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@uti.co.in, Website: www.utimf.com
COMMON APPLICATION FORM
FOR INCOME SCHEMES
UTI - Bond Fund
UTI - Floating Rate Fund STP
(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)
(An open-ended Income Scheme)
The product is suitable for investors who are
seeking*:
l
Regular income over short-term
l
UTI - Credit Opportunities Fund
Low risk
(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)
l
(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
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
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)
Low risk
l
(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 .
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)
Investment in Central Government
Securities, Treasury Bills, Call Money
and Repo
l
Low risk
l
1
July 1, 2013
Investment in floating rate debt / money
market instruments, fixed rate debt /
money market instruments swapped for
floating rate return
(Blue)
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 shortterm with capital preservation.
l Investment in money market securities &
high quality debt
l
Low risk
(Blue)
UTI - Mahila Unit scheme
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)
(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 - Short Term Income Fund
UTI - MIS-Advantage Plan
UTI - Treasury Advantage Fund
UTI - Money Market Fund
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
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)
(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)
(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)
(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)
(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)
(YELLOW)
(BROWN)
Investors understand that
their principal will be at low
risk
Investors understand that
their principal will be at
medium risk
Investors understand that
their principal will be at high
risk
COMMON APPLICATION FORM FOR INCOME SCHEMES
Sr.No. 2013/
PLEASEUSESEPARATEFORMFOREACHSCHEME
PLEASE FILL IN ALL COLUMNS IN CAPITAL LETTERS ONLY
Registrar Sr. No.
(PLEASEREADINSTRUCTIONSCAREFULLYTOHELPUSSERVEYOUBETTER)
DISTRIBUTOR INFORMATION (only empanelled Distributors/Brokers will be permitted to distribute Units) (refer instruction ‘h’)
ARN
NameofFinancialAdvisor
SubARNCode
SubCode/
Bank Branch Code
MOCode
EUINo. @
ARN - 11770
BDA / CA Code
UTI RM No.
E020436
UpfrontcommissionshallbepaiddirectlybytheinvestortotheAMFI/NISMcertifiedUTIMFregisteredDistributorsbasedontheinvestors’assessmentofvariousfactorsincludingtheservicerenderedbythedistributor.
@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. ( PleasetickandsignbelowwhenEUINboxisleftblank)(referinstruction‘v’).
Ê
Signature of 1st Applicant / Guardian
Signature of 2nd Applicant
Signature of 3rd Applicant
TRANSACTION CHARGES TO BE PAID TO THE DISTRIBUTOR (Please tick any one of the below) (Refer Instruction ‘i’)
IAMAFIRSTTIMEINVESTORINMUTUALFUNDS
` 150willbedeductedastransactionchargesperSubscriptionof `10,000andabove
IAMANEXISTINGINVESTORINMUTUALFUNDS
`100willbedeductedastransactionchargesperSubscriptionof `10,000andabove
OR
Scheme Name:
Existing Unit Holder information
APPLICANT’S PERSONAL DETAILS
Mr.
Ms.
Folio Number:
Mrs.
M/s.
* Denotes Mandatory Fields
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)
F
I
R
L
S
A
T
S
T
Date of Birth
d
d
M
m
I
m
D
y
D
y
L
y
E
y
Mandatory for minors
First Applicant’s Address (Do not repeat the name) Name & Address of resident relative in India(forNRIs)(P.O.BoxNo.isnotsufficient)
Village/Flat/Bldg./Plot*
Street/Road/Area/Post
State
City/Town*
Pin*
*PAN OF 1st APPLICANT (whose particulars are furnished in the form)
Enclosed
AADHAR CARD NO.
PAN Card Copy
Please ()
Know Your Customer (KYC)* Acknowledgement Copy
OVERSEAS ADDRESS (Overseas address is mandatory for NRI / FII applicants in addition to mailing address in India)
City*
State
Country*
Zip/Pin*
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)
F
I
R
S
T
M
I
D
D
L
E
L
Mr.
Ms.
A
S
Mrs.
T
$ 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).
OPTION FOR DESPATCH OF STATEMENT OF ACCOUNT
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
DETAILS OF OTHER APPLICANTS
Name of 2nd Applicant
F
I
R
*PAN of 2nd Applicant
Mr.
S T
Ms.
Mrs.
M
M/s.
I
D
D
L
d
m
E
m
y
y
y
L
A
S
T
AADHAR CARD NO.
Enclosed
Name of 3rd Applicant
F
I
R
*PAN of 3rd Applicant
d
DateofBirthof2ndApplicant
S
Mr.
T
Ms.
Mrs.
M
PAN Card Copy
M/s.
I
D
Know Your Customer (KYC)* Acknowledgement Copy
d d
DateofBirthof3rdApplicant
D
L
E
m m
L
A
y
PAN Card Copy
Please ()
y
S
AADHAR CARD NO.
Enclosed
Know Your Customer (KYC)* Acknowledgement Copy
y
y
y
T
Please ()
PAYMENT DETAILS
#Cheque/DD/NEFT/RTGS Ref. No.
/ Unique Serial No. (For Cash)
Cash Account type
(please )
Account No.
Branch
Current
NRO
DD issued from abroad
NRE
# Please mention the application No. on the reverse of
thecheque/DD,NEFT/RTGSadvice.Cheque/DD
must be drawn in favour of “TheNameoftheScheme”
& crossed “A/cPayeeOnly”
 Investment amount shall be Rs. 2 lacs and above
in case of payments through NEFT / RTGS.
Amt. of investment (i)
DD Charges if any (ii)
Net amount paid (i-ii)
Date
Bank
Savings
Amt. in words
BANK PARTICULARS OF 1ST APPLICANT (MandatoryasperSEBIGuidelines)
Bank Name
Branch
Address
MICR Code
(thisisa9-digitnumbernexttoyourchequenumber)
City
Account type (please )
Account No.
IFS Code
(this is a 11-digit number)
Pin*
Savings

Received from Mr / Ms / M/s
An application under
alongwithCheque/DDNo.$ /Cash
Drawnon(Bank)
for `(infigures)
$
Cheques and drafts are subject to realisation.
Current
NRO
NRE
ACKNOWLEDGEMENT
(TobefilledinbytheApplicant)

Sr. No. 2013
(scheme name)
dated
StampofUTIAMCOffice/
Authorised Collection Centre
INVESTMENT DETAILS (For “DIRECT PLAN” Please tick here
UTI-BOND FUND UTI-MAHILA UNIT SCHEME UTI-CREDIT OPPORTUNITIES FUND
UTI-MONTHLY INCOME SCHEME
& tick Scheme, Plan / Option given below) (Refer instruction ‘j’)
UTI-CRTS UTI-DYNAMIC BOND FUND UTI-G-SEC FUND-(STP)
✔ Growth Dividend Payout
Dividend Reinvestment (Default – Growth Option)
UTI-FIXED MATURITY PLAN Yearly Series (YFMP)
Half Yearly Series (HFMP) Quarterly Series (QFMP)
Regular Plan
✔ Growth
Dividend Payout
Dividend Reinvestment (Use separate form for each series) 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
UTI-GILT ADVANTAGE FUND-LTP
UTI-LIQUID CASH PLANInstitutional
✔
✔
✔
UTI-MIS-ADVANTAGE PLAN
✔
Growth Monthly Reinvestment Growth Plan Flexi Dividend Plan Payout Daily Div. Reinvestment Weekly Div. Reinvestment Monthly Payout
(Default – Daily Div. Reinvestment)
Monthly Div. Plan Payout Monthly Div. Plan Reinvestment
Flexi Dividend Plan Reinvestment Monthly Payment Plan (Default Plan - Growth Plan)
✔ Growth Daily Div. Reinvestment Weekly Div. Payout Weekly Div. Reinvestment
(Default – Growth Option) UTI-MONEY MARKET FUND Institutional Plan
UTI-SHORT TERM INCOME FUND
- Institutional Option
Growth Sub Option
UTI-TREASURY ADVANTAGE FUND
- Institutional Plan
Unitholding Option
Growth Daily Div. Reinvestment Weekly Div. Reinvestment
Flexi Dividend Payout
Flexi Dividend Reinvestment (Default – Growth Option)
Growth Plan
Dividend Plan Payout
Dividend Plan Reinvestment (Default – Growth Plan)
Growth Quarterly Div. Payout Demat Mode
Div Payout Sub Option ✔
Div. Reinvestment Sub Option (Default – Div. Reinvestment Sub Option)
Weekly Div. Payout Weekly Div. Reinvestment Monthly Div. Payout Monthly Div. Reinvestment
Daily Div. Reinvestment
Quarterly Div. Reinvestment Annual Div. Payout Annual Div. Reinvestment Bonus Option
(Default – Daily Div. Option)
✔
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
Depository Name ______________________________________
Securities
Depository DP ID No.
Limited
Beneficiary
Account No.
Enclosures : Client Master List (CMl)
Central
Depository
Securities
Limited
Transaction cum Holding Statement Depository Name _______________________________________________________
Target ID No.
Delivery Instruction Slip (DIS)
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.
Name
Address:
F I
R S T
M
Relationship with the applicant (optional)
I
D
D
L
E
L A S T
Email
Annual Income of First Individual Applicant (Please ()
Mobile
< 5 Lacs
> 5 Lacs - < 15 Lacs
> 15 Lacs - < 25 Lacs
> 25 Lacs
GENERAL INFORMATION - Please () wherever applicable
Resident Individual
Minor through guardian
HUF
Partnership
Trust
STATUS
Company
Sole Proprietorship
Society
Body Corporate
Others
AOP
BOI
FII
NRI
MODE OF HOLDING
Anyone or survivor
Joint
Single
First holder or Survivor (for UTI MUS)
MARITAL STATUS
Unmarried
Married
Wedding
D D M M
Anniversary
OCCUPATION
Business
Student
Agriculture
Self-employed
Others
Professional
Housewife
Retired
Service
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.
Sign.
here
Ê
Name and Address of Nominee
Name
To be furnished in case nominee is a minor
Name of the guardian
ddmmyyyy
Date of Birth (in case of nominee is a minor)
Address with pin code
Address of guardian
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)
Ê
* 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 Mobile Number
Details
Tel. (R) STD CODE
No. (O) STD CODE
Sign.
here
Ê
Signature of 1st Applicant / Guardian
Name of 1st Authorised Signatory
______________________________________
Designation ___________________________

Signature of 2nd Applicant
Name of 2nd Authorised Signatory
______________________________________
Designation ___________________________
)
*E mail _____________________________________________
Alternate E-mail ________________________________________
Signature of 3rd Applicant
Name of 3rd Authorised Signatory
______________________________________
Designation ___________________________

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@karvy.com