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BROKER/AGENT CODE SUB-BROKER CODE BANK/BRANCH BANK SERIAL NO. REGISTRAR SERIAL NO. DATE OF RECEIPT
ARN -
1. Sole / First Applicant’s Personal Details
Sole / First Applicant Salutation Mr. Ms. M/s Dr. Minor Gender Male Female
F I R S T M I D D L E L A S T N A M E
Date of Enclosed please (9) PAN Card Copy Form 60 / 61
D D / M M / Y Y Y Y PAN M A N D A T O R Y
Birth (Mandatory for Investments of Rs. 50,000/- and above)
Guardian (if Sole/1st Applicant is Minor) OR Contact Person (For Non Individual Investors)
F I R S T M I D D L E L A S T N A M E
Complete Address for Correspondence (only P.O. Box Address is not sufficient) Home Office
Overseas Address (Mandatory in case of NRI / FII Applicants in addition to mailing address) Home Office
Branch Address
3rd Applicant F I R S T M I D D L E L A S T N A M E
Enclosed please (9) PAN Card Copy Form 60 / 61
Date of Birth D D / M M / Y Y Y Y PAN M A N D A T O R Y
(Mandatory for Investments of Rs. 50,000/- and above)
MODE OF HOLDING (Please 9) Anyone or Survivor Joint (Default, in case of more than one applicant)
4. Investment Details
Regular Plan* (Minimum Rs. 5,000/-) Institutional Plan (Minimum Rs. 5 Crores.) (only for Banks, FIIs, FIs, Insurance Companies, Pension Funds,
Army, Air Force, Navy and other para-military)
Growth* Dividend Payout Dividend Reinvestment
Growth* Dividend Payout Dividend Reinvestment
Your Status Bank FII FI Insurance Company Pension Fund Army, Air Force, Navy and
other para-military
* Default option: This will be applied in case of discrepancy, ambiguity or no information.
Type of Investment Lumpsum Investment Systematic Investment
Please fill up Section on Lumpsum Available only in Regular Plan. Please fill up the enclosed Please use separate Application
OR Forms for Lumpsum
Investment below SIP Auto Debit (ECS) Form - B and submit it together
with Application Form - A. & Systematic Investment
Drawn on Bank
Branch City
For NRI / FII Investors, please indicate account type of your remittance (please 9) NRE NRO FCNR Others Please specify
Enclosed (please 9 ) Account Debit Foreign Inward Remittance Certificate Others
5. Nomination Details
I/We do hereby nominate the person described hereunder in respect of Units held by me/us. Nominee Date of Birth (In case of Minor) D D / M M / Y Y Y Y
Nominee Name F I R S T M I D D L E L A S T N A M E
Guardian Name Relationship
(in case of Minor)
Address
City State Pin Code
6. Documents to be submitted
For documents to be submitted, please refer to the Checklist provided below.
Guardian
the terms and conditions applicable thereto. I /We hereby declare that I /We am / are authorised to make this investment and
that the amount invested in the Scheme is through legitimate sources only and does not involve and is not designed for the
purpose of any contravention or evasion of any Act, Rules, Regulations, Notifications or Directions issued by any regulatory
authority in India. I / We hereby authorise AIG Global Investment Group Mutual Fund , its Investment Manager and its agents to Second
disclose details of my investment to my bank(s) / AIG Global Investment Group Mutual Fund‘s bank(s) and / or Distributor / Broker Applicant
/ Investment Adviser. I / We have neither received nor been induced by any rebate or gifts, directly or indirectly, in making this
investment. I /We declare that the information given in this application form is correct, complete and truly stated.
APPLICABLE FOR NRIs : I / We confirm that I am/ we are Non-Resident(s) of Indian Nationality / Origin and that I /We have
remitted funds from abroad through approved banking channels or from funds in my / our NRE / FCNR Account. I/We undertake Third
that all additional purchases made under this folio will also be from funds received from abroad through approved banking Applicant
channels or from funds in my / ourNRE/FCNRAccount.
If the investment is being made by a Constituted Attorney please furnish Name and KYC Acknowledgment Letter of Power of Attorney Holder (POA) in respect of each applicant below:
Name POA Holder for Applicant 1 POA Holder for Applicant 2 POA Holder for Applicant 3