SBI Mutual Fund
Principal Trustee : State Bank of India, Investment Manager : SBI Funds Management Ltd. 191, Maker Tower ‘E’, Cuffe Parade, Mumbai - 05. Tel.: 022-2180221-27 Fax : 2182187, www.sbimf.com
APPLICATION NO.
A P P L I C A T I O N
Name & Code No. of SBIMF Agent/Broker Sub-Broker/ Subagent Code SBIMF ISCS/Registrar/ SBI Designated Branches
F O R M
Reference No. (To be filled by Registrar) Received Date Time
NJ IndiaInvest Pvt Ltd
ARN-0155
54934 9285
Application Amount Details
I would like to invest in Magnum TaxGain subject to terms of the offer document. (Minimum application amount of Rs. 500 and in multiples of Rs. 500 thereafter.) A. Amount Paid (Rs. in Figures) B. Draft Charges Deducted (Rs.) C. Net Amount Paid (A-B) (Rs. in Figures)
Cheque
DD Cheque/DD No.
Date
Bank & Branch Details Net Amount Paid (Rs. in Words) Dividend Plan ( ✓ ) Name
(Mr/Ms/M/s)
Reinvest dividend
Payout dividend Particulars of First Applicant
Local Address Name of Father/Husband Tel. No. Name of guardian (in case of minor only) Foreign Address
(if applicable)
Pin
Email
Date of Birth (In case of minor only)
D
D
M
M
Y
Y
Pin Circle/Ward/District Signature (1st Applicant) Signature (2nd Applicant) Signature (3rd Applicant) Bank Particulars (for dividend/redemption/refund (compulsory)
PAN/GIR No.
(if investment amount is over Rs. 50,000)
Name of 2nd Applicant Mr./Ms./M/s.
Name of 3rd Applicant Mr./Ms./M/s.
Bank name and address Account Type (Please ✓) Current Saving No. of Cheques Amount for each cheque Rs. Systematic Withdrawal Plan (SWP) Amount for each cheque Rs.
M M Y Y Y Y
NRO
FCNR Cheque Nos.
NRE
Account No. Drawn on Amount in words Amount in words
Systematic Investment Plan (SIP)
Month and Year of Commencement of SWP: (MM/YYYY)
(e.g. For April 2001, please indicate 0
4 2
0 0
1
)
Nomination Facility (Available only for individuals applying on their own behalf, either singly or jointly upto three. )(!) : Required
Not Required
(If nomination is required please (!) appropriate box. The Registrar will send you a nomination form which may please be completed and sent back to the Registrar.) For Electronic Clearing Service (only for select centres having ECS) 9 digit MICR Code Account No. Ledger No./Ledger Folio No.
Account type (S.B. Account/Current Account or Cash Credit) with code 10/11/13 (photocopy of cheque to be enclosed) General Information – Please ( ✓ ) wherever applicable Status Mode of Holding Occupation Correspondence to Individual Minor through guardian HUF Company/Body Corporate/PSU NRI/OCB on Repatriable basis Single Self Employed Local Addr. Joint Professional Foreign Addr. Either or Survivor Housewife < Rs. 10,000 Trust/Society Partnership NRI/OCB non Repatriable basis Former or Survivor(s) Retired < Rs. 20,000 Service < Rs. 40,000 Others > Rs. 40,000 Others
Monthly Income
SBI Mutual Fund
191, Maker Tower ‘E’, Cuffe Parade, Mumbai - 05. Tel.: 022-2180221-27 Fax: 022-2182187, www.sbimf.com
A C K N OW L E D G E M E NT S L I P
Reinvest dividend Payout dividend
APPLICATION NO.
(To be filled in by the First applicant) : Received from Name : Address : Amount in figures Amount in words Cheque/DD Drawn on
under Date Stamp Signature & Date
SBI-FORM/JF/PEN-II