COMMON APPLICATION FORM Application No.

Name & Broker Code / Sub Broker / Sub Agent Code Internal Code for ISC Date Time Stamp
ARN / RIA Code Agent ARN Code EUIN* Sub-Agent/Employee Reference No.

Declaration for “Execution Only” Transaction (where Employee Unique Identification Number-EUIN* box is left blank). Please refer instruction 12 of KIM for complete details on EUIN. I/We hereby confirm that the EUIN box
Please Read All Instructions as given in KIM, to help you complete the Application Form Correctly.

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.

st
Signature of 1 Applicant / Guardian / Signature of 2nd Applicant / Guardian / Signature of 3rd Applicant / Guardian /
Authorised Signatory /PoA/Karta Authorised Signatory /PoA Authorised Signatory /PoA

Please  Lumpsum Investment Micro Application SIP Application

TRANSACTION CHARGES (Please  any one of the below. Refer Instruction No. 11)
I AM A FIRST TIME INVESTOR IN MUTUAL FUNDS OR I AM AN EXISTING INVESTOR IN MUTUAL FUNDS
Applicable transaction charges will be deducted in case your distributor has opted for such charges. Upfront commission shall be paid directly by the investor to the ARN Holder (AMFI registered
Distributor) based on the investor’s assessment of various factors including the services rendered by the ARN Holder.
1. EXISTING UNIT HOLDER INFORMATION [Please ll in your Folio Number, KIN, Section 2 & proceed to Section 7 - Investment Details]

Folio No. CKYC Identication No. (KIN)

2. APPLICANT(S) NAME AND INFORMATION [Refer Instruction 2] If the 1st / Sole Applicant is Minor, then please provide details of natural / legal guardian

1st SOLE APPLICANT Mr. / Ms. / M/s. PAN

Pls indicate if US Person or a resident for tax purpose / Resident of Canada

CKYC ID No. (KIN)
Yes No$ ($Default if not )
GUARDIAN (In case 1st Applicant is a Minor) Relationship with Minor (Please )
Mr. / Ms. / M/s. Mother Father Legal Guardian

GUARDIAN CKYC KYC (Please ) GUARDIAN

ID No. (KIN) Proof Attached PAN

POA / Custodian Name: KYC (Please ) Proof Attached

POA / Custodian POA / Custodian
CKYC ID No. (KIN) PAN

Contact Person for Corporate Investor: Name Designation:

05-2017
3. FIRST APPLICANT AND KYC DETAILS
st
1 SOLE APPLICANT Individual or Non-Individual [Please ll Ultimate Benecial Ownership (UBO) Declaration Form in section 11a & 11b - Refer Instruction No. 17]

*Date of Birth Incorporation D D M M Y Y Y Y Proof of Date of Birth (Please ) Birth Certicate School Leaving Certicate / Mark Sheet
(Individual) (Non-individual) (For minor applicant) (Please specify)
Passport of the Minor Others
Place of Birth / Country of Birth / Nationality: Gender Male Female Other
Incorporation: Incorporation:

Type: Resident Individual Sole Prop NRI - NRE Trust Bank / Fls FIIs PIO Society/AOP/BOI Minor thru Guardian NRI - NRO

HUF LLP Listed Company Private Company Public Ltd. Company Articial Juridicial Person Partnership Firm FOF - MF Schemes (Please specify)
Others ____________________

Private Sector Public Sector Government Service Student Professional Housewife

a*. Occupation Details [Please tick ()]
Business Retired Agriculture Proprietorship (Please specify)
Others___________________

b*. Gross Annual Income (`) [Please tick ()] Below 1 Lakh 1-5 Lakh 5-10 Lakh 10-25 Lakh >25 Lakh > 1 Crore

c*. Politically Exposed Person (PEP) Status (Also applicable for authorised signatories/Promoters/Karta/Trustee/Whole time Directors) I am PEP I am Related to PEP Not Applicable

d*. Net-worth (Mandatory for Non-Individuals) `_______________________________________________ as on D D M M Y Y Y Y (Not older than 1 year)

e*. Non-Individual Investors involved/providing Foreign Exchange / Money Changer Services Gaming/Gambling/Lottery/Casino Services
any of the mentioned services Money Lending / Pawning None of the above
4. BANK ACCOUNT DETAILS - Mandatory [Refer Instruction Nos. 3 & 4]

Name of the Bank:

Core Banking A/c No. A/c. Type Pls. () NRE CURRENT SAVINGS NRO

Branch Name: Address:

Bank Branch City: State: Pin Code

Please attach a cancelled cheque IFSC Code (Mandatory for

MICR Code OR a clear photo copy of a cheque Credit via NEFT/RTGS)

* mandatory elds
 5. JOINT APPLICANTS, IF ANY AND THEIR KYC DETAILS

Mode of Holding: Anyone or Survivor Single Joint (Please note that the Default option is Anyone or Survivor)

2nd APPLICANT Mr. / Ms. / M/s. (Not Applicable in case of Minor Applicant) Gender Male Female Other

PAN Details Pls indicate if US Person or a resident for tax purpose / Resident of Canada Yes No* (*Default if not )

CKYC ID No. (KIN) KYC Pls  Proof Attached Date of Birth (Mandatory) D D M M Y Y Y Y

Place of Birth Country of Birth Nationality:

Private Sector Public Sector Government Service Student Professional Housewife

a*. Occupation Details [Please tick ()]
Business Retired Agriculture Proprietorship (Please specify)
Others___________________

b*. Gross Annual Income (`) [Please tick ()] Below 1 Lakh 1-5 Lakh 5-10 Lakh 10-25 Lakh >25 Lakh > 1 Crore

c*. Politically Exposed Person (PEP) Status I am PEP I am Related to PEP Not Applicable

d. Net-worth `_______________________________________________ as on D D M M Y Y Y Y (Not older than 1 year)

Mode of Holding: Anyone or Survivor Single Joint (Please note that the Default option is Anyone or Survivor)

3rd APPLICANT Mr. / Ms. / M/s. (Not Applicable in case of Minor Applicant) Gender Male Female Other

PAN Details Pls indicate if US Person or a resident for tax purpose / Resident of Canada Yes No* (*Default if not )

CKYC ID No. (KIN) KYC Pls  Proof Attached Date of Birth (Mandatory) D D M M Y Y Y Y

Place of Birth Country of Birth Nationality:

Private Sector Public Sector Government Service Student Professional Housewife

a*. Occupation Details [Please tick ()]
Business Retired Agriculture Proprietorship (Please specify)
Others___________________

b*. Gross Annual Income (`) [Please tick ()] Below 1 Lakh 1-5 Lakh 5-10 Lakh 10-25 Lakh >25 Lakh > 1 Crore

c*. Politically Exposed Person (PEP) Status I am PEP I am Related to PEP Not Applicable

d. Net-worth `_______________________________________________ as on D D M M Y Y Y Y (Not older than 1 year)

6a. MAILING ADDRESS [Please provide your E-mail ID and Mobile Number to help us serve you better]

Local Address of 1st Applicant

City State Pin Code

Tel. Off. Resi. Mobile

E - Mail^^

^^Please Use Block Letters. Investors providing email ID would mandatorily receive all Communications, Statement of Accounts and Abridged Annual Report through e-mail only.
6b. Mandatory for NRI / Fll Applicant [Please provide Full Address. P. O. Box No. may not be sufcient. For Overseas Investors, Indian Address is preferred]

Overseas Correspondence Address

7. INVESTMENT AND PAYMENT DETAILS ( For complete information on Investment Details please refer to Instructions No. 6. )
Scheme Regular Plan Dividend* Div frequency*
Direct Plan Growth (Default) Payout Reinvestment

Payment Type [Please ()] Self (Non-Third Party Payment) Third Party Payment (Please attach ‘Third Party Payment Declaration Form’)
Amount of Cheque / DD / DD Charges, Net Purchase Drawn on Bank / Pay-In Bank A/c No.
Cheque / DD / UTR No. & Date
RTGS / NEFT in gures (Rs.) if any Amount Branch (For Cheque Only)

*Dividend frequency is applicable only for Mirae Asset Cash Management Fund & Mirae Asset Savings Fund.
8. DEMAT ACCOUNT DETAILS - Mandatory for units in Demat Mode - Please ensure that the sequence of names as mentioned under section 3 matches as per the Depository Details.
National Securities Depository Limited (NSDL) Central Depository Services (India) Limited (CDSL)
DP Name DP Name

DP ID I N Benef. A/C No. 16 Digit A/C No.

Enclosures - Please () Client Masters List (CML) Transaction cum Holding Statement Delivery Instruction Slip (DIS)
9. NOMINATION DETAILS [Minor / HUF / POA Holder / Non Individuals cannot Nominate - Refer Instruction No. 9]
PLEASE REGISTER MY/OUR NOMINEE AS PER BELOW DETAILS OR I/WE DO NOT WISH TO NOMINATE
Date of Birth Name of the Guardian
No. Nominee(s) Name Relationship % of Share Signature of Nominee / Guardian
(in case of Minor) (in case of Minor)
1 D D M M Y Y Y Y

2 D D M M Y Y Y Y

3 D D M M Y Y Y Y

* mandatory elds
 FOR NON-INDIVIDUALS ONLY
10. FATCA & CRS DETAILS (Please consult your professional tax advisor for further guidance on FATCA & CRS classication)
PART A To be lled by Financial Institutions or Direct Reporting Non Finacial Entity (NFEs)

We are a, GIIN
Financial institution
Note: If you do not have a GIIN but you are sponsored by another entity, please provide your sponsor's GIIN above and indicate your sponsor's name below
or
Direct reporting NFE
Name of sponsoring entity:
[Please tick ()]

GIIN not available [Please tick ()] Applied for Not required to apply for - please specify 2 digits sub-category Not obtained – Non-participating FI

PART B (please ll any one as appropriate “to be lled by NFEs other than Direct Reporting NFEs”)

1 Is the Entity a publicly traded company Yes (If yes, please specify any one stock exchange on which the stock is regularly traded)
(that is, a company whose shares are regularly
traded on an established securities market) Name of stock exchange:

2 Is the Entity a related entity of a publicly Yes (If yes, please specify name of the listed company and one stock exchange on which the stock is regularly traded)
traded company (a company whose shares are
regularly traded on an established securities market) Name of listed company:
The detail of this page should be lled by Non-Individual investors only.

Nature of relation Subsidiary of the Listed Company or Controlled by a Listed Company

Name of stock exchange:

3 Is the Entity an active NFE Yes (If yes, please ll UBO declaration in the next section.)

Nature of Business:

Please specify the sub-category of Active NFE Mention code: Refer instruction 16(c)

4 Is the Entity a passive NFE Yes (If yes, please ll UBO declaration in the next section.)
Nature of Business:
For details refer instruction No. 16.
11a. DECLARATION FOR ULTIMATE BENEFICIAL OWNERSHIP [UBO] (Refer instruction No. 17)*
*This declaration is not needed for Companies that are listed on any recognized stock exchange or is a Subsidiary of such Listed Company or is Controlled by such Listed Company. Please list below the details of controlling
person(s), confirming ALL countries of tax residency / permanent residency / citizenship and ALL Tax Identification Numbers for EACH controlling person(s). Owner-documented FFI's should provide FFI Owner Reporting
Statement and Auditor's Letter with required details as mentioned in Form W8 BEN E.
11b. DETAILS OF ULTIMATE BENEFICIAL OWNERS [Mandatory] (If the given space below is not adequate, please attach multiple declaration forms)
Name of UBO & Address Address Type$$ PAN/Tax Payer Document Type Country of tax Country of UBO Code KYC (Yes / NO) % of beneficial
Identification No./ Refer instruction Residency/ citizenship (Mandatory) [please attach interest
%
Equivalent ID No. No. 16(d) permanent the KYC
residency* acknowledgement
copy]

$$ Address Type: Residential or Business (default)/Residential/Business/Registered Office. Attached documents should be self certi ed by the UBO and certi ed by the applicant or Authorised signatory. In case the above
information is not provided, it will be presumed that applicant is the UBO, with no declaration to submit. In such case, MAMF/AMC reserves the right to reject the application or reverse the allotment of units, if subsequently it is found
that applicant has concealed the facts of bene cial ownership. I/We also undertake to keep you informed in writing about any changes/modi cation to the above information in future and also undertake to provide any other additional
information as may be required at your end.
# If passive NFE, please provide below additional details. (Please attach additional sheets if necessary). Also provide below mandatory details if the UBO does not have a PAN. (Refer Instruction No. 16)
PAN / Any other Identication Number (PAN, Aadhar, Passport, Occupation Type: Service, Business, Others
DOB: Date of Birth
Election ID, Govt. ID, Driving Licence NREGA Job Card, Others) Nationality:
Gender: Male, Female, Other
City of Birth - Country of Birth Father's Name: Mandatory if PAN is not available

1. PAN: Occupation Type:

Date Of Birth:
City of Birth: Nationality:
Gender Male Female Other
Country of Birth: Father's Name:

2. PAN: Occupation Type:

Date Of Birth:
City of Birth: Nationality:
Gender Male Female Other
Country of Birth: Father's Name:

3. PAN: Occupation Type:

Date Of Birth:
City of Birth: Nationality:
Gender Male Female Other
Country of Birth: Father's Name:

# Additional details to be lled by controlling persons with tax residency / permanent residency / citizenship / Green Card in any country other than India.
* To include US, where controlling person is a US citizen or green card holder
%In case Tax Identication Number is not available, kindly provide functional equivalent

For Lumpsum ‘OR’ SIP

ACKNOWLEDGMENT SLIP

Received Application from Mr. / Ms. / M/s. _____________________________________________________________________________ as per details below:
Scheme Name and Plan Payment Details Date & Stamp of Collection Centre / ISC
Amount (Rs.) ____________________________________
Cheque / DD No.: ________________________________
Dated _________________________________________
Bank & Branch __________________________________
Cheque / DD is subject to realisation
 12. FATCA AND CRS DETAILS (Self Certication) (Refer instruction No. 16) (FOR INDIVIDUALS & NON-INDIVIDUALS)
FOR INDIVIDUALS: Please indicate all countries in which you are resident for tax purposes and the associated Tax Reference Numbers below.
FOR NON-INDIVIDUALS: Is the “Entity” a tax resident of any country other than India? Yes No
(If Yes, please provide country/ies in which the entity is a resident for tax purpose and the associated Tax Identication No. below)

1st Applicant (Sole / Guardian / Non-Individual) 2nd Applicant 3rd Applicant

Do you have any non-Indian Do you have any non-Indian Do you have any non-Indian
Country(ies) of Birth / Country(ies) of Birth / Country(ies) of Birth /
Citizenship / Nationality Yes No Citizenship / Nationality Yes No Citizenship / Nationality Yes No
and Tax Residency and Tax Residency and Tax Residency

Country of Birth / Country of Birth Country of Birth

Incorporation

Country Citizenship / Country Citizenship / Country Citizenship /

Nationality Nationality Nationality

Are you a US specied Yes No Are you a US specied Yes No Are you a US specied Yes No
person? Please provide Tax Payer Id. person? Please provide Tax Payer Id. person? Please provide Tax Payer Id.

For non-Individual investor in case, if you country of incorporation / Tax resistance in US, but you are not a specied US person then please mention exemption code____________(Refer instruction 16(e))
Individual or Non-Individual investors ll this section Individual investor have to ll in below details in case of joint applicants
if ticked Yes above.

Country: Country: Country:

Tax Residency Tax Residency Tax Residency

Status: 1 No.: Status: 1 No.: Status: 1 No.:

Type: Type: Type:

Country: Country: Country:

Tax Residency Tax Residency Tax Residency

Status: 2 No.: Status: 2 No.: Status: 2 No.:

Type: Type: Type:

Country: Country: Country:

Tax Residency Tax Residency Tax Residency

Status: 3 No.: Status: 3 No.: Status: 3 No.:

Type: Type: Type:

Address Type Address Type Address Type

(Address Type: Residential or Business (default) / Residential / Business / Registered Ofce) (For address mentioned in form / existing address appearing in folio)

In case of applications with POA, the POA holder should ll separate form to provide the above details mandatorily.

13. DECLARATION AND SIGNATURES / THUMB IMPRESSION OF APPLICANT(s) [Refer Instructions 2(e)]
To The Trustees, Mirae Asset Mutual Fund (The Fund) – (A) Having read and understood the contents of the SID of the Scheme(s), I/We hereby apply for units of the scheme(s) and agree to abide by the terms, conditions, rules and regulations governing the scheme.
(B) I/We hereby declare that the amount invested in the scheme(s) is through legitimate sources only and does not involve and is not designed for the purpose of the contravention of any provisions of the Income Tax Act, Anti Money Laundering Laws or any other
applicable laws enacted by the Government of India from time to time. (C) Signature of the nominee acknowledging receipts of my/our credit will constitute full discharge of liabilities of Mirae Asset Mutual Fund. (D) The information given in / with this application form is
true and correct and further agrees to furnish additional information sought by Mirae Asset Global Investments (India) Limited (AMC)/ Fund and undertake to update the information/details with the AMC / Fund/Registrars and Transfer Agent (RTA) from time to time. I/We
hereby confirm that the AMC/Fund shall have the right to share my information and other details with the regulatory and government authorities as and when needed. I/We will indemnify the Fund, AMC, Trustee, RTA and other intermediaries in case of any dispute
regarding the eligibility, validity and authorization of my/our transactions. (E) I/We further declare that "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. (F) I/We hereby confirm that I/We have not been offered/ communicated any indicative portfolio and/ or any indicative yield by the
Fund/AMC/its distributor for this investment. I/We have not received nor have been induced by any rebate or gifts, directly or indirectly in making this investment. (G) Applicable to Investors availing the online facility:- I/We have read, understood and shall be
bound by the terms & conditions of the PIN agreement available on the AMC website for transacting online. (H) RIA:- I/We hereby permit the AMC to share my/our current & historic transaction details to the Registered Investment Advisor (RIA), if any transactions are
carried out using the RIA code. (I) Applicable to Foreign Resident's Residing in India:- I/ We confirm that I/We satisfy the Residency test as prescribed under FEMA provisions. I/We further declare that I/We am/are "Person Resident in India" and are allowed to invest
into the Scheme as per the said FEMA regulations and other applicable laws and regulations. (J) I / We confirm that I am / We are not United States person(s) under the laws of United States or resident(s) of Canada. In case of change to this status, I / We shall
notify the AMC, in which event the AMC reserves the right to redeem my / our investments in the Scheme(s). (K) FATCA /CRS Certification: I / We have understood the information requirements of this Form (read along with the FATCA & CRS Instructions) and
hereby confirm that the information provided by me / us on this Form is true, correct, and complete. I / We also confirm that I / We have read and understood the FATCA& CRS Terms and Conditions and hereby accept the same. In case the above information is not
provided, it will be presumed that applicant is the ultimate beneficial owner, with no declaration to submit. In such case, the concerned SEBI registered intermediary reserves the right to reject the application or reverse the allotment of units, if subsequently it is found that
applicant has concealed the facts of beneficial ownership. I/We also undertake to keep you informed in writing about any changes/modification to the above information in future & also undertake to provide any other additional information as may be required at your end.
(H) RIA: I/We hereby agree to consent the AMC to share my transaction details to the registered investment advisor (RIA) through the registrar or otherwise.

Signature of 1st Applicant / Guardian / Signature of 2nd Applicant / Guardian / Signature of 3rd Applicant / Guardian /
Authorised Signatory /PoA/Karta Authorised Signatory /PoA Authorised Signatory /PoA

Application No.: Cheque/DD should be Drawn in favour of the Scheme Name

Mirae Asset India Opportunities Fund Mirae Asset Emerging Bluechip Fund Mirae Asset Great Consumer Fund
Mirae Asset Prudence Fund Mirae Asset Tax Saver Fund Mirae Asset Cash Management Fund
Mirae Asset Savings Fund Mirae Asset China Advantage Fund Mirae Asset Dynamic Bond Fund

Mutual Fund investments are subject to market risks, read all scheme related documents carefully.
 SYSTEMATIC INVESTMENT PLAN (SIP) WITH TOP-UP FACILITY
Registration Cum Mandate Form For NACH/Direct Debit Application No.:

Name & Broker Code / Sub Broker / Sub Agent Code EUIN* Internal Code for ISC Date Time Stamp
ARN / RIA Code Agent ARN Code Sub-Agent/Employee Reference No.

Declaration for “Execution Only” Transaction (where Employee Unique Identification Number-EUIN* box is left blank). Please refer instruction 12 of KIM for complete details on EUIN. 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.

st nd rd
Signature of 1 Applicant / Guardian / Authorised Signatory / PoA / Karta Signature of 2 Applicant / Guardian / Authorised Signatory / PoA Signature of 3 Applicant / Guardian / Authorised Signatory / PoA

Please  Enrollment for New Registration (Please ll all sections) OR Change my/our bank account for existing SIP(s) OR SIP Top-up Facility
1. EXISTING UNIT HOLDER INFORMATION (The details in our records under the folio number mentioned will apply for this application.)
Folio No. Name of 1st Unit Holder
2. SIP ENROLMENT DETAILS (Please check the Minimum Amount Criteria for the scheme applied for. [Refer Instruction 18 Overleaf]).
Frequency Please  Monthly (Default) Quarterly Regular Plan Direct Plan Growth (Default) Dividend Payout Dividend Reinvestment

Scheme Div frequency*

*Dividend frequency is applicable only for Mirae Asset Cash Management Fund & Mirae Asset Savings Fund.
st th th st th
SIP Date Please  01 10 (Default) 15 21 28 SIP Amount (`) 5,000 10,000 25,000 Any other Amount. (`)
SIP Start Date: M M Y Y Y Y OR Enter SIP End Date: M M Y Y Y Y End Date : Perpetual Dec 2099 (Till you instruct Mirae Asset Mutual Fund to discontinue your SIP)
2a. SIP TOP-UP FACILITY (You can start SIP Top-up facility after minimum 6 months from 1st SIP) Refer Instruction No. 23 on the reverse on SIP Top-up
All Applicants have to submit NACH mandate and will need to ll the maximum amount in line with Top Up amount, SIP amount & tenure.

Top-up Amount (`) (minimum ` 500/- and in multiples of ` 1/- only) Top-up Start Date M M Y Y Y Y
Frequency Please  Half Yearly Yearly (Default) Top-up End Date M M Y Y Y Y

For Existing Investors: Original SIP details - SIP Date - SIP Amount (`)- Scheme -
3. SIP PAYMENT DETAILS
3a - Only for Existing Investors - I/We wish to register my/our SIP on the basis of Cancelled Cheque leaf or Photocopy of the Cheque submitted  Please
3b - For New Investors - Please provide copy of cancelled cheque and mention relevant SIP details in the form and NACH mandate. Cheque leaf enclosed

First SIP Cheque No. Drawn on Bank

Cheque Date A/c. Type NRE CURRENT SAVINGS NRO

05-2017
4. BANK ACCOUNT DETAILS (Mandatory)
I/We hereby authorise Mirae Asset Global Investments (India) Pvt. Ltd., Investment manager to Mirae Asset Mutual Fund acting through their authorised service providers to debit
my/our following Bank A/c. by NACH/ECS (Auto Debit Clearing / Direct Debit) Facility or any other facility for collection of SIP payments.
Name of 1st A/c. Holder as in Bank Records
Bank Name Core Banking A/c. No.

Branch Name & Address City

9 Digit MICR Code Bank Account Type  NRE CURRENT SAVINGS NRO
DECLARATION & SIGNATURE: To The Trustees, Mirae Asset Mutual Fund - I/We have read and understood the contents of the SID of the applied Scheme and the terms & conditions of SIP enrolment and registration through NACH/ECS or Direct Debit (Auto Debit).
I/We also agree that if the transaction is delayed or not effected for reasons of incomplete or incorrect or any other operational reasons, I/We would not hold Mirae Asset Global Investments (India) Pvt. Ltd., their appointed service providers or representatives
responsible. I/We also undertake to keep sufficient funds in my bank account on the date of execution of the said standing instructions. "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". "I/We have not made any other Micro application [including Lumpsum + SIPs] which together with the current
application would result in aggregate investments exceeding Rs. 50,000 in a rolling 12 month period or in a financial year".

Signature of 1st Applicant/Guardian/Authorised Signatory/PoA/Karta Signature of 2nd Applicant/Guardian /Authorised Signatory/PoA Signature of 3rd Applicant/Guardian/Authorised Signatory/PoA
(AS IN BANK RECORDS) (AS IN BANK RECORDS) (AS IN BANK RECORDS)
NACH MANDATE INSTRUCTION FORM (Refer Instruction over leaf before (Filling)

Tick()7 UMRN
1
For ofce use only 2
Date DD MM YYYY
Create
 Sponsor Bank Code3 Utility Code4
Modify
I/We, hereby authorize 5
Mirae Asset Global Investments (India) Pvt. Ltd. To Debit (Tick )6 SB / CA / CC / SB-NRE / SB-NRO / Other
Cancel 8
Bank A/c Number

Bank Name9 IFSC10 or MICR11

Amount in words12 Amount in Figures13 `

Frequency14 Mthly Qtly H-Yrly Yrly  As & when presented Debit Type15 Fixed Amount  Maximum Amount
16 18
Ref 1 : Folio No. Mobile

Ref 217 : Scheme Email ID19

I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my accounts as per latest schedule of charges of the bank.
Period20 D D M M Y Y Y Y
From

To 21 Signature of primary account holder Signature of joint account holder Signature of joint account holder

Or Until cancelled
22 Name of primary account holder Name of joint account holder Name of joint account holder
This is to confirm that declaration has been carefully read, understood & made by me/us. I am authorizing the User entity/Corporate to debit my account, based on the instructions as agreed and signed by me. I have understood that I am authorized
to cancel/amend this mandate by appropriately communicating the cancellation/amendment request to the User entity/corporate or the bank where I have authorized debit.