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KYC Application Form - Individual

(Please read instructions overleaf) UMIN : ____________________________
(For Office Use)

I hereby furnish the following information pertaining to me sought under Prevention of Money Laundering Act, 2002, the rules notified thereunder and SEBI’s guidelines on Anti Money Laundering.
For existing Mutual Fund investors, the information furnished herein will supersede the information available in the records of the Mutual Fund/Authorised Agent.
Please fill in BLOCK Letters (Every Information as applicable from Point No.1 to 10 is mandatory)
Applicant’s Information
1. Name of Applicant - Mr/Ms
First Name
Middle Name Affix a Recent Colour
Last Name Photograph
Here
2. Date of Birth d d - m m - y y y y

3. Status Please tick (ü ) Resident Individual Non-Resident Indian Person of Indian Origin (PIO)– Attach copy of PIO Card
Sign across the Photograph
4. Nationality : ____________________________________________________________________________________________________
Proof of identity to be provided by Applicant. Please submit copy of ANY ONE of the following valid documents: Please tick (ü )
PAN Passport No. Driving License No.
Voter's Id Card No. UIN Card No. Photo Ration Card
Photo Debit Card No. (Issued by Bank)
Any Other Proof of Identification with Photograph as listed under Instruction (7). Please specify
5. Address for Correspondence

District State Country Pin Code

6. Permanent Address of Resident Applicant /Overseas Address of Non-Resident Applicant

District State Country Pin Code

7. Contact Details
ISD Code STD Code Tel. Off. Extn.
Mobile Tel. Resi.
E-Mail Id.

8. Proof of address to be provided by Applicant.Please submit copy of ANY ONE of the following latest documents duly self - certified : Please tick (ü )
Telephone Bill of land line /Mobile Driving License Demat Account statement Registered Lease / Sale
Electricity Bill Bank Passbook Voter Identity Card,(With Address) Agreement of residence
Passport Bank Account Statement Ration Card Any other Address Proof as listed
under Instruction (7)
9. Annual Income Please tick (ü )
Upto Rs.5,00,000 Rs.5,00,001 to Rs.25,00,000 Rs.25,00,001 to Rs.1,00,00,000 Rs.1,00,00,001 to Rs.5,00,00,000 Rs.5,00,00,001 and above.

10. Occupation Please tick (ü ) one or more occupations that are applicable.
Private Sector Service Professional Forex Dealer Distributor/Finanicial Advisor
Public Sector / Government Service Housewife Member of Civil Service Others, please specify
Politically Exposed Person Student (IAS/ IPS/IFS/IRS...) ____________________________
Retired Agriculturist Judicial Authority ____________________________
Business Current / Former Head of State (Courts of Law), ____________________________

DECLARATION
I hereby confirm that I have read and understood the terms, conditions and instructions provided herein and apply to UTI Mutual Fund to open an account as indicated above for the purpose of transacting
in units issued by Mutual Fund registered under the SEBI (Mutual Funds) Regulations,1996. I agree to abide by the terms, conditions, rules and regulations and other statutory requirements applicable
to Mutual Find and other regulatory authorities. I hereby declare that I am not making this application for the purpose of contravention of any Act, Rules, Regulations or any statute or legislation or any
other applicable laws or any Notifications, Directions issued by any governmental or statutory authority from time to time. I hereby declare that the particulars given herein are true, correct and complete
to the best of my knowledge and belief. I hereby confirm that the documents submitted alongwith this application are genuine and have been procured through proper channel. I hereby undertake to
promptly inform UTI Mutual Fund of any changes to the information provided above and agree and accept that Mutual Fund its authorised agents and representatives are not liable or responsible for
any losses, costs, damages to me arising out of any actions undertaken or activities performed by them on the basis of the information provided by me as also due to me not intimating such changes or
out of any delay in intimating such changes on my part. I hereby authorise Mutual Fund to disclose, share, remit in any form, mode or manner, all / any of the information provided by me to Mutual Fund
or to their authorised agents and representatives including all changes, updates to such information as and when provided by me. I hereby agree to provide any additional information/documentation
that may be required by Mutual Fund, its authorised agents and representatives, in connection with this application.

I hereby declare that the above information is true and correct. Signature
Ý

Place : of
Date : Applicant

For Office Use Only

Proof of Identity received Proof of Address received Common Proof of Identity & Address received PoS Name
& Location :
Date :
Signature____________________________

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INSTRUCTIONS
1. This Know Your Client (KYC) Form of UTI Mutual Fund is for use by
Individuals only. A minor cannot apply for UTI Mutual Fund Investor
Identification Number (UMIN). In case of investments through minor the
UMIN of the Guardian must be provided. Upon the Minor becoming a Major,
he/she should immediately apply for a UMIN in his/her own capacity as an
adult individual and intimate the Mutual Fund, in order to be able to transact
further himself/herself.
2. The Application Form should be completed in English and in BLOCK
LETTERS. Please tick in the appropriate box wherever applicable.
Overwriting in the form is not allowed. Corrections if any should be counter-
signed by the applicant.
3. Applications incomplete in any respect are liable to be rejected.
4. Applications which are not accompanied by legible documents shall be
rejected.
5. Submission of this Application Form is only for allotment of UMIN. UMIN
must be used by the Applicant while investing in any UTI Mutual Fund
Scheme.
6. Applications complete in all respects should be submitted at the designated
Points of Service (PoS) of UTI Mutual Fund. Submission of UMIN Application
Form is in addition to the Application Form for subscription to any of the
schemes of UTI Mutual Fund.
7. In addition to the documents listed for proof of identity, investors can also
submit Photo identification issued by Bank Managers of Scheduled
Commercial Banks, Gazetted Officers or Elected representatives to the
Legislative Assembly or Parliament. Proof of identity and address can also
be established by any document containing the photograph, address and
signature, duly attested by a manager of a scheduled commercial bank (the
designation seal should be affixed), notary public or gazetted officer.
8. Documents submitted to support Identity and Address should be (a) Original
Documents + Self-attested photocopies duly verified by an Officer of UTI
AMC Pvt. Ltd. or an ARN holder appointed by UTI AMC as agent (Originals
will be returned over-the-counter after verification) or (b) True Copies attested
in original by a Notary Public / Gazetted Officer / Manager of a Scheduled
Commercial Bank (Name, Designation and Seal should be affixed). Mere
photocopies of an original document or of notarised copies are not adequate.
9. Information relating to address(es) provided under the KYC form
overleaf will supersede existing information and will be overwritten in
the records of the Mutual Fund / Registrars and Transfer Agent to the
Mutual Fund. UTI Mutual Fund will not be liable for any errors or
omissions on the part of Unit holders in the KYC form.
10. Name of Applicant / Unit holder as appearing in the KYC form should match
with that on the supporting documents provided to establish proper proof of
Identity. Address as provided in this KYC form must match in any of the
documents supporting your Proof of Address.
11. PoA holder should fill in a KYC form and obtain a UMIN. Such UMIN shall
need to be quoted to the Mutual Fund in addition to the UMIN of the investor.
Other requirements of PoA of UTI MF will additionally be applicable.
CHECKLIST FOR ALL INDIVIDUAL APPLICANTS
Please ensure the following while submitting your KYC Application Form
KYC Form is complete in all respects
KYC Form is signed by the applicant
Signature on the KYC Form must match with that on the identity proof submitted
Photograph is pasted on the form and the investor has signed across the photograph
Address mentioned in the form is matching with the address proof submitted
Required documents as under are attached to KYC Form
Proof of Identity (any one of the following)
Valid Passsport Photo PAN Card
Voter's Identity Card Valid Driving Licence
UN (MAPIN) Card
DN Card
Valid Photo Debit Card issued by a bank in India
Valid Ration Card with your photograph
Photo Identification issued by Bank Managers of Scheduled
Commercial Banks / Gazetted Officer / Elected Representatives to
the Legislative Assembly / Parliament
Non-Resident Indians must mention their Mailing and Overseas Address supported by valid documents
For Resident Indians proof of address for correspondence is a must
For queries / clarification please call the nearest PoS
e-mail us at : www.utimf.com
12. Financial / Non Financial Transaction requests must not be submitted along
with KYC forms. They must be submitted at any of the designated Official
Points of Acceptance. Applicants / Unitholders must quote their UMIN along
with every financial / non financial transaction.
13. After allotment of UMIN, any change(s) in address (both permanent and
present or any one such address) or change in name / status must be
intimated to the designated PoS immediatley along with required supporting
documents, using the prescibed form for such changes, quoting the UMIN.
For change of signature (e.g., upon marriage), please submit prescribed
application at PoS furnishing UMIN, old as well as revised signature, duly
attested by your banker.
If the present address and permanent address is the same, please mention one
address, duly supported with documentary proof. In such a case please mention
"same as above" in the box for Permanant Address. If they are different, please
mention both addresses, duly supported with documentary proof.
14. UTI Mutual Fund reserves the right to seek additional information /
documentation in terms of the Prevention of Money Laundering Act, 2002
at any point of time.
15. In respect of existing unitholders, signature on the UMIN Application Form
should match with that on the records of the Mutual Fund.
In respect of new investors, signature on the Application Form for investing
/ transacting in Mutual Fund should match with that on this UMIN Application
Form.
16. In the event of any operation of law, e.g., transmission of units upon death
of a unitholder, the claimant / person/s entering the Register of Unitholders
of the Mutual Fund will be required to obtain UMIN.
17. Any single investment made for amounts equal to and greater than
Rs. 50,000 will require a UMIN. Such Unitholders must quote their UMIN
on the Application Form(s) / Transaction Slip(s) for investing with UTI
Mutual Fund. Such investments not accompanied by the UMIN are liable
to be rejected.
18. UTI Mutual Fund will, on a best effort basis ensure, the documents received
in support of UMIN requirements are verified. In the event of any KYC form
being rejected for lack of information / defeciency / insufficiency of mandatory
documentation, investment amounts as specified under (17) above will be
refunded at applicable NAV, subject to payment of exit load were ever
applicable. Such refunds will be dispatched within a maximum period of 21
days from Date of Allotment of Units.
19. UTI Mutual Fund, UTI Asset Management Company Private Limited, UTI
Trustee Company Private Limited and their Directors, employees and agents
shall not be liable in any manner for any claims arising whatsoever on account
of freezing the folios / rejection of any application/ non-allotment of units or
mandatory redemption of units due to non-compliance with the provisions
of the PML Act 2002, SEBI guidelines or where the AMC / Mutual Fund
believes that transaction(s) by and applicant/unit holder is/are suspicious in
nature within the purview of the PML Act,, 2002 and SEBI guidelines and
required reporting the same to Financial Intelligence Unit - India (FIU-IND).
Proof of Address (any one of the following)
Telephone Bill* Electricity Bill *
Valid Passport Bank Passbook / bank account statement*
Demat Account Statement* Voters Identity Card (wtih address)
Valid Driving Licence
Valid Ration Card
Valid Registered Rent Agreement / Sale Agreement
Any other document containing the photograph, addresss and signature duly
attested by a person (mentioned in the last item under proof of Identity section)
* Not over 3 months old
or
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