Application Form (Except for ETFs, HDFC Retirement Savings Fund and HDFC Children’s Gift Fund)

Investors must read the Key Information Memorandum, the instructions and Product Labeling on page 11 & 12 before completing this Form.
The Application Form should be completed in English and in BLOCK LETTERS only.

KEY PARTNER / AGENT INFORMATION (Investors applying under Direct Plan must mention “Direct” in ARN column.) (Refer Instruction 1) FOR OFFICE USE ONLY CAMS bar code
ARN/RIA Code/Stock Broker/ ARN/RIA/Portfolio Internal Code Employee Unique (TIME STAMP)
Portfolio Manager Registration Manager's/ Stock Broker's Sub Agent’s ARN Bank Branch Code for Sub-Agent/ Identification Number
Number (PMRN) Name Employee (EUIN)

ARN-
EUIN Declaration (only where EUIN box is left blank) (Refer Instruction 1)
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.
SIGN

First/ Sole Applicant/ Guardian Second Applicant Third Applicant

TRANSACTION CHARGES FOR APPLICATIONS THROUGH DISTRIBUTORS ONLY (Refer Instruction 2)

In case the purchase/ subscription amount is Rs. 10,000 or more and your Distributor has opted in 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.

1. EXISTING UNIT HOLDER INFORMATION (IF YOU HAVE EXISTING FOLIO, PLEASE FILL IN SECTIONS viz. 1, 5, 6, 10 AND 13 ONLY. Refer instruction 3).
Folio No. The details in our records under the folio number mentioned alongside will apply for this application.

2. MODE OF HOLDING [Please tick (P)] Single Joint Anyone or Survivor

3. UNIT HOLDER INFORMATION (Refer instruction 4) DATE OF BIRTH@ D D M M Y Y Y Y Proof of date of birth@ Please (P)

NAME OF FIRST / SOLE APPLICANT (In case of Minor, there shall be no joint holders) Attached
Mr. Ms. M/s.
Nationality PAN#/ PEKRN#
KYC Number KYC # [Please tick (P)] (Mandatory) Proof Attached

Status of First/ Sole Applicant [Please tick (P)] Individual Non - Individual [Please attach FATCA, CRS & Ultimate Beneficial Ownership (UBO) Self Certification Form (Mandatory)
(Refer Instruction 4 & 19)
Resident Individual Partnership Trust HUF AOP PIO Company Minor through guardian BOI OCI Body Corporate LLP Society / Club
NRI-Repatriation NRI-Non Repatriation Foreign National Resident in India FPI Sole Proprietorship Non Profit Organisation (please specify)
Others _________________________
LEI No. Expiry Date: D D M M Y Y Y Y
(Mandatory for Non - Individuals transacting / proposing to transact for an amount of Rs. 50 crores or more)
NAME OF GUARDIAN (in case of First / Sole Applicant is a Minor) / NAME OF CONTACT PERSON – DESIGNATION (in case of non-individual Investors)
Mr. Ms.
Nationality Designation Contact No.
PAN#/ PEKRN#
KYC Number KYC # [Please tick (P)] (Mandatory) Proof Attached

Relationship with Minor@ Please (P) Father Mother Court appointed Legal Guardian Proof of relationship with minor@ Please (P) Attached @ Mandatory

MAILING ADDRESS OF FIRST / SOLE APPLICANT (Mandatory) (Refer Instruction 4a)

CITY STATE PIN CODE

CONTACT DETAILS OF FIRST / SOLE APPLICANT

Country Code STD Code
Telephone : Off. Res. Fax
eAlerts Mobile eDocs Email of First / Sole holder^ IN CAPITALS
This email id belongs to (Mandatory Please P): Self Spouse Dependent Children Dependent Siblings Dependent Parents Guardian POA Custodian (for FPIs only) PMS
This mobile number belongs to (Mandatory Please P): Self Spouse Dependent Children Dependent Siblings Dependent Parents Guardian POA Custodian (for FPIs only) PMS
I hereby declare that I shall immediately notify any change to the mobile number/ email id. (Refer instruction 10)
I/ We would like to register for online access to transact on HDFCMFOnline Investors as per the terms & conditions displayed on website: www.hdfcfund.com (Email id mandatory)
(only for non individuals and individuals with mode of holding as 'Joint'). Refer Instruction 12.
^ On providing email-id investors shall receive the scheme wise annual report or an abridged summary thereof/ account statements/ statutory and other documents by email.
However, if the investors wish to receive physical copy of the scheme wise annual report or an abridged summary thereof [Please tick (P)] Opt-in (Refer Instruction 10 & 12)
4. JOINT APPLICANT DETAILS, If any (Refer instruction 4) (In case of Minor, there shall be no joint holders)
1. NAME OF SECOND APPLICANT
Mr. Ms. M/s.
Nationality PAN#/ PEKRN#
April 2022

KYC Number KYC # [Please tick (P)] (Mandatory) Proof Attached

2. NAME OF THIRD APPLICANT
Mr. Ms. M/s.
Nationality PAN#/ PEKRN#
KYC Number KYC # [Please tick (P)] (Mandatory) Proof Attached

ACKNOWLEDGEMENT SLIP (To be flled in by the Investor) [For any queries please contact our nearest Investor Service Centre or call us at our Customer Service Number 1800 3010 6767 / 1800 419 7676 (Toll Free)]
HDFC MUTUAL FUND Date :
Head Office : HDFC House, 2nd Floor, H.T. Parekh Marg,
165-166, Backbay Reclamation, Churchgate, Mumbai - 400 020. ISC Stamp & Signature

Received from Mr. / Ms. / M/s. ________________________________________________________________________________________________

an application for Purchase of Units of the Scheme(s) alongwith Cheque / DD / Payment Instrument as detailed overleaf.
... continued overleaf
 5. ADDITIONAL KYC DETAILS (Refer instruction 4b)
Occupation details for 1st Applicant 2nd Applicant 3rd Applicant Guardian Politically Exposed Person (PEP) details: Is a PEP Related to PEP Not Applicable
Private Sector Service 1st Applicant
Public Sector Service 2nd Applicant
Government Service 3rd Applicant
Business
Guardian
Professional
Authorised Signatories
Agriculturist
Retired Promoters
Housewife Partners
Student Karta
Proprietorship Whole-time Directors
Others (Please specify) Trustee
Mandatory

Non-Individual Investors involved/ providing any of the mentioned services Foreign Exchange / Money Changer Services Gaming / Gambling / Lottery / Casino Services
Money Lending / Pawning None of the above
Gross Annual Income Range (in Rs.) 1st Applicant 2nd Applicant 3rd Applicant Guardian Gross Annual Income Range (in Rs.) 1st Applicant 2nd Applicant 3rd Applicant Guardian
Below 1 lac 10-25 lac
1-5 lac 25 lac- 1 cr
5-10 lac > 1 cr

OR Networth in Rs. (Mandatory as on

for Non Individual) (not older
than 1 year) DD MM YYYY

# Please attach Proof. Refer instruction No 16 for PAN/PEKRN and No 18a for KYC (KRA). Refer instruction No 18b for KYC Identification Number issued by CKYCR.
6. FATCA AND CRS INFORMATION (for Individual including Sole Proprietor) (Self Certification) (Refer instruction 4)
The below information is required for all applicant(s)/ guardian
Address Type: Residential or Business Residential Business Registered Office (for address mentioned in form/existing address appearing in Folio)
First Applicant (including Minor) Second Applicant/ Guardian Third Applicant
Is the applicant(s)/guardian's Country of Birth/Citizenship/
Yes No Yes No Yes No
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.
Category First Applicant (including Minor) Second Applicant/ Guardian Third Applicant
Place/ City of Birth

Country of Birth

Country of Tax Residency#

Mandatory

Tax Payer Ref. ID No^

Identification Type
[TIN or other, please specify]

Country of Tax Residency 2

Tax Payer Ref. ID No. 2

Identification Type
[TIN or other, please specify]

Country of Tax Residency 3

Tax Payer Ref. ID No. 3

Identification Type
[TIN or other, please specify]
#To also include USA, where the individual is a citizen/ green card holder of USA. ^In case Tax Identification Number is not available, kindly provide its functional equivalent.
7. POWER OF ATTORNEY (PoA) HOLDER DETAILS
Name of PoA Mr. Ms. M/s.
PAN#/ PEKRN#
KYC Number KYC # [Please tick (P)] (Mandatory) Proof Attached
# Please attach Proof. Refer instruction No 16 for PAN/PEKRN and No 18a for KYC (KRA). Refer instruction No 18b for KYC Identification Number issued by CKYCR.
8. BANK ACCOUNT DETAILS OF THE FIRST / SOLE APPLICANT (For redemption/ IDCW Payments if any) (refer instruction 5)
(Mandatory to attach proof, in case the pay-out bank account is different from the bank account mentioned under Section 10 below.)
For unit holders opting to hold units in demat form, please ensure that the bank account linked with the demat account is mentioned here.
Bank Name
Mandatory

Branch Name Bank City

Account Number
MICR Code (The 9 digit code appears on your cheque next to the cheque number)
April 2022

Account Type (Please P) Savings Current NRO NRE FCNR Others (please specify) _______________________
*** Refer Instruction 5C (Mandatory for Credit via NEFT / RTGS) (11 Character code appearing on your
IFSC Code*** cheque leaf. If you do not find this on your cheque leaf, please check for the same with your bank)

Particulars
Scheme Name / Plan / Option / Sub-option / Cheque / DD / Payment Instrument /
Drawn on (Name of Bank and Branch) Amount in figures (Rs.)
Payout Option UTR No. / Date

Please Note: All Purchases are subject to realisation of cheques / demand drafts / Payment Instrument.
9. MODE OF PAYMENT OF REDEMPTION / IDCW PROCEEDS (refer instruction 11)
I / We would like to receive redemption / IDCW proceeds :
directly into my / our bank account (as per Section 8) (Default mode) OR via cheque / demand draft
10. INVESTMENTS & PAYMENT DETAILS [Please (P)] (refer instruction 6 & 7 for Scheme details and instruction 8 & 9 for Payment Details) The name of the first/ sole applicant must be pre-printed on the cheque.
Regular Plan (Purchase/ Subscription routed through Distributor) Direct Plan (Purchase/ Subscription made directly with the Fund)
Mention valid ARN in Key Par tner/ Agent Information Mention DIRECT in Key Par tner/ Agent Information
Scheme/Plan/Sub Option/ Frequency
Growth Option Income Distribution cum Capital Withdrawal (IDCW) Option Payout
(The amounts can be distributed out of investor’s capital (Equalization Reserve), which is part of sale price that represents realized gains.) Reinvestment
Mode of Payment Cheque Demand Draft NEFT/ RTGS/ Fund Transfer One Time Mandate (OTM)
Please note that OTM can be selected as mode of payment provided OTM is already registered. In case OTM is not registered please fill in the attached OTM Debit Mandate to make future
transactions via OTM
Payment Type [Please (P)] Non-Third Party Payment Third Party Payment (Please attach ‘Third Par ty Payment Declaration Form’)
Pay-In Bank Account No. Cheque/ DD/ Cheque/ DD/ Amount of Cheque / DD / DD Charges, Net Cheque/ DD
Drawn on Bank / Branch (For Cheque Only) Payment Instrument/ Payment Instrument/ Payment Instrument / if any
UTR No. UTR Date RTGS/ NEFT in figures (Rs.) Amount

Cheque/ DD Amount (in words):

11. UNIT HOLDING OPTION DEMAT MODE* PHYSICAL MODE (Default) ( refer instruction 13)
*Demat Account details are mandatory for (i) FPIs and (ii) investors who wish to hold the units in Demat Mode (Account statement (CAS) for units held in demat mode will be issued only by NSDL/CDSL)
Beneficiary
NSDL DP Name DP ID I N Account No.

Beneficiary
CDSL DP Name Account No.
*Investor opting to hold units in demat form, may provide a copy of the DP statement for us to match the demat details as stated in the application form.
12. NOMINATION (refer instruction 15) (Mandatory for new folios of Individuals and Sole Proprietors where mode of holding is single) (For Units in Non-Demat Form)
I/We wish to nominate as under: OR I/We do not wish to Nominate ....................................................................................................... (Sole applicant's signature mandatory)
Relationship
Name and Address of Nominee(s) of Guardian Date of Birth Name and Address of Guardian Signature of Nominee Proportion (%) in which the
units will be shared by
PAN with Nominee (Optional)/ Guardian of each Nominee (should
(IN CAPITALS) (Proof to be Nominee (Mandatory)
(to be furnished in case the Nominee is a minor) aggregate to 100%)
attached)

Nominee 1

Nominee 2

Nominee 3

Proof of Relationship of Guardian with Minor: Birth Certificate School Leaving Certificate Passport Others _________________________
I/We have read and understood the instructions on nomination and I/We hereby undertake to abide by the same. The instructions contained herein supercedes all previous nominations made by
me/us in respect of the folio(s) mentioned above.
POA holder cannot
nominate. So sole/all joint
applicants must sign
First / Sole Applicant Second Applicant Third Applicant
13. DECLARATION & SIGNATURE/S (refer instruction 14)
I / We have read, understood the terms and conditions of the scheme related documents of the respective scheme(s) SIGN HERE
and agree to comply with the same as an Unitholder. I /We hereby apply to the Trustees for allotment of Units of the
Scheme(s) of HDFC Mutual Fund (‘Fund’) and confirm and declare as under: (Please write Application Form No. / Folio No.
(a) I/We am/are eligible Investor(s) as per the scheme related documents and not prohibited by any order/ruling/ on the reverse of the Cheque / Demand Draft /
judgment passed by SEBI/ Statutory Authority or Courts in India and Foreign laws. I am/We are authorised to
make this investment as per the Constitutive documents/ authorization(s). The amount invested in the Payment Instrument.)
Scheme(s) is through legitimate sources only and is not for the purpose of contravention and/or evasion of any
act, rules, regulations, notifications or directions issued by any regulatory authority in India.
(b) I / We will be bound by the Fund's terms and conditions as amended from time to time.
(c) The information given by me /us in or along with this application form is true and correct and I/we shall furnish
such other further/additional information as may be required by the HDFC Asset Management Company Limited
(AMC)/ Fund .I/We undertake to promptly inform the AMC / Fund/Registrars and Transfer Agent (RTA) in writing First / Sole
about any change in the information furnished by me/us from time to time. Applicant /
(d) I/We hereby authorize you to disclose, share, remit in any form/manner/mode the above information and/or any
part of it including the changes/updates that may be provided by me/us to the Fund, its Sponsor/s, Trustees, Guardian
Asset Management Company, its employees, agents and third party service providers, SEBI registered
intermediaries for single updation/ submission, any Indian or foreign statutory, regulatory, judicial, quasi- judicial
authorities/agencies including but not limited to Financial Intelligence Unit-India (FIU-IND) etc without any SIGN
intimation/advice to me/us.
(e) I/We hereby consent for providing transactions data feed, portfolio holdings, NAV etc. in respect of my/our
transactions under Direct Plan to the RIA/Portfolio Managers/Stock Broker registered in the concerned folio, if
applicable.
(f) I/We shall be liable and responsible for any loss, claims suffered, directly or indirectly by AMC/ Fund/ RTA/ SEBI
Intermediaries, arising out of any false, misleading, inaccurate and incomplete information furnished by me/us at
the time or investing/redeeming the units. I/We hereby unconditionally and irrevocably indemnify and at all time
keep indemnified, save and harmless AMC/Fund/Trustee and their officers, directors and employees against all
actions, proceedings, claims, losses, damages, charges and expenses incurred or suffered /paid by AMC/Fund
SIGNATURE(S)

in this regard and in case of any dispute regarding the eligibility, validity and authorization of my/our transactions. Second
(g) The ARN holder (AMFI registered Distributor) has disclosed to me/us all the commissions (in the form of trail Applicant
commission or any other mode), payable to him/them for the different competing Schemes of various Mutual
April 2022

Funds from amongst which the Scheme is being recommended to me/us.

(h) I/WE HEREBY CONFIRM THAT I/WE HAVE NOT BEEN OFFERED/ COMMUNICATED ANY INDICATIVE SIGN
PORTFOLIO AND/ OR ANY INDICATIVE YIELD BY THE FUND/AMC/ITS DISTRIBUTOR FOR THIS
INVESTMENT.
Consent for Telemarketing (Refer Instruction 20):
I/We hereby accord my/our consent to HDFC AMC for receiving the promotional information/ material via email,
SMS, telemarketing calls etc. on the mobile number and email provided by me/us in this Application Form.
Consent for disclosure of Personal Information in terms of Privacy Policy
I/We hereby confirm to have read, understood and agree to the terms of Privacy Policy (available on
https://www.hdfcfund.com) (“Policy”) of HDFC AMC/ Fund.
I/We hereby accord my/our consent to HDFC AMC/Fund for collecting, receiving, possessing, storing, dealing,
handling or disclosure of my/ our Personal Data and hereby authorize to disclose it to the third party or another body Third
corporate or any person acting under a lawful contract with HDFC AMC, in accordance with the Privacy Policy. Applicant
For Foreign Nationals Resident in India only:
I/We will redeem my/our entire investment/s before I/We change my/our Indian residency status. I/We shall be
fully liable for all consequences (including taxation) arising out of the failure to redeem on account of change in SIGN
residential status.
For NRIs/ PIO/ OCIs/ FPIs only:
I/We confirm that my application is in compliance with applicable Indian and foreign laws.
For NRIs/ PIO/OCIs Please (P) Repatriation basis Non-repatriation basis