Transaction Charges for Applications routed through Distributors/agents only (Refer Instruction 1 (viii))

Employee Unique ID. No. (EUIN)

Sub Broker Code

Sub Broker Name & ARN/ RIA No.Distributor Name & ARN/ RIA No.

MUTUAL FUNDS

Aditya Birla Sun Life Mutual Fund

Common Application Form

For Resident Indians and NRIs/FIIs/FPIs

(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.)

Application No.

First Applicant / Authorised Signatory

Second Applicant

Third Applicant

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.

` `

Existing Unitholder please fill in your Folio No., Name & Email ID and then proceed to Section 5 (Applicable details and Mode of holding will be as per the existing Folio No.)

Existing Folio No.

FIRST / SOLE APPLICANT INFORMATION (MANDATORY) (Refer Instruction No. 2,3,4) Fresh / New Investors fill in all the blocks. (1 to 8) In case of investment "On behalf of Minor", Please Refer Instruction no. 2(ii)

Name of First/Sole Applicant

(as per PAN/ Aadhaar Card)#

Mr. Ms.

M/s.

PAN / PEKRN (Mandatory)

Date of Birth**

D D

M M Y Y Y Y

AADHAR

Card Number

CKYC

Number

(Prefix

if any)

14 digit CKYC Number

Name of the Second Applicant

(as per PAN/ Aadhaar Card)#

Mr. Ms.

M/s.

PAN / PEKRN (Mandatory)

Date of Birth**

D D

M M Y Y Y Y

AADHAR

Card Number

CKYC

Number

(Prefix

if any)

14 digit CKYC Number

Name of the Third Applicant

(as per PAN/ Aadhaar Card)#

Mr. Ms.

M/s.

PAN / PEKRN (Mandatory)

Date of Birth**

D D

M M Y Y Y Y

AADHAR

Card Number

CKYC

Number

(Prefix

if any)

14 digit CKYC Number

Name of the Guardian (In case First / Sole Applicant is minor) / Contact Person - Designation - Poa Holder (In case of Non-individual Investors)(as per PAN/ Aadhaar Card)#

Mr. Ms.

M/s.

PAN / PEKRN (Mandatory)

Date of Birth**

D D M M Y Y Y Y

AADHAR

Card Number

CKYC

Number

(Prefix

if any)

14 digit CKYC Number

Relationship of Guardian (Refer Instrcution No. 2(ii))

ISD CODE

TEL: OFF.

T D

TEL: RESI

Proof of the Relationship with Minor**

** Mandatory in case the First / Sole Applicant is Minor

Tax Status [Please tick (3)] (Applicable for First / Sole Applicant)

Resident Individual FIIs NRI - NRO HUF Club / Society PIO Body Corporate Minor Government Body

Trust NRI - NRE Bank and FI Sole Proprietor Partnership Firm QFI Provident Fund Others

(Please Specify)

Acknowledgement Slip (To be filled in by the Investor)

Common Application Form

Application No.

Received from Mr. / Ms. __________________________________________________________ Date : _____/_____/___________

Collection Centre /

ABSLAMC Stamp & Signature

PAN/PEKRN Proof

KYC Complied

Yes

[Please Tick (3)] Enclosed

NECS Form

Aditya Birla Sun Life AMC Limited

(Formerly known as Birla Sun Life Asset Management Company Limited)

Regn. No.: 109. Regd Office: One Indiabulls Centre, Tower 1, 17th Floor, Jupiter Mill Compound,

841, Senapati Bapat Marg, Elphinstone Road, Mumbai - 400013

+91 22 4356 7000 | care.mutualfunds@adityabirlacapital.com | www.adityabirlasunlifemf.com | CIN: U65991MH1994PLC080811

1800-270-7000

adityabirlacapital.com

#The application is liable to get rejected if

does not match with PAN card/ Aadhar card

EUIN is mandatory for “Execution Only” transactions. Ref. Instruction No. 9

I/we hereby confirm that the EUIN box has been intentionally left blank my 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.

Distributor Mobile No. Distributor Email Id

Qfund Mutual Fund India

Mutual Fund India

Below 1 Lac 1-5 Lacs 5-10 Lacs 10-25 Lacs > 25 Lacs - 1 Crore > 1 Crore

Below 1 Lac

1-5 Lacs 5-10 Lacs 10-25 Lacs

> 25 Lacs - 1 Crore

> 1 Crore OR Net Worth ______________________________________

No.

Scheme Name

Plan / Option

Net Amount Paid (`)

Payment Details

Cheque/DD No./UTR No.

(in case of NEFT/RTGS)

Bank and Branch

ABSL

GO GREEN [Please tick (3)] (Refer Instruction No. 10)

BANK ACCOUNT DETAILS (Please note that as per SEBI Regulations it is mandatory for investors to provide their bank account details) Refer Instruction No. 3(A)

INVESTMENT DETAILS [Please tick (3)] (Refer Instruction No. 5, 9 & 14) (If this section is left blank, only folio will be created)

Joint Single Anyone or Survivor (Default option is Anyone or survivor)

MODE OF HOLDING [Please tick (3)] (Please Refer Instruction No. 2(v))

MAILING ADDRESS OF FIRST / SOLE APPLICANT (P. O. Box Address is not sufficient. Please provide full address.)

CITY

STATE PINCODE

SMS Transact Online Access

Mobile No.

+91

I/ We would like to register for my/our SMS Transact and/

or Online Access

Email Id

Facebook Id

Twitter Id

Default Communication mode is E-mail only, if you wish to receive following document(s) via physical mode: [Please tick (3)]

Account Statement

Annual Report

Other Statutory Information

Name of the Bank

Branch Address

Pin Code

City

Account No.

Account Type [Please tick (3)]

11 Digit IFSC Code 9 Digit MICR Code

SAVINGS CURRENT NRE NRO FCNR OTHERS

(Please Specify)

Seperate cheque/ demand draft must be issued for each investment drawn in favour of respective scheme name and the instrument should be crossed “A/c Payee Only”.

Please write appropriate scheme name as well as the Plan/Option/Sub Option

No.

Cheque / DD Favouring

Scheme Name* (refer Instruction 5)

Plan/Option

Cheque

Date

Amount

Invested (`)

Charges^

Net Amount

Paid (`)

Cheque/DD No./UTR No.

(in case of NEFT/RTGS)

ABSL

OCCUPATION [Please tick (3)]

FIRST APPLICANT

Private Sector Service Public Sector Service

Government Service

Business

Professional

Agriculturist

Retired

Housewife

Student Forex Dealer

Others .............................................................................................. (please specify)

GROSS ANNUAL INCOME [Please tick (3)]

FIRST APPLICANT

[Not older than 1 year]

D D M M Y Y Y Y

SECOND APPLICANT

THIRD APPLICANT

# (Type of Account : Saving / Current / NRE / NRO / FCNR / NRSR) *All purchases are subject to realization of funds ^Refer to Instruction No. 5 (vi)

Net worth (Mandatory for Non - Individuals) Rs. ______________________________________ as on

KYC DETAILS (Mandatory)

SECOND APPLICANT

Private Sector Service Public Sector Service

Government Service

Business

Professional

Agriculturist

Retired

Housewife

Student Forex Dealer

Others .............................................................................................. (please specify)

THIRD APPLICANT

Private Sector Service Public Sector Service

Government Service

Business

Professional

Agriculturist

Retired

Housewife

Student Forex Dealer

Others .............................................................................................. (please specify)

Below 1 Lac

1-5 Lacs 5-10 Lacs 10-25 Lacs

> 25 Lacs - 1 Crore

> 1 Crore OR Net Worth ______________________________________

OVERSEAS ADDRESS (Mandatory for NRI/FII Applicant.)

CITY

ZIP CODECOUNTRY

Drawn on Bank/Branch: ______________________________________________________________ A/c no._____________________________________ A/c Type: ______________

ABSL

Drawn on Bank/Branch: ______________________________________________________________ A/c no._____________________________________ A/c Type: ______________

ABSL

Drawn on Bank/Branch: ______________________________________________________________ A/c no._____________________________________ A/c Type: ______________

Mutual Fund India

Mutual Fund in India

Mutual Fund India

I am

Politically

Exposed

Person

For Individuals

I am

Related to

Politically

Exposed

Person

Not

Applicable

For Non-Individual Investors (Companies, Trust, Partnership etc.)

Is the company a Listed Company or Subsidiary of Listed Company or Controlled by a Listed Company:

(If No, please attach mandatory UBO Declaration)

Yes No

Foreign Exchange / Money Charger Services

Yes No

Gaming / Gambling / Lottery / Casino Services

Yes No

Money Lending / Pawning

Yes No

DEMAT ACCOUNT DETAILS (OPTIONAL) (Please ensure that the sequence of names as mentioned in the application form matches with that of the A/c. held with the depository participant.) Refer Instruction No. 3(B)

Depository Participant Name: _______________________________

Depository Participant Name: ______________________________________

Beneficiary A/c No.

DPID No.:

Beneficiary A/c No.

I N

NSDL:

CDSL:

Enclosed:

Client Master

Transaction/ Statement Copy/ DIS Copy

NOMINATION DETAILS (Mandatory) (Refer Instruction No. 7)

I/We wish to nominate I/We DO NOT wish to nominate and sign here ................................................................................................. 1st Applicant Signature (Mandatory)

Nominee Name and Address

Guardian Name (in case of Minor)

Allocation %

Nominee/ Guardian Signature

Nominee 1

Nominee 2

Nominee 3

FATCA & CRS INFORMATION [Please tick (3)] For Individuals & HUF (Mandatory) Non Individual investors should mandatorily fill separate FATCA detail form

The below information is required for all applicant(s)/ guardian

Address Type:

Is the applicant(s)/ guardian's Country of Birth / Citizenship / Nationality / Tax Residency other than India?

If Yes, please provide the following information [mandatory]

Please indicate all countries in which you are resident for tax purposes and the associated Tax Reference Numbers below.

Residential or Business Residential

Business Registered Office (for address mentioned in form/existing address appearing in Folio)

Yes No