Application No.
FORM 1 - FOR LUMP SUM / SIP INVESTMENTS
(PLEASE READ THE INSTRUCTIONS BEFORE FILLING UP THE FORM. All sections to be completed in ENGLISH in BLACK / BLUE COLOURED INK and in BLOCK LETTERS.)
TRANSACTION CHARGES FOR APPLICATIONS ROUTED THROUGH DISTRIBUTORS/AGENTS ONLY
(Refer Instruction No. 20)
In case the subscription (lumpsum) 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.
` `
I confirm that I am a first time investor across Mutual Funds.
I confirm that I am an existing investor in Mutual Funds.
OR
Received subject to realisation, verification and conditions, an application for purchase of Units as mentioned in the application form.
ACKNOWLEDGMENT SLIP
From
Application No.
Cheque no.
Date Amount
Scheme
Stamp & Signature
SECOND APPLICANT
Mr. Ms.
M/s.
GUARDIAN DETAILS (In case First / Sole Applicant is minor) / CONTACT PERSON - DESIGNATION / PoA HOLDER (In case of Non-individual Investors)
Relationship Of Guardian (Refer Instruction No. 11)
Proof of the Relationship with Minor
Date of Birth
D D M M Y Y Y Y
CKYC No.
14 digit CKYC Number
THIRD APPLICANT
Mr. Ms.
M/s.
Date of Birth
D D M M Y Y Y Y
CKYC No.
14 digit CKYC Number
Mr. Ms.
M/s.
Date of Birth
D D M M Y Y Y Y
CKYC No.
14 digit CKYC Number
Birth Certificate
School Certificate
Passport
Other
Specify
TAX STATUS (Applicable for First / Sole Applicant)
Resident Individual FIIs NRI - NRO HUF Club / Society PIO Body Corporate Minor Government Body Trust NRI - NRE Bank & FI
Sole Proprietor Partnership Firm QFI Provident Fund Others
Specify
PAN (Mandatory)
PAN (Mandatory)
PAN (Mandatory)
EXISTING INVESTOR'S FOLIO NUMBER
(Applicable details and Mode of holding will be as per the existing Folio No.)
(If you have an existing folio with KYC validated,
please mention here and skip to section 6/7.)
Anyone or Survivor
Joint (Default)
Single
MODE OF HOLDING
(in case of Demat Purchase Mode of Holding should be same as in Demat Account)
INVESTMENT TYPE
(Please tick any one)
LUMP SUM WITH STP
LUMP SUM WITH SIP
LUMP SUM
SINGLE CHEQUE MULTIPLE SCHEMES
Aadhaar No.
Aadhaar No.
Serial No., Date & Time Stamp
Sub-Distributor ARN
Distributor ARN
EUIN
Internal Sub-Broker / Sol ID
Employee Code
ARN ARN E
RIA CODE^
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.
^I/We, have invested in the scheme(s) of Axis Mutual Fund under Direct Plan. I/We hereby give my/our consent to share/provide the transactions data feed/ portfolio holdings/ NAV etc. in respect of my/our investments under Direct Plan(s) of all
the below mentioned scheme(s) of Axis Mutual Fund, to the above mentioned SEBI Registered Investment Adviser.
First / Sole Applicant /
Guardian
Second Applicant
Third Applicant
“I/We hereby confirm that the EUIN box has been intentionally left blank by me/us as this
transaction is executed without any interaction or advice by the employee/relationship
manager/sales person of the above distributor/sub broker or notwithstanding the advice of in-
appropriateness, if any, provided by the employee/relationship manager/sales person of the
distributor/sub broker.”
Power of Attorney Holder
Aadhaar No.
APPLICANT INFORMATION (MANDATORY)
1
(In case of investment "On behalf of Minor", Please Refer Instruction no. 11.)
FIRST / SOLE APPLICANT
Mr. Ms.
M/s.
PAN (Mandatory)
Date of Birth
D D M M Y Y Y Y
CKYC No.
14 digit CKYC Number
Address
State City Pin Code
Aadhaar No. Mobile No.
Email ID
Mobile No.
Email ID
Optional
Optional
Optional
Optional
(words)
Amount
(figures)
TO BE DETACHED BY KARVY & PRESENTED TO AXIS BANK CMS
authorise you to debit my/our account no.
I/ We
Name of the account holder(s)
DEBIT MANDATE
Application No.
(For Axis Bank A/c only.) To be processed in CMS software under client code “AXISMF”
Signature of First Account Holder
D D M M Y Y
Date
6
Signature of Second Account Holder Signature of Third Account Holder
Savings
NRO
NRE
Current FCNR
Others
Specify
Account type
Axis Bluechip Fund, Axis Long Term Equity Fund, Axis Regular Saver Fund, Axis Triple Advantage Fund, Axis Midcap Fund, Axis Focused 25 Fund, Axis Arbitrage Fund,
Axis Equity Saver Fund, Axis Multicap Fund, Axis Dynamic Equity Fund OR Axis MF Multiple Schemes Axis Equity Hybrid Fund Axis Small Cap Fund Axis Growth Opportunities Fund
to pay for the purchase of