Sip Registration Form
Sip Registration Form
for first time investors, submit Common Application form along with this form.
Distributor SUB-Distributor Internal Employee RIA PMR (Portfolio Manager's Serial No., Date
SUB-Broker/Sol ID EUIN Number ^^ & Time Stamp
ARN ARN Code CODE^ Registration)
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 of all schemes of
Axis Mutual Fund, to the above mentioned SEBI Registered Investment Adviser. ^^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 of all schemes of Axis Mutual Fund, to the above mentioned SEBI Registered Portfolio Manager.
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.
You/ Sole Applicant /Guardian Second Applicant Third Applicant Power of Attorney Holder
TRANSACTION CHARGES FOR APPLICATIONS THROUGH DISTRIBUTORS ONLY (Refer Instruction No. 20)
I confirm that I am a first time investor across Mutual Funds. OR I confirm that I am an existing investor across Mutual Funds.
In case the subscription amount is ` 10,000 or more and your Distributor has opted to receive Transaction Charges, the same are deductible as applicable from the purchase/subscription amount and payable to the
Distributor. Units will be issued against the balance amount invested.
Your Name (as in PAN Card / KYC records) Mr. Ms. M/s.
Name of the Guardian Mr. Ms. M/s. (In case First / Sole Applicant is minor) / Contact Person - Designation / PoA HOLDER (In case of Non-individual Investors)
DO NOT FILL THE MANDATE BELOW, IF OTM DETAILS ARE PROVIDED IN SECTION 2 ON THE NEXT PAGE.
To register Axis One Time Mandate, please fill and submit the One Time Mandate form separately.
Tick ( ) Sponsor Bank Code Bank use Utility Code Bank use
CREATE I/We hereby authorize Axis Mutual Fund to debit (tick ) SB CA CC SB-NRE SB-NRO Other
MODIFY
Bank a/c number
CANCEL
with Bank Name of customers bank IFSC or MICR
an amount of Rupees In Words ` In Figures
FREQUENCY Mthly Qtly H-Yrly Yrly As & when presented DEBIT TYPE Fixed Amount Maximum Amount
Reference 1 PAN No. Phone No.
Reference 2 All Schemes of Axis Mutual Fund Email ID
I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my accounts as per latest schedule of charges of the bank.
PERIOD
From D D M M Y Y Y Y
To D D M M Y Y Y Y Signature Primary Account holder Signature of Account holder Signature of Account holder
Maximum period of validity of this mandate is 1. 2. 3.
40 years only Name as in bank records Name as in bank records Name as in bank records
This is to confirm that the declaration (as mentioned overleaf) has been carefully read, understood & made by me / us. I am authorizing the User Entity / Corporate to debit my account, based on the instructions as agreed and signed by me.
I have understood that I am authorized to cancel / amend this mandate by appropriately communicating the cancellation / amendment request to the User entity / Corporate or the bank where I have authorized the debit.
MANDATORY FIELDS : • Instrument Date • Account type • Bank A/c number (core banking a/c no only) • Bank name • IFSC code or MICR code (as per the cheque / pass book)
• Amount (in words & in figures) • Period start date and end date • Account holder signature • Account holder name as per bank records
Investor Name
3. Declaration and Signature (to be signed by all unit holders if mode of holding is ‘joint’)
I / We declare that the particulars furnished here are correct. I / We authorize Axis Mutual Fund acting through its service providers to debit my / our bank account towards
payment of SIP installments and/ or any lumpsum payments through an Electronic Debit arrangement / NACH (National Automated Clearing House) as per my request from
time to time. If the transaction is delayed or not effected at all for reasons of incomplete or incorrect information, I/We would not hold the user institution responsible. I/We
will also inform Axis Mutual Fund about any changes in my bank account. I/We hereby authorize to honour such payments and have signed and endorsed the Mandate Form.
Further, I authorize my representative (the bearer of this request) to get the above Mandate verified. Mandate verification charges, if any, may be charged to my/our account.
You/ Sole Applicant /Guardian Second Applicant Third Applicant
01 INVESTOR DETAILS (If One Time Mandate registration is not required, skip this section and only fill the NACH Mandate below.)
Name of Applicant
PAN
I / We declare that the particulars furnished here are correct. I / We authorize Axis Mutual Fund acting through its service providers to debit my / our bank account towards
payment of SIP installments and/ or any lumpsum payments through an Electronic Debit arrangement / NACH (National Automated Clearing House) as per my request from time
to time.
If the transaction is delayed or not effected at all for reasons of incomplete or incorrect information, I/We would not hold the user institution responsible.
I/We will also inform Axis Mutual Fund about any changes in my bank account.
I/We hereby authorize to honour such payments and have signed and endorsed the Mandate Form.
Further, I authorize my representative (the bearer of this request) to get the above Mandate verified. Mandate verification charges, if any, may be charged to my/our account.
I/ We hereby agree to read the respective SID and SAI of the mutual fund before investing in any scheme of Axis Mutual Fund using this facility.
I/ We request you to make provisions for me/ us and/ or an advisor authorized by me to be able to utilize this mandate for any transaction (not limited to SIP and/ or Lumpsum
payments) in all the folios associated with my PAN mentioned above any mode of transaction available to me time to time from Axis Mutual Fund.
I/ We give my consent to Axis Asset Management Company Limited and its agents to contact me over phone, SMS, email or any other mode to address my investment related
queries and/or receive communication pertaining to transactions/ non-commercial transactions/ promotional/ potential investments and other communication/ material
irrespective of my blocking preferences with the Customer Preference Registration Facility.
Date D D M M Y Y Y Y Place
Tick ( ) Sponsor Bank Code Bank use Utility Code Bank use
CREATE I/We hereby authorize Axis Mutual Fund to debit (tick ) SB CA CC SB-NRE SB-NRO Other
MODIFY
Bank a/c number
CANCEL
with Bank Name of customers bank IFSC or MICR
an amount of Rupees In Words ` In Figures
FREQUENCY Mthly Qtly H-Yrly Yrly As & when presented DEBIT TYPE Fixed Amount Maximum Amount
Reference 1 PAN No. Phone No.
Reference 2 All Schemes of Axis Mutual Fund Email ID
I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my accounts as per latest schedule of charges of the bank.
PERIOD
From D D M M Y Y Y Y
To D D M M Y Y Y Y Signature Primary Account holder Signature of Account holder Signature of Account holder
Maximum period of validity of this mandate 1. 2. 3.
is 40 years only Name as in bank records Name as in bank records Name as in bank records
This is to confirm that the declaration (as mentioned overleaf) has been carefully read, understood & made by me / us. I am authorizing the User Entity / Corporate to debit my account, based on the instructions as agreed and signed by me.
I have understood that I am authorized to cancel / amend this mandate by appropriately communicating the cancellation / amendment request to the User entity / Corporate or the bank where I have authorized the debit.
MANDATORY FIELDS : • Instrument Date • Account type • Bank A/c number (core banking a/c no only) • Bank name • IFSC code or MICR code (as per the cheque / pass book)
• Amount (in words & in figures) • Period start date and end date • Account holder signature • Account holder name as per bank records
ACKNOWLEDGMENT SLIP (To be filled by the investor)
PAN No.