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FIDELITY - INDIVIDUAL KYC FORM
Know Your Client (KYC)
Application Form (For Individuals Only) Application
No. :
Please fill this form in ENGLISH and in BLOCK LETTERS (All Information as applicable in Sections A, B and C below is mandatory)
This information is sought under the Prevention of Money Laundering Act, 2002, the rules notified thereunder and SEBI’s guidelines on Anti Money Laundering.
For existing Mutual Fund investors, the address(es) furnished herein will be replaced in the records of the Mutual Fund / Authorised Agent. (Refer Notes / Guidelines overleaf)
1. Name of Applicant (As appearing in supporting identification document) Title Mr. Ms. Others
DECLARATION
2. Date of Birth
Please affix
most recent
colour photograph
30 mm x 40 mm
Sign across the photograph
I hereby confirm that I have read and understood the Instructions mentioned overleaf and apply to CDSL Ventures Limited ('CVL') or other agent of the mutual
fund registered under the SEBI (Mutual Funds) Regulations, 1996 for compliance of Know Your Client (KYC) procedure for transacting in units issued by Mutual
Funds and I agree to abide by the terms, conditions, rules, regulations and other statutory requirements applicable to the respective Mutual Funds. I hereby declare
that the particulars given herein are true, correct and complete to the best of my knowledge and belief, the documents submitted along with this application are
genuine and I am not making this application for the purpose of contravention of any Act, Rules, Regulations or any statute or legislation or any Notifications,
Directions issued by any governmental or statutory authority from time to time. I hereby undertake to promptly inform CVL / the mutual fund agent of any changes
to the information provided hereinabove and agree and accept that CVL, the respective Mutual Funds, their authorised agents and representatives ('the Authorised
Parties') are not liable or responsible for any losses, costs, damages arising out of any actions undertaken or activities performed by them on the basis of the information
provided by me as also due to my not intimating / delay in intimating such changes. I hereby authorize CVL / the mutual fund agent to disclose, share, remit in
any form, mode or manner, all / any of the information provided by me to the respective Mutual Funds in which I may transact / have transacted and / or to their
authorised agents and representatives including all changes, updates to such information as and when provided by me. I hereby agree to provide any additional
information / documentation that may be required by the Authorised Parties, in connection with this application. I hereby confirm that this is a unique KYC application
and I have not applied for KYC in the past.
Name
Father's Name
5. Proof of Identity Permanent Account Number (PAN) (MANDATORY)
Please tick () Copy of PAN Card attached
For
Office
Use
Only
Name and Employee Number of Receiver
(Attested) True copies of documents received
(Originals Verified) Self Certified Document copies received
A. Identity Details (Please see guidelines A1 to A6 overleaf)
Please specify Gender Male Female
SIGNATURE OF APPLICANT
Place :
Date :
Stamp of POS
(Name & Location)
& Receiver's Signature K
Y
C
Re f. I
"P
le as e no te t ha t th e KY
C
Ap pl ic at io n Fo rm a nd o ve rle
af in st ru ct io ns s ho ul d be p rin
te d on t he s am e pa ge (
ba ck t o ba ck ).
If pr in te d se pa ra te ly t he n bo th t he p ag es s ho ul d be a tt ac he d an d si gn ed b y th e ap pl ic an t."
4. Status Please tick () Resident Individual Non Resident: Passport / PIO Card / OCI card No.___________________________
(Passport copy & overseas address proof mandatory for NRI)
/ /D D M M Y Y Y Y
3. Nationality Indian Others Please specify
B. Address Details (Please see guidelines B1 to B4 overleaf)
5. Proof of address to be provided by Applicant. Please submit ANY ONE of the following valid documents & tick () against the document attached.
Latest Land Line Telephone Bill Latest Electricity Bill Passport Driving License Latest Bank Passbook Latest Bank Account Statement
Latest Demat Account statement Voter Identity Card Ration Card Registered Lease / Sale Agreement of residence For NRIs - Any other document attested by local authority.
3. Proof of address to be provided by Applicant. Please submit ANY ONE of the following valid documents & tick () against the document attached.
Latest Land Line Telephone Bill Latest Electricity Bill Passport Driving License Latest Bank Passbook Latest Bank Account Statement
Latest Demat Account statement Voter Identity Card Ration Card Registered Lease / Sale Agreement of residence Any other proof of address document (as listed overleaf)
2. Contact Details
4. Permanent Address of Resident Applicant if different from B1 above OR Overseas Address (Mandatory) for Non-Resident Applicant
1. Address for Correspondence
City / Town / Village Postal Code
State Country
E-Mail Id.
Tel. (Off.) (ISD) (STD) Tel. (Res.) (ISD) (STD)
Mobile (ISD) (STD) Fax (ISD) (STD)
City / Town / Village Postal Code
State Country
1. Gross Annual Income Details Please tick ()
Upto Rs. 5,00,000 Rs. 5,00,001 to Rs. 25,00,000 Rs. 25,00,001 to Rs. 1,00,00,000 Rs. 1,00,00,001 to Rs. 5,00,00,000 Rs. 5,00,00,001 and above.
2. a. Occupation Details Please tick () any one
Private Sector Service Public Sector / Government Service Business Professional Agriculturist Retired Housewife
Student Forex Dealer Others (Please specify) _______________________________________
b. If the following is additionally applicable to you Please tick () as applicable
Politically Exposed Person (PEP) Related to a Politically Exposed Person (PEP)
For definition of PEP, please refer guideline C3 overleaf
C. Other Details (Please see guidelines C1 and C2 overleaf)
FIDELITY - INDIVIDUAL KYC FORM
8. If an individual becomes a Mutual Fund Investor due to an operation of law, e.g., transmission
of units upon death of an investor, the claimant / person(s) entering the Register of Unitholders
of the participating Mutual Fund(s) will be required to be KYC compliant before such transfer
can take place.
9. The KYC process requires investors to provide their Proof of identity (PAN card copy only) and
Proof of Address (any valid documents listed in section B of the KYC Application Form) to
comply with KYC requirements. Participating Mutual Funds reserve the right to seek any
additional information / documentation in terms of the PMLA at any point of time.
10. Participating Mutual Funds/ CVL will not be liable for any errors or omissions on the part of
the applicant / Unit holders in the KYC Application Form. Documents received in support of
KYC requirements will be verified at the designated “Points of Service” (PoS), on a best effort
basis. However acceptance and processing of the KYC Application Form is subject to independent
verification by CVL. In the event of any KYC Application Form being rejected for lack of
information / deficiency / insufficiency of mandatory documentation, etc. CVL will inform the
applicant of such rejection.
11. The participating Mutual Fund, its Asset Management Company (AMC), Trustee Company and
their Directors, employees and agents shall not be liable in any manner for any claims arising
whatsoever on account of freezing the folios / rejection of any application / non-allotment of
units or mandatory redemption of units / refund due to non-compliance with the provisions
of the PMLA, SEBI guidelines or where the AMC / Mutual Fund believes that transaction(s) by
an applicant / investors is / are suspicious in nature within the purview of the PMLA and SEBI
guidelines and requires reporting the same to Financial Intelligence Unit - India (FIU-IND).
12. Once the investor is KYC compliant, he will be required to intimate his/her KYC details to all
the participating Mutual Funds with whom he/she has investments. The KYC Compliance will
be deemed to have been completed for the investor in all folios held by him/her (identified
by his/her PAN) in the records of the participating Mutual Fund.
13. In case of NRI, details of overseas address along with proper proof for the same & passport
copy are mandatory documents.
1. This Application Form is meant to enable a person to comply with the client identification
programme laid down by the Prevention of Money Laundering Act, 2002 (PMLA) hereinafter
referred to as Know Your Client (KYC) requirements. It is for use by INDIVIDUALS only. A
separate form is provided for non-individual entities such as Hindu Undivided Family (HUF),
Corporates, Trusts, Societies, etc.
2. This form is not an Investment Application Form, and is only meant for providing information
and documents required for KYC compliance. Applicant must be KYC compliant while
investing with any SEBI registered Mutual Fund which has subscribed to the services of CDSL
Ventures Limited (CVL) for compliance of the KYC procedure. A list of participating Mutual
Funds is available on the website of AMFI at www.amfiindia.com.
3. Subscription to participating Mutual Fund Units may be made only after obtaining the KYC
Acknowledgement at their respective designated Points of Acceptance / Investor Service
Centres.
4. Each Unitholders / Investors must attach their KYC Acknowledgement along with the Investment
Application Form(s) / Transaction Slip(s) while investing for the first time in every folio.
Applications Forms / Transaction Slips not accompanied by KYC Acknowledgement are liable
to be rejected by the participating Mutual Funds.
5. Joint Holders: Joint holders need to be individually KYC compliant before they can invest with
any participating Mutual Fund. e.g. in case of three joint holders, all holders need to be KYC
compliant and copies of each holder’s KYC Acknowledgement must be attached to the
investment application form with any Mutual Fund.
6. Minors: In case of investments in respect of a Minor, the Guardian should be KYC compliant
and attach their KYC Acknowledgement while investing in the name of the minor. The Minor,
upon attaining majority, should immediately apply for KYC compliance in his/her own capacity
and intimate the participating Mutual Fund(s) concerned, in order to be able to transact further
in his/her own capacity.
7. Power of Attorney (PoA) Holder: Investors desirous of investing through a PoA must note
that the KYC compliance requirements are mandatory for both the PoA issuer (i.e. Investor)
and the Attorney (i.e. the holder of PoA), both of whom should be KYC compliant in their
independent capacity and attach their respective KYC Acknowledgements while investing.
IMPORTANT NOTES - PLEASE READ BEFORE FILLING UP THE FORM
(documents to establish relationship also to be submitted) name as supporting documents.
Please tick the box as applicable, for the document provided by you. You may attach any one
of the following documents (Any document having an expiry date should be valid on the date
of submission):
• Latest* Land Line Telephone Bill • Latest* Electricity Bill • Passport • Driving License • Latest*
Bank Passbook • Latest* Bank Account Statement • Voter Identity Card • Ration Card • Latest*
Demat Account Statement • Registered Lease / Sale Agreement of residence • Proof of Address
issued by Bank Managers of Scheduled Commercial Banks / Multinational Foreign Banks /
Gazetted Officer/ Notary Public / Elected Representatives to the Legislative Assembly / Parliament /
Any other document approved by AMFI as a valid address proof.
* These documents should not be more than three months old as on the date of submission
of this form.
4. Permanent Address / Overseas Address: If you are a Resident Indian, and your Permanent
address is different from the one mentioned in the Address for Correspondence, please state
it here. If you are a Non-Resident Indian or a Person of Indian Origin, it is mandatory for you
to state your Overseas Address here.
C. Other details
1. Gross Annual Income details: Please tick the applicable box indicating your Gross Annual
Income (including both taxable and tax-free incomes).
2. Occupation details: Please indicate your current occupation by ticking the one most applicable
to you. You are required to fill up the next section, if it additionally applies to you.
3. Politically Exposed Persons (PEP) are defined as individuals who are or have been entrusted
with prominent public functions in a foreign country, e.g., Heads of States or of Governments,
senior politicians, senior Government/judicial/ military officers, senior executives of stateowned corporations, important political party officials, etc.
After you have completed filling up the KYC Application Form, please submit the same
along with the entire set of supporting documents to any designated PoS. Please also
submit a photocopy of the Form for acknowledgement purpose, which you can retain for
your records.
Other important notes, after the KYC Acknowledgement is issued to you:
1. Please preserve the document from CVL which confirms your KYC compliance. You will need
to attach photocopies of this document when you invest for the first time in every folio, in
any participating Mutual Fund.
2. If you observe any error in the details captured by CVL, you are requested to approach your
nearest designated PoS.
3. If you are already holding investments in any participating Mutual Funds, please provide a copy
of your KYC acknowledgement, giving details of your folio / account numbers to such Funds
or their Registrars. Please note that your signature on the KYC Application Form should match
with that on the records of the participating Mutual Funds.
4. In respect of new investors, signature on the Application Form for investing / transacting in
participating Mutual Fund should match with that on this KYC Application Form.
5. After allotment of KYC compliance, if there are any changes in an Applicant’s details such as
Name, Address, Status, Income bracket, Occupation or Signature, the change should be
registered with CVL through a designated PoS expeditiously, by using the KYC Details Change
form. It should be noted that only after such registration will the change be reflected
in the participating Mutual Fund’s records. Particularly with respect to change of
address, investors should register such change giving 10 days time for the subsequent
communications from participating Mutual Funds to reach them at their new address.
Original / Attested copies of documents supporting the change will be required to be submitted
together with the KYC Details Change Form. For any other investment related information
or changes thereto, the applicant should approach the participating Mutual Funds or
their Registrars.
General
1. The Application Form should be completed in ENGLISH and in BLOCK LETTERS.
2. Please tick in the appropriate box wherever applicable.
3. Please fill the form in legible handwriting so as to avoid errors in your application processing.
Please do not overwrite. Corrections should be made by canceling and re-writing, and such
corrections should be counter-signed by the applicant.
4. Applications incomplete in any respect and/or not accompanied by required documents are
liable to be rejected.
5. Applications complete in all respects and carrying necessary documentary attachments should
be submitted at the designated PoS. A complete list of PoS is available on the website of AMFI
at www.amfiindia.com, www.cdslindia.com and Mutual Fund websites.
6. You are required to submit a Proof-of-Identity document and a Proof-of-Address document
for each address filled by you in this form. Documents submitted to support Identity and
Address should be
i. Proof of Identity
• Original PAN Card + Self-attested photocopies (Originals will be returned over-the-counter
after verification)
ii. Proof of Address
• Original Documents + Self-attested photocopies (Originals will be returned over-the-counter
after verification) OR
• True Copies attested by a Notary Public / Gazetted Officer / Manager of a Scheduled Commercial
Bank or Multinational Foreign Banks (Name, Designation and Seal should be affixed on the
copy). Unattested photocopies of an original document are not acceptable
• If the above documents including attestation / certifications are in regional language or foreign
language then the same has to must be translated into English for submission.
A. Identity Details
1. Name: Please state your name as Title (Mr/Mrs/Ms/Dr/Commander/etc.), First, Middle and Last
Name in the space provided. This should match with the name as mentioned in the PAN
card failing which the application is liable to be rejected. If the PAN card has a name
by which the applicant has been known differently in the past, than the one provided
in this application form, then requisite proof should be provided e.g. marriage
certificate, or gazetted copy of name change.
2. Date of Birth: Please ensure that this matches with the Date of Birth as indicated in the PAN
card.
3. Nationality: Foreign Nationals are not allowed to apply, unless they are Non-Resident Indians
(NRIs) or Persons of Indian Origin (PIO).
4. Status : Please tick your current residential status.
5. Please affix most recent colour photograph and sign across the photograph.
B. Address Details
1. Address for Communication : Please provide here the address where you wish to receive all
communications sent by the participating Mutual Funds with whom you invest. The address
you give here will supercede existing information in the records of the participating
Mutual Fund / Registrars and Transfer Agent to the participating Mutual Fund. This
address should match with the address in the ‘Proof-of-Address’ submitted as
supporting document; otherwise the KYC Application Form is liable to be rejected.
2. Contact Details: Please provide your Telephone / Email contact details. The contact details given
by you here will not supercede existing information in the records of the participating Mutual
Fund / Registrars and Transfer Agent to the participating Mutual Fund. You will have to
independently communicate the same to them in case of any change(s).
3. Proof of Address Documents : Please note that each of the two addresses mentioned by you
will need to be supported by a ‘Proof-of-Address’ bearing your or your spouse’s / parent’s
GUIDELINES FOR FILLING UP THE KYC APPLICATION FORM
CHECKLIST
(Before submitting this form, please go through the following checklist)
1. Please ensure that the form is completed in all respects and signed by you.
2. Please affix your recent photograph and sign across the photograph.
3. Please attach your PAN card as proof of Identity. This should be a photocopy plus original for verification.
4. Please attach a Proof of Address Document (one for each distinct address). These should be either original + photocopies or attested / notarised photocopies.
5. If you are an NRI, you must mention your overseas address in B(4).
6. Please submit a photocopy of the duly completed KYC Application Form.
a lo k g ra p h ic s For assistance or enquiries please approach the Point of Service where you had submitted your KYC Application Form.
Investors Applying for KYC, Please Submit the KYC Documents on A4 Size Paper Only.

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