1
COMMON APPLICATION FORM
FOR INCOME SCHEMES
UTI - Bond Fund
(An open ended pure debt fund)
The product is suitable for investors who are
seeking*:
l Regular returns for long-term
l Investment predominantly in medium to
long term debt as well as money market
instruments
l Low risk (Blue)
UTI - Credit Opportunities Fund
(An open-ended Income scheme)
The product is suitable for investors who are
seeking*:
l Reasonable income and capital appreciation
over long-term
l Investment in debt and money market
instruments across different maturities &
credit rating
l Low risk (Blue)
UTI - Dynamic Bond Fund
(An open ended income scheme)
The product is suitable for investors who are
seeking*:
l Optimal returns with adequate liquidity
over medium-term
l Investment in debt/ money market
instruments
l Low risk (Blue)
UTI - Fixed Maturity Plan
(An close-ended Umbrella Income Scheme
comprising of several Investment Plans)
The product is suitable for investors who are
seeking*:
l Regular income for short term
l Investment in Debt/Money Market
Instrument/ Govt. Securities
l Low risk (Blue)
UTI - Floating Rate Fund STP
(An open-ended Income Scheme)
The product is suitable for investors who are
seeking*:
l Regular income over short-term
l Investment in floating rate debt / money
market instruments, fixed rate debt /
money market instruments swapped for
floating rate return
l Low risk (Blue)
UTI - Gilt Advantage Fund LTP
(An open-ended Gilt Scheme)
The product is suitable for investors who are
seeking*:
l Long-term credit risk free return
l Investment in sovereign securities
issued by the Central Government and/
or a State Government and / or any
security unconditionally guaranteed by
the Central Government and / or a State
Government
l Low risk (Blue)
UTI - G-SEC STP
(An open-ended dedicated gilt fund)
The product is suitable for investors who are
seeking*:
l Short term credit risk free return .
l Investment in Central Government
Securities, Treasury Bills, Call Money
and Repo
l Low risk (Blue)
UTI Mutual Fund
UTI Asset Management Company Limited
UTI Trustee Company Private Limited
UTI Tower, Gn Block, Bandra Kurla Complex, Bandra (East), Mumbai – 400 051.
Tel: (022) 6678 6666, Email: service [at] uti [dot] co [dot] in, Website: www.utimf.com
July 1, 2013
Please read overleaf
UTI - Liquid Cash Plan
(An open-ended income scheme)
The product is suitable for investors who are seeking*:
l Steady and reasonable income over short-term with capital preservation.
l Investment in money market securities & high quality debt
l Low risk (Blue)
UTI - Mahila Unit scheme
(An open-ended debt oriented scheme)
This product is suitable for investors who are seeking*:
l Reasonable income with moderate capital appreciation over a long-term horizon
l Investment in equity instrument (maximum-30%) and debt/ money market instruments
l Medium risk (Yellow)
UTI - MIS-Advantage Plan
(An open-ended income scheme)
The product is suitable for investors who are seeking*:
l Long-term capital appreciation and regular income over medium-term
l Investment in equity instruments (maximum-25%) and fixed income securities (debt and money market securities)
l Medium risk (Yellow)
UTI - Money Market Fund
(An open-ended Money Market Mutual Fund)
The product is suitable for investors who are seeking*:
l Current income consistent with preservation of capital over short-term
l Investment in short-term money market securities
l Low risk (Blue)
UTI - Monthly Income Scheme
(An open-ended debt oriented scheme)
The product is suitable for investors who are seeking*:
l Regular income over medium-term
l Investment in equity instruments (maximum-15%) and fixed income securities (debt and money market securities)
l Medium risk (Yellow)
UTI - Short Term Income Fund
(An open-ended income scheme)
The product is suitable for investors who are seeking*:
l Steady and reasonable income over short-term
l Investment in money market securities/ high quality debt
l Low risk (Blue)
UTI - Treasury Advantage Fund
(An open-ended Income Scheme)
The product is suitable for investors who are seeking*:
l Capital preservation and liquidity for short-term
l Investment in quality debt securities/ money market instruments
l Low risk (Blue)
UTI - Unit Scheme for Charitable & Religious Trusts & Registered Societies (UTI-C.R.T.S)
(An open-ended income scheme)
The product is suitable for investors who are seeking*:
l Regular income over long-term
l Investment in equity instruments (maximum-30%) and debt/ money market instruments
l Medium risk (Yellow)
* Investors should consult their financial advisers if in doubt about whether the product is suitable for them.
Note: Risk is represented as:
(BLUE)
Investors understand that their principal will be at low risk
(YELLOW)
Investors understand that their principal will be at medium risk
(BROWN)
Investors understand that their principal will be at high risk
Sr.No. 2013/
Registrar Sr. No.
OPTION FOR DESPATCH OF STATEMENT OF ACCOUNT
*PAN of 3rd Applicant
Name of 2nd Applicant Mr. Ms. Mrs. M/s.
Date of Birth of 2nd Applicant
d d m m y y y y
*PAN of 2nd Applicant
Name of 3rd Applicant Mr. Ms. Mrs. M/s.
Date of Birth of 3rd Applicant
d d m m y y y y
F I R S T
M I D D L E
L A S T
Enclosed
PAN Card Copy Know Your Customer (KYC)* Acknowledgement Copy Please ()
F I R S T
M I D D L E
L A S T
Enclosed
PAN Card Copy Know Your Customer (KYC)* Acknowledgement Copy Please ()
DETAILS OF OTHER APPLICANTS
Name of First Applicant / Other Mentally Handicapped Persons (for UBF / MIS) and Adult Female Persons (For MUS) (as appearing in ID proof given for KYC)
First Applicant’s Address (Do not repeat the name) Name & Address of resident relative in India (for NRIs) (P.O. Box No. is not sufficient)
Village/Flat/Bldg./Plot*
City/Town*
State
Pin*
Street/Road/Area/Post
F I R S T
M I D D L E
L A S T
Date of Birth
Mandatory for minors
d d m m y y y y
*PAN OF 1st APPLICANT (whose particulars are furnished in the form) AADHAR CARD NO.
Enclosed
PAN Card Copy Know Your Customer (KYC)* Acknowledgement Copy Please ()
APPLICANT’S PERSONAL DETAILS Mr. Ms. Mrs. M/s. * Denotes Mandatory Fields
OVERSEAS ADDRESS (Overseas address is mandatory for NRI / FII applicants in addition to mailing address in India)
City*
State
Country*
Zip/Pin*
$ Proof of date of birth and proof of relationship with minor to be attached or else sign the declaration on the reverse ( Refer instruction f).
F I R S T
M I D D L E
L A S T
TRANSACTION CHARGES TO BE PAID TO THE DISTRIBUTOR (Please tick any one of the below) (Refer Instruction ‘i’) I AM A FIRST TIME INVESTOR IN MUTUAL FUNDS OR I AM AN EXISTING INVESTOR IN MUTUAL FUNDS
` 150 will be deducted as transaction charges per Subscription of ` 10,000 and above ` 100 will be deducted as transaction charges per Subscription of ` 10,000 and above
Existing Unit Holder information Scheme Name: Folio Number:
COMMON APPLICATION FORM FOR INCOME SCHEMES
PLEASE USE SEPARATE FORM FOR EACH SCHEME
PLEASE FILL IN ALL COLUMNS IN CAPITAL LETTERS ONLY
(PLEASE READ INSTRUCTIONS CAREFULLY TO HELP US SERVE YOU BETTER)
Applicant’s address (for NRIs) At my Overseas address as mentioned above / To be despatched to my resident relative’s address in India as given above
$ Cheques and drafts are subject to realisation.
ACKNOWLEDGEMENT
(To be filled in by the Applicant)
Stamp of UTI AMC Office/
Authorised Collection Centre
dated
(scheme name)
Sr. No. 2013
Received from Mr / Ms / M/s
An application under
along with Cheque / DD No.$ /Cash
Drawn on (Bank)
for ` (in figures)
AADHAR CARD NO.
AADHAR CARD NO.
DISTRIBUTOR INFORMATION (only empanelled Distributors/Brokers will be permitted to distribute Units) (refer instruction ‘h’)
BDA / CA Code
Upfront commission shall be paid directly by the investor to the AMFI / NISM certified UTI MF registered Distributors based on the investors’ assessment of various factors including the service rendered by the distributor.
@ I/We confirm that the EUIN box is intentionally left blank by me/us as this is an “execution-only” transaction without any interaction or advice by the distributor personnel concerned or notwithstanding the advice of
in-appropriateness, if any, provided by such distributor personnel and the distributor has not charged any advisory fees for this transaction. (
Please tick and sign below when EUIN box is left blank) (refer instruction ‘v’).
ARN Name of Financial Advisor Sub ARN Code Sub Code/ M O Code EUI No.@ UTI RM No.
Bank Branch Code
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Signature of 1st Applicant / Guardian
Name of 1st Authorised Signatory
Signature of 2nd Applicant
Name of 2nd Authorised Signatory
Signature of 3rd Applicant
Name of 3rd Authorised Signatory
Amt. in words
PAYMENT DETAILS
Account No.
Date
Bank
Branch
Amt. of investment (i)
DD Charges if any (ii)
Net amount paid (i-ii)
# Please mention the application No. on the reverse of the cheque / DD, NEFT / RTGS advice. Cheque / DD must be drawn in favour of “The Name of the Scheme” & crossed “A/c Payee Only”
 Investment amount shall be Rs. 2 lacs and above in case of payments through NEFT / RTGS.
#Cheque/DD/NEFT/RTGS Ref. No.
/ Unique Serial No. (For Cash)
Account type Savings Current NRE
(please
) NRO DD issued from abroad Cash
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BANK PARTICULARS OF 1ST APPLICANT (Mandatory as per SEBI Guidelines)
City Pin*
Bank Name Branch
Address MICR Code
(this is a 9-digit number next to your cheque number)
IFS Code
(this is a 11-digit number)
Account type (please )
Savings
Current
NRO
NRE
Account No.
NAME IN FULL OF THE FATHER (OR) MOTHER/ GUARDIAN (If Minor)$ / Contact Person And Designation - For Institutional Applicants / Alternate Applicant ( incase of UBF / MIS / MUS)
Mr.
Ms.
Mrs.
Notes :
1. If the application is incomplete and any other requirement is not fulfilled, the application is liable to be rejected.
2. Consolidated Account Statement (CAS) will be sent within 10 days of the following month of the transaction.
3. Please ensure that all KYC Compliance Proof and PAN details are given, failing which your application will be rejected. PAN not applicable for Micro SIP.
4. All communication relating to issue of Statement of Account, Change in name, Address or Bank particulars, Nomination, Redemption, Death Claims etc., may please be addressed to the Registrar :
M/s. Karvy Computershare Private Limited, Narayani Mansion, H.No.1-90-2/10/E, Vittalrao Nagar, Madhapur, Hyderabad – 500 081. Tel. 040-23312454, Fax: 040-23115503,
E-mail: uti [at] karvy [dot] com
INVESTMENT DETAILS (For “DIRECT PLAN” Please tick here & tick Scheme, Plan / Option given below) (Refer instruction ‘j’) UTI-BOND FUND
UTI-CREDIT OPPORTUNITIES FUND UTI-CRTS
UTI-DYNAMIC BOND FUND
UTI-G-SEC FUND-(STP)
UTI-MAHILA UNIT SCHEME
UTI-MONTHLY INCOME SCHEME
Growth
Dividend Payout
Dividend Reinvestment (Default – Growth Option) UTI-FIXED MATURITY PLAN -
Regular Plan
(Use separate form for each series)
Yearly Series (YFMP)
Half Yearly Series (HFMP)
Quarterly Series (QFMP)
Growth
Dividend Payout Dividend Reinvestment
Cheque / DD should be drawn in favour of UTI-Fixed Maturity Plan – YFMP (mm/yy) / HFMP (mm/yy) / QFMP (mm/yy-Plan No.) (Default – Growth Option)
UTI-FLOATING RATE FUND (STP) -
Regular Plan
Growth
Daily Div. Reinvestment Weekly Div. Reinvestment Flexi Dividend Payout Flexi Dividend Reinvestment (Default – Growth Option) UTI-GILT ADVANTAGE FUND-LTP Growth Plan
Dividend Plan Payout
Dividend Plan Reinvestment (Default – Growth Plan) UTI-LIQUID CASH PLAN- Institutional Growth
Daily Div. Reinvestment
Weekly Div. Reinvestment Monthly Payout
Monthly Reinvestment (Default – Daily Div. Reinvestment) UTI-MIS-ADVANTAGE PLAN
Growth Plan Monthly Div. Plan Payout Monthly Div. Plan Reinvestment Flexi Dividend Plan Payout
Flexi Dividend Plan Reinvestment
Monthly Payment Plan (Default Plan - Growth Plan) UTI-MONEY MARKET FUND -
Institutional Plan
Growth Daily Div. Reinvestment Weekly Div. Payout Weekly Div. Reinvestment
(Default – Growth Option) UTI-SHORT TERM INCOME FUND
- Institutional Option Growth Sub Option
Div Payout Sub Option
Div. Reinvestment Sub Option (Default – Div. Reinvestment Sub Option) UTI-TREASURY ADVANTAGE FUND - Institutional Plan Growth Daily Div. Reinvestment Weekly Div. Payout Weekly Div. Reinvestment Monthly Div. Payout Monthly Div. Reinvestment Quarterly Div. Payout Quarterly Div. Reinvestment Annual Div. Payout Annual Div. Reinvestment Bonus Option (Default – Daily Div. Option)
Unitholding Option Demat Mode Physical Mode (Available under all scheme except UTI-CRTS, UTI-MUS & UTI-FMP)
DEMAT ACCOUNT DETAILS - (Please ensure that the sequence of names as mentioned in the application form matches with that of the account held with any one of the Depository Participant. Demat Account details are compulsory if demat mode is opted above
National Securities
Depository Limited
Depository Name ______________________________________
Central Depository
Securities Limited
Depository Name _______________________________________________________
DP ID No.
Beneficiary
Account No.
Target ID No.
Enclosures : Client Master List (CMl) Transaction cum Holding Statement Delivery Instruction Slip (DIS)
Sign.
here
Ê
Sign.
here
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Signature of 1st Applicant / Guardian
Name of 1st Authorised Signatory
______________________________________
Designation ___________________________
Signature of 2nd Applicant
Name of 2nd Authorised Signatory
______________________________________
Designation ___________________________
Signature of 3rd Applicant
Name of 3rd Authorised Signatory
______________________________________
Designation ___________________________
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GENERAL INFORMATION - Please () wherever applicable Resident Individual Minor through guardian HUF Partnership Trust Company Sole Proprietorship Society Body Corporate Others AOP BOI FII NRI
STATUS Business Student Agriculture Self-employed Others Professional Housewife Retired Service
OCCUPATION Single First holder or Survivor (for UTI MUS) Anyone or survivor Joint
MODE OF HOLDING Unmarried
MARITAL STATUS Married Wedding
Anniversary
D
D
M
M
NOMINATION DETAILS (Please ) (please sign if you do not wish to nominate) I/We hereby nominate the undermentioned Nominee to receive the amounts to my / our credit in the event of my / our death. I/We also understand that all payments and settlements made to such Nominee and signature of the Nominee acknowledging receipt thereof, shall be a valid discharge by the AMC / Mutual Fund / Trustee.
Name and Address of Nominee
To be furnished in case nominee is a minor
Name
Date of Birth d d m m y y y y
(in case of nominee is a minor)
Name of the guardian
Address of guardian
Address with pin code
Signature of Nominee / guardian (for minor)
Investors who wish to nominate two or three persons may fill in the separate form prescribed for the same and attach it with this application form.
I/We do not wish to nominate
Signature of 1st Applicant / Guardian
Signature of 2nd Applicant
Signature of 3rd Applicant
DECLARATION AND SIGNATURE OF APPLICANT/s
l I / We have read and understood the contents of the Scheme Information Document, Statement of Additional Information and Key Information Memorandum, addenda issued till date and apply to the Trustee of UTI Mutual Fund as indicated above. I / We agree to abide by the terms and conditions, rules and regulations of the scheme as on the date of investment. I / We undertake to confirm that this investment has been duly authorised by appropriate authorities in terms of all relevant documents and procedural requirements. l I / We have not received nor been induced by any rebate or gifts, directly or indirectly in making investments. l I/We hereby authorize UTI MF/UTI AMC to share my data furnished in the Form to my distributor and other service providers of the UTI MF for the purpose of servicing, issue of account statement/consolidated statement of account etc and cross selling of products/schemes of the UTI MF. l The ARN holder has disclosed to me/us all the commissions (in the form of trail commission or any other mode), payable to him for the different competing Schemes of various Mutual Funds from amongst which the Scheme is being recommended to me/us. l I / We confirm that we are Non-Residents of Indian Nationality / Origin and that the funds are remitted from abroad through approved banking channels or from my / our NRE / NRO Account. I / We undertake to provide further details of source of funds and any such other relevant documents, if called for by UTI Mutual Fund. (Applicable for NRIs) l I hereby solemnly declare that I am the father/mother/guardian of the minor child in whose name the application is made. The date of birth stated by me is true and correct. I do not have any documents in support of the date of birth and relationship with minor child. (Strike out if this declaration is not applicable)
* Please send the Account Statement, Abridged Annual Report, Transaction confirmation, communication of change of address, change of bank details etc. through email only at the below email ID. (If you wish to receive in physical form please tick )
First Applicant Details
Mobile Number
Tel.
No.
(R)
STD CODE
(O)
STD CODE
*E mail _____________________________________________
Alternate E-mail ________________________________________
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Annual Income of First Individual Applicant (Please () < 5 Lacs > 5 Lacs - < 15 Lacs > 15 Lacs - < 25 Lacs > 25 Lacs
FRIEND IN NEED DETAILS (refer instruction - k) In case UTI MF is unable to communicate with me/us at my / our registered address, I / we authorize UTI MF to correspond with the following person to ascertain my/our updated contact details.
Email
Name
Address:
Relationship with the applicant (optional)
Mobile
F I R S T
M I D D L E
L A S T