SIP REGISTRATION FORM

for first time investors, submit Common Application form along with this form.

Distributor Sub-Distributor Internal Sub-Broker/

ARN ARN Sol ID

EUIN Employee RIA CODE^

Code

PMR (Portfolio Manager's Registration) Number ^^

Upfront commission shall be paid directly by the investor to the AMFI registered distributor based on the investor's assessment of various factors including the service rendered by the
distributor. ^I/We, have invested in the scheme(s) of Axis Mutual Fund under Direct Plan. I/We hereby give my/our consent to share/provide the transactions data feed/portfolio
holdings/ NAV etc. in respect of my/our investments under Direct Plan of all schemes of Axis Mutual Fund, to the above mentioned SEBI Registered Investment Adviser. ^^I/We, have
invested in the scheme(s) of Axis Mutual Fund under Direct Plan. I/We hereby give my/our consent to share/provide the transactions data feed/portfolio holdings/ NAV etc. in
respect of my/our investments under Direct Plan of all schemes of Axis Mutual Fund, to the above mentioned SEBI Registered Portfolio Manager.

“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.”

You/ Sole Applicant /Guardian Second Applicant Third Applicant Power of Attorney Holder

TRANSACTION CHARGES FOR APPLICATIONS THROUGH DISTRIBUTORS ONLY (Refer Instruction No. 10)
I confirm that I am a first time investor across Mutual Funds. OR I confirm that I am an existing investor across Mutual Funds.

In case the subscription amount is ` 10,000 or more and your Distributor has opted 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.

DO NOT FILL THE MANDATE BELOW, IF OTM DETAILS ARE PROVIDED IN SECTION 2 ON THE NEXT PAGE.
To register Axis One Time Mandate, please fill and submit the One Time Mandate form separately.

UMRN Bank use Date D D M M Y Y Y Y

Tick ( ) Sponsor Bank Code Bank use Utility Code Bank use
CREATE I/We hereby authorize Axis Mutual Fund to debit (tick ) SB CA CC SB-NRE SB-NRO Other
MODIFY
Bank a/c number
CANCEL
with Bank Name of customers bank IFSC or MICR
an amount of Rupees In Words ` In Figures

FREQUENCY Mthly Qtly H-Yrly Yrly As & when presented DEBIT TYPE Fixed Amount Maximum Amount
Reference 1 PAN No. Phone No.
Reference 2 All Schemes of Axis Mutual Fund Email ID
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.

PERIOD
From D D M M Y Y Y Y

To D D M M Y Y Y Y Signature Primary Account holder Signature of Account holder Signature of Account holder
Or Until Cancelled 1. 2. 3.
Name as in bank records Name as in bank records Name as in bank records
This is to confirm that the declaration (as mentioned overleaf) 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 the debit.

MANDATORY FIELDS : • Instrument Date • Account type • Bank A/c number (core banking a/c no only) • Bank name • IFSC code or MICR code (as per the cheque / pass book) • Amount (in words & in figures) • Period start date and end date or
until cancelled • Account holder signature • Account holder name as per bank records. Reference 1 - PAN.
ACKNOWLEDGMENT SLIP (To be filled by the investor)
Investor Name

SIP Scheme 1 Top-up Yes No

SIP Scheme 2 Top-up Yes No

SIP Scheme 3 Top-up Yes No Stamp & Signature

 1. YOUR INFORMATION (MANDATORY) EXISTING INVESTOR’S FOLIO NUMBER Folio number
(If you have an existing folio with KYC validated, please mention here)

Your Name (as in PAN Card / KYC records) Mr. Ms. M/s.

Name of the Guardian Mr. Ms. M/s. (In case First / Sole Applicant is minor) / Contact Person - Designation / PoA HOLDER (In case of Non-individual Investors)

Your PAN 2nd Holder PAN

3rd Holder PAN

2. SIP DETAILS SIP Registration Mode A-OTM K-OTM Mandate along with SIP form

OTM Reference No. (if Multiple One Time Mandate are registered)

SIP Amount TOP-UP Facility

SIP Date Enrollment Period (Optional) Only available for Monthly SIP
Scheme / Plan / Option Frequency *Mandatory to write both
(DD) (MMYY) figures and in words Frequency Amount

Monthly in figures Half Yearly in figures

From ` `
Yearly Default To Yearly
SIP Date 7th in words in words
or 1 2 9 9 Dynamic TOP-UP

Monthly in figures Half Yearly in figures

From ` `
Yearly Default To Yearly
SIP Date 7th in words in words
or 1 2 9 9 Dynamic TOP-UP

Monthly in figures Half Yearly in figures

From ` `
Yearly Default To Yearly
SIP Date 7th in words in words
or 1 2 9 9 Dynamic TOP-UP
SIP initial payment details (Optional)
Drawn on bank / branch name Amount

Mode Cheque/DD Cheque/DD Dated D D M M Y Y Y Y

In case of multiple SIP, mention "Axis MF Multiple Schemes" on the payment instrument.

INSTRUCTIONS FOR SIP & TOP-UP

1. Multiple SIP registration facility is not available for Axis Children's Gift Fund, Axis Liquid Fund, The requirement of minimum application amount shall not be applicable if the investment
ETF schemes and during NFO. amount falls below the minimum requirement due to deduction of transaction charges from
2. Investors are required to submit Form along with a photo copy/cancelled cheque of Debit the subscription amount.
Bank Account at least 21 days before the first SIP Installment date. However, the option to charge “transaction charges” is at the discretion of the distributors.
3. Investor shall have the option of choosing any date of the month as the SIP date except the Investors may note that distributors can opt to receive transaction charges based on type of
dates 29th, 30th and 31st. If SIP date is not mentioned, default date would be considered as the Scheme. Accordingly, the transaction charges would be deducted from the subscription
7th of every month. If the SIP date falls on a non-business day or a bank holiday, the SIP debit amounts, as applicable.
will be processed on the following business day. 11. Investor will not hold Axis Mutual Fund, its registrars and other service providers responsible
4. Please refer below table for minimum monthly/yearly installments: if the transaction is delayed or not effected or the investor bank account is debited in advance
Scheme Monthly Yearly or after the specific SIP date due to various clearing cycles of NACH Debit/ Local/Bank
Minimum Minimum Minimum Minimum holiday. Axis Mutual Fund, its registrars and other service providers shall not be held
Amount (`) Installments Amount (`) Installments responsible or liable for damages / compensation / loss incurred by the investor as a result of
using the SIP or ECS / Auto debt facility. The investor assumes the entire risk of using this
All Schemes except below schemes, 1000 6 facility and takes full responsibility.
Axis Overnight Fund & Axis Liquid Fund
12. Investor can change bank details for SIP by submitting a “CHANGE OF BANK MANDATE -
Axis Bluechip Fund, Axis Midcap Fund, 500 6 12000 3 FOR SIP” form available on the website or at any Investor Service Centre along with
Axis Multicap Fund, Axis Smallcap cancelled cheque of the new bank with the investor’s name printed on it.
Fund, Axis Focused 25 Fund &
Axis Nifty 100 Index Fund 13. TOP-UP Facility: Under this facility the Investor can increase the SIP installment at pre-defined
intervals by a fixed amount or any time as per the request. This facility is available for individual
Axis Long Term Equity Fund* 500 6 6000 3 investors only. For availing the said facilities, investors are required to note the following:
Note: For all schemes, minimum amount is as per above table and thereafter in multiple of ` 1. • Investor willing to register TOP-UP should provide the TOP-UP details along with the SIP
For Long Term Equity Fund Minimum amount is as per above table and thereafter in multiple enrolment details.
of ` 500*. • The minimum amount for Axis TOP-UP facility is ` 500/- and in multiples of ` 1/- for all
5. If no amount is mentioned minimum scheme amount would be considered i.e. for Axis Long schemes; except Axis Long Term Equity Fund the minimum amount is ` 500 and in
Term Equity Fund minimum amount would be ` 500/- and for other schemes minimum multiples of ` 500 thereafter.
amount would be ` 1,000/-. • If no amount is mentioned as TOP-UP amount under frequency yearly and half-yearly,
6. For details about the Scheme and its facility please refer the SID, SAI & KIM of the respective minimum TOP-UP amount would be considered, i.e., ` 500/- for all schemes.
schemes / Addendum issued from time to time carefully before investing. • TOP-UP frequencies available are Half-Yearly/ Yearly/ Dynamic requested intervals.
7. The SIP will be discontinued automatically if payment is not received for three successive • In case TOP-UP frequency is not indicated, it will be considered as Yearly by Default.
installments.
• The date for Axis Mutual Fund TOP-UP Facility will correspond to the registered SIP.
8. Investors can discontinue a SIP at any time by sending a written request to any Official Point of
Acceptance or to the registrar M/s. KFin Technologies Private Limited. Notice of such • TOP-UP will continue till the End of the SIP tenure by default.
discontinuance should be received at least 20 days prior to the due date of the next • In case an investor wishes to change the Top-Up amount, he/she has to provide a
installment / debit. cancellation for the existing SIP and register fresh SIP.
9. Mandate will be processed through NACH platform offered by NPCI. • Only TOP-UP cannot be discontinued anywhere during the SIP tenure.
10. As per SEBI circular dated August 22, 2011, Transaction Charge per subscription of • In case of Dynamic Top up option, any changes in the amount can be made only after
` 10,000/- and above shall be charged from the investors and shall be payable to the completion of 6 months from the date of the first installment and minimum gap between
distributors/ brokers (who have not opted out of charging the transaction charge) in respect two top up requests should be 3 months and amount specified in last request shall be
of applications routed through distributor/broker relating to Purchases / subscription / new continued till the End of the SIP tenure.
inflows only (lumpsum and SIP), subject to the following: • Please see the illustration below to know how to calculate SIP Top-Up amount:
• For Existing / New investors: `100 / `150 as applicable per subscription of `10,000/– • SIP Starts on 07/May/2016 ∙ SIP ends on 07/12/2099 ∙ SIP amount is `1000
and above. • Top-Up amount is ` 500 ∙ Top-Up Frequency is Half-yearly
• Transaction charge for SIP shall be applicable only if the total commitment through SIP Top-Up date SIP Amount Top-Up New SIP
amounts to `10,000/- and above. In such cases the transaction charge would be (`) Amount (`) Amount (`)
recovered in maximum 4 successful installments. 7-Nov-2016 1000 500 1500
• There shall be no transaction charge on subscription below `10,000/-. 7-May-2017 1500 500 2000
• There shall be no transaction charges on direct investments. 7-Nov-2017 2000 500 2500
• There shall be no transaction charges for transaction other than purchases/subscriptions 7-May-2018 2500 500 3000
relating to new inflows such as Switches, etc.
14. It is Mandatory to write SIP amount in both figures and in words.
• Transactions carried out through the Stock Exchange platforms for mutual funds shall not
be subject to transaction charges.
 3. Declaration and Signature (to be signed by all unit holders if mode of holding is ‘joint’)

I / We declare that the particulars furnished here are correct. I / We authorize Axis Mutual Fund acting through its service providers to debit my / our bank account towards
payment of SIP installments and/ or any lumpsum payments through an Electronic Debit arrangement / NACH (National Automated Clearing House) as per my request from
time to time. If the transaction is delayed or not effected at all for reasons of incomplete or incorrect information, I/We would not hold the user institution responsible. I/We will
also inform Axis Mutual Fund about any changes in my bank account. I/We hereby authorize to honour such payments and have signed and endorsed the Mandate Form.
Further, I authorize my representative (the bearer of this request) to get the above Mandate verified. Mandate verification charges, if any, may be charged to my/our account.

You/ Sole Applicant /Guardian Second Applicant Third Applicant