT (Including Minor) SECOND APPLICANT / GUARDIAN THIRD APPLICANT
Occupation >> Private Sector Service Retired Private Sector Service Retired Private Sector Service Retired
Public Sector Service Business Public Sector Service Business Public Sector Service Business
Government Sector Agriculturist Government Sector Agriculturist Government Sector Agriculturist
Professional Forex Dealer Professional Forex Dealer Professional Forex Dealer
Housewife Student Housewife Student Housewife Student
Others (please specify) ....................... Others (please specify) ........................... Others (please specify) ........................
Gross Annual Income >> Below 1 Lac 1-5 Lacs Below 1 Lac 1-5 Lacs Below 1 Lac 1-5 Lacs
5-10 Lacs 10-25 Lacs 5-10 Lacs 10-25 Lacs 5-10 Lacs 10-25 Lacs
>25 Lacs-1 crore >1 crore >25 Lacs-1 crore >1 crore >25 Lacs-1 crore >1 crore
Networth in (Mandatory for Non-individual) Networth in Networth in
` ..................................................... as on ` ........................................................... as ` ................................................... as on
D D / M M / Y Y Y Y D D / M M / Y Y Y Y D D / M M / Y Y Y Y
on
(not older than 1 year) (not older than 1 year) (not older than 1 year)

Others >> Not Applicable Not Applicable Not Applicable

Politically Exposed Person Politically Exposed Person Politically Exposed Person
Related to Politically Exposed Person Related to Politically Exposed Person Related to Politically Exposed Person

Additional KYC Details for Non - Individuals

For Non Individuals >> Is the company a Listed Company or Subsidiary of Listed Company or Controlled by a Listed Company: Yes No
only (Companies, (if No, mandatory to attach the UBO declaration)
Trust, Partnership Non Individual investors involved/providing any of the mentioned services
etc.) Foreign Exchange / Money Changer Services Gaming / Gambling / Lottery / Casino Services
Money Lending / Pawning None of the above

9. Foreign Account Tax Compliance Act (FATCA) & CRS Details Refer Sec. K
For Individuals FIRST APPLICANT (including Minor) SECOND APPLICANT / GUARDIAN THIRD APPLICANT
Country of Birth >>

Place of Birth >>

Nationality >> Indian U. S. Indian U. S. Indian U. S.

Others (Please specify) _________________ Others (Please specify) _________________ Others (Please specify) _________________
Type of address given at KRA >> Residential or Business Residential Residential or Business Residential Residential or Business Residential
Registered Office Business Registered Office Business Registered Office Business
Are you also a resident in >> No Yes No Yes No Yes
any other country(ies) for tax
purposes? If yes, complete section below.
Country of Tax Residency 1 >>

Tax Identification Number 1 >>

Identification Type 1 >>

If TIN is not available please >> Reason A B C Reason A B C Reason A B C

tick the reason A, B or C *
Country of Tax Residency 2 >>

Tax Identification Number 2 >>

Identification Type 2 >>

If TIN is not available please >> Reason A B C Reason A B C Reason A B C

tick the reason A, B or C *
* Reason A: The country where the Account Holder is liable to pay tax does not issue Tax Identification Numbers to its residents; Reason B: No TIN required (Select this reason
only if the authorities of the respective country of tax residence do not require the TIN to be collected); Reason C: Others- Please state the reasons thereof
FATCA & CRS Related Details for Non Individuals: Please submit Form W8 BEN-E / Specified declaration (Enclosed)
10. Nomination Details (All fields are Mandatory) Refer Sec. L
Select any one
I do not wish to nominate. I / We hereby confirm that I / We do not wish to appoint any nominee(s) for my mutual fund units held in my / our mutual fund folio and understand the issues involved in non appointment of nominee(s) and further
are aware that in case of death of all the account holder(s), my / our legal heirs would need to submit all the requisite documents issued by Court or other such competent authority, based on the value of assets held in the mutual fund folio.
Register nomination as below: I / We want the details of my / our nominee with % to be printed in the statement of holding, provided to me/ us: Yes No (Default)
1st Nominee Details
Name Date of Birth
D D / M M / Y Y Y Y
Email Mobile PAN / PEKRN

Relationship with Sole/1 Holder st

Allocation (%) Signature of Nominee / Guardian

Identity Type Identity Number (Only last 4 digits in case the Identity Type is Aadhaar)
PAN Driving Licence Aadhaar Passport
Address of Nominee / Guardian (in case of Minor Nominee)

State PIN Country

Guardian Name in case of Minor Nominee Guardian PAN Relationship of Guardian with Nominee

2nd Nominee Details

Name Date of Birth
D D / M M / Y Y Y Y
Email Mobile PAN / PEKRN

Relationship with Sole/1st Holder Allocation (%) Signature of Nominee / Guardian

Identity Type Identity Number (Only last 4 digits in case the Identity Type is Aadhaar)
PAN Driving Licence Aadhaar Passport
Address of Nominee / Guardian (in case of Minor Nominee)

State PIN Country

Guardian Name in case of Minor Nominee Guardian PAN Relationship of Guardian with Nominee

3rd Nominee Details

Name Date of Birth
D D / M M / Y Y Y Y
Email Mobile PAN / PEKRN

Relationship with Sole/1st Holder Allocation (%) Signature of Nominee / Guardian

Identity Type Identity Number (Only last 4 digits in case the Identity Type is Aadhaar)
PAN Driving Licence Aadhaar Passport
Address of Nominee / Guardian (in case of Minor Nominee)

State PIN Country

Guardian Name in case of Minor Nominee Guardian PAN Relationship of Guardian with Nominee

Sign here 1st Applicant Signature / Thumb Impression 2nd Applicant Signature / Thumb Impression 3rd Applicant Signature / Thumb Impression

11. Demat Account Details Refer Sec. M

Fill these details only if you wish to have your units in Demat mode.
Ensure that the
Depository participant Name
sequence of names
as mentioned in the
application form
matches with that of the Central Depository Securities Limited National Securities Depository Limited
account held with the Target ID No. DP ID No.
Depository Participant.
In case the details are I N
found to be incorrect, Beneficiary Account No.
Units will be allotted in
physical mode.
12. Declaration and Signatures Refer Sec. N
I/We am/are not prohibited from accessing capital markets under any order/ruling/judgment etc., of any regulation, including SEBI. I/We confirm that my application is in compliance with applicable Indian and foreign laws. I / We hereby confirm and declare as under:-
(1) I / We have read, understood and hereby agree to comply with the terms and conditions of the scheme related documents and apply for allotment of Units of the Scheme(s) of Tata Mutual Fund (‘Fund’) indicated in this application form. (2) I/We am/are eligible Investor(s) as per
the scheme related documents and am/are authorised to make this investment. The amount invested in the Scheme(s) is through legitimate sources only and is not for the purpose of contravention and/or evasion of any act, rules, regulations, notifications or directions issued by any
regulatory authority in India. (3) The information given in / with this application form is true and correct and further agree to furnish such other further/additional information as may be required by the Tata Asset Management Pvt. Ltd. (TAMPL)/ Fund and undertake to inform the
AMC / Fund/Registrars and Transfer Agent (RTA) in writing about any change in the information furnished from time to time. (4) That in the event, the above information and/or any part of it is/are found to be false/ untrue/misleading, I/We will be liable for the consequences arising
therefrom. (5) I/We hereby authorize you to disclose, share, remit in any form/manner/mode the above information and/or any part of it including the changes/updates that may be provided by me/us to the Mutual Fund, its Sponsor/s, Trustees, Asset Management Company, its
employees, agents and third party service providers, SEBI registered intermediaries for single updation/ submission, any Indian or foreign statutory, regulatory, judicial, quasi- judicial authorities/agencies including but not limited to Financial Intelligence Unit-India (FIU-IND) etc without
any intimation/advice to me/us. I/We hereby authorize you to share the account statement of the folio with the distributor /broker / advisor on record. (6) I/We will indemnify the Fund, AMC, Trustee, RTA and other intermediaries in case of any dispute regarding the eligibility, validity
and authorization of my/our transactions. (7) The ARN holder (AMFI registered Distributor) has disclosed to me/us all the commissions (in the form of trail commission or any other mode), payable to him/them for the different competing Schemes of various Mutual Funds from amongst
which the Scheme is being recommended to me/us. (8) I/We hereby confirm that I/We have not been offered/ communicated any indicative portfolio and/ or any indicative yield by the Fund/AMC/its distributor for this investment. (9) I / We agree that the unit balance(s) reflecting in
the account statement is subject to realisation of Cheque accompanying the purchase request, PAN validation and KYC compliance. (10) For Foreign Nationals Resident in India only: I/We will redeem my/our entire investment/s before I/We change my/our Indian residency status. I/We
shall be fully liable for all consequences (including taxation) arising out of the failure to redeem on account of change in residential status. (11) For NRIs/ PIO/OCIs only: I/We confirm that my application is in compliance with applicable Indian and Foreign laws. (12) I/We hereby accord
my/our consent to TATA AMC for receiving the promotional information/ material via email, SMS, telemarketing calls, etc. on the mobile number and email provided by me/us in this Application Form. Date: _____________________

1st Applicant Signature / 2nd Applicant Signature / 3rd Applicant Signature /

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