Common Application Form
Common Application Form
App. No.
Time Stamp
Please refer to the general instructions for assistance and complete all sections in English. For legibility, please use BLOCK LETTERS in black or dark ink.
Distributor/RIA Code Sub-Distributor ARN Sub-Distributor Code EUIN Branch Code
Transaction Charges: SEBI (Mutual Fund) Regulations allow deduction of transaction charges of Rs. 100/- from your investment for payment to your distributor if your distributor has opted to receive
transaction charges for investments sourced by him. The transaction charges deductible are Rs. 150/- if you are investing in Mutual Funds for the first time. If you are making a SIP Investment, the transaction
charges would be deducted over 3-4 instalments. No transaction charges would be levied if you are not investing through a Distributor or your investment amount is less than Rs.10,000/-.
If this is the first time, you are investing in any mutual fund, please tick here
Investor’s Declaration where EUIN is not furnished: I/We confirm that the EUIN box has been intentionally left blank by me/us as this is an “execution only” transaction without any interaction or advice by
the employee/relationship manager/sales person of the above distributor and/or notwithstanding the advice of inappropriateness, if any, provided by the employee/relationship manager/sales person of distributor
and the distributor has not charged any advisory fees on this transaction.
1. EXISTING UNIT HOLDER’S INFORMATION (If you hold a Folio with L&T Mutual Fund, please furnish the below information and move to Investment & Payment Information section.)
Name of Sole/1st Unit Holder Mr. Ms. M/s First Name Middle Name Last Name Folio No.
Name of 1st/Sole Applicant Mr. Ms. M/s First Name Middle Name Last Name
Name Mr. Ms. M/s First Name Middle Name Last Name
Relationship with Minor Applicant Proof of Date of Birth Proof of the Relationship with minor
Natural Guardian Birth Certificate Copy Passport Copy Birth Certificate Copy Passport Copy Court Appointment Order
3. Details of other Applicant(s) (Please note that where the sole/1st applicant is a minor, no joint holders are allowed)
Name of 2nd Applicant Mr. Ms. M/s First Name Middle Name Last Name
Name of 3rd Applicant Mr. Ms. M/s First Name Middle Name Last Name
Correspondence Address
Tel (R) (ISD) (STD) Tel (O) (ISD) (STD) Fax (ISD) (STD)
Non Resident Indian Individual (NRI) – Repatriable Partnership Firm Limited Liability Partnership (LLP) Gratuity Fund
Non Resident Indian Individual (NRI) –Non Repatriable Public Ltd. Co. Financial Institutions Overseas Corporate Body
Minor (Resident Indian) Foreign Portfolio Investor (FPI) Non Govt. Organization (NGO)
Private Ltd. Co.
Foreign Institutional Investor (FII) Association of Persons(AOP)/Body
Minor (NRI - Repatriable)
Body Corporate of Individuals(BOI)
Minor (NRI – Non Repatriable) FPI - Category I
Unlisted Company Bank
FPI - Category II
Hindu Undivided Family (HUF) – Indian
Government Body Pension and Retirement Fund
FPI - Category III
Hindu Undivided Family (HUF) – NRI - Repatriable Global Development Network
NPS Trust Insurance Company
Hindu Undivided Family (HUF) – NRI – Non- Others
Repatriable Provident Fund / EPF / PF Trust Defence Establishment
Are you a Non Profit Organization
Person of Indian Origin (PIO) Mutual Fund Society (NPO) Yes No
7. Mode of Holding
Please ü Sole/1st Holder only Any one or Survivor* Joint
(If the mode of operation is not specified, for folios opened with more than one applicant, the mode of operation would be taken as “Any one or Survivor”)
If your investment is being made by a Constituted Attorney on your behalf, please furnish the below details and enclose a original notarised copy of the Power of Attorney for
registering the same:
POA Holder’s Name Mr. Ms. First Name Middle Name Last Name
PoA for Sole / First Applicant Second Applicant Third Applicant E-mail Id
This is only acknowledgment of receipt of application and will be processed as per the contents filled in the application, subject to realisation of cheque and furnishing of mandatory
information/ documents.
Note: Effective February 1, 2021, units will be allotted only upon receipt of subscription amount by the Fund House for utilisation irrespective of any scheme
category/investment amount. Net Asset Value (NAV) will be applied based on realization of funds for all purchases including systematic transactions registered
prior or post February 1, 2021. Please retain this slip till you receive your account statement.
call 1800 4190 200 or 1800 2000 400 email [email protected] www.ltfs.com
Please note our lines are open from 9 am to 6 pm, Monday to Friday and 9 am to 1 pm on Saturday
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10. Investment & payment information (Please ensure that the cheque complies to the Cts 2010 standards)
1. Investment Type (ü) Lumpsum SIP Multi-Scheme Lumpsum Multi-Scheme SIP (Please fill Multi-Scheme SIP investment form)
Micro SIP (For SIP/Micro SIP, please fill SIP Investment Form)
For Lumpsum & Sip Investment (Please issue cheque favouring scheme name)
Scheme Name L&T Option (ü) Growth* IDCW@ Payout IDCW@ Reinvestment Bonus^
IDCW@ Frequency (üwherever applicable) Daily Weekly Monthly* Quarterly Annual^ Semi-Annual^
For Multi-Scheme SIP/Multi-Scheme Lumpsum (Please issue cheque favouring L&T MF Multi-Scheme SIP and L&T MF Multi Scheme Lumpsum respectively)
Total Investment Amount (`) DD Charges (if applicable `) Net Amount (`)
Scheme 1 : L&T Option (ü) Growth* IDCW@ Payout IDCW@ Reinvestment Bonus^
Scheme 2 : L&T Option (ü) Growth* IDCW@ Payout IDCW@ Reinvestment Bonus^
Scheme 3 : L&T Option (ü) Growth* IDCW@ Payout IDCW@ Reinvestment Bonus^
If One Time Mandate, Please fill, Unique Mandate Reference Number (UMRN)
11. kyc details (Mandatory. If left blank the application is liable to be rejected)
categories First Applicant/ Guardian Second Applicant Third Applicant
Below 1 lac 1-5 Lacs Below 1 lac 1-5 Lacs Below 1 lac 1-5 Lacs
Gross Annual 5-10 Lacs 10-25 Lacs 5-10 Lacs 10-25 Lacs 5-10 Lacs 10-25 Lacs
Income 25 Lacs - 1 crore > 1 Crore 25 Lacs - 1 crore > 1 Crore 25 Lacs - 1 crore > 1 Crore
(For Individuals Net-worth in (Mandatory for Non-Individuals) Net-worth Net-worth
and Non
Individuals) (`) as on (`) as on (`) as on
D D / M M / Y Y Y Y (Not older than 1 year) D D / M M / Y Y Y Y (Not older than 1 year) D D / M M / Y Y Y Y (Not older than 1 year)
Private Sector Service Retired Private Sector Service Retired Private Sector Service Retired
Public Sector Service Student Public Sector Service Student Public Sector Service Student
Occupation
Details Government Service Forex Dealer Government Service Forex Dealer Government Service Forex Dealer
(For Individuals Business Agriculturist Business Agriculturist Business Agriculturist
only) Professional Housewife Professional Housewife Professional Housewife
Others Please specify Others Please specify Others Please specify
Others I am politically Exposed Person I am politically Exposed Person I am politically Exposed Person
(For Individuals I am Related to Politically Exposed Person I am Related to Politically Exposed Person I am Related to Politically Exposed Person
only) Not Applicable Not Applicable Not Applicable
Additional KYC Details for Non-Individuals
Is the company a Listed Company or Subsidiary of Listed Company or Controlled by a Listed Company YES NO
Others
(If No, please attach Ultimate Beneficiary Ownership Declaration mandatorily)
(For Non-
If the Entity involved/providing any of the following services: YES (Please ü from below) NO
Individuals only)
Gaming/Gambling/Lottery/Casino Services Foreign Exchange/ Money Changer Services Money Lending/Pawning
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12. information required for tax reporting (Mandatory. If left blank the application is liable to be rejected)
I am a tax resident of India and not a resident of any other country Yes No
If No, please mandatorily enclose the FATCA & CRS Declaration for Individual Investors.
For non-Individuals: Please mandatorily enclose the FATCA, CRS & UBO Declaration for Non Individuals with all the sections filled.
13. NOMINATION DETAILS (Please note that where the sole/1st applicant is a minor, no nomination is allowed)
(Please ü) I/We wish to Nominate I/We do not wish to Nominate
I/We do hereby nominate the person(s) named below to receive the units allotted to my/our credit in my/our folio in the event of my/our death. I/We also understand that all
payments and settlements made to Nominee(s), and signature(s) of the Nominee(s) acknowledging receipt thereof, will be noted as be a valid discharge by the AMC/Mutual Fund/
Trustee. This instruction supercedes all previous nominations made by me/us in respect of the folio indicated above.
Particulars 1st Nominee 2nd Nominee 3rd Nominee
Name
Address
City
State
Country
Pincode
Allocation %
Signature of Guardian
(if nominee is minor) (mandatory)
Signature of Nominee
Date: D D M M Y Y Y Y
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General Instructions for common application form
Please read the below instructions carefully before filling the form. Please fill up the form in English in BLOCK LETTERS with black or dark ink. All information sought
in the form is mandatory except where it is specifically indicated as optional. All instructions & notes are subject to SEBI & AMFI guidelines as amended from time to
time. Please note in case of any error while fi lling the form all applicants must sign against the corrections.
1. Existing Unit Holders: If you hold a folio with us, please furnish the Folio For non-Individual applicants, KYC Compliance requires identification
Number, Name and PAN of Sole/First Applicant in Section 1 of the Form. of the customer by seeking relevant information on incorporation,
Your investment would be processed in the specified folio. commencement of business, tax status, nature of entity, nature
Your personal information and bank account details would apply to this of business, address and certain details of Promoters/Partners/
investment as well. Trustees/Whole Time Directors/Kartas of HUF. SEBI has appointed
KYC Registration Agencies ( KRA) to facilitate a single KYC across
2. New Applicants: New Applicants need to provide their personal information all SEBI registered intermediaries. For more information on KYC
in Section 2 of the Form. requirements, please visit our web site or speak to your investment
If there are more than one applicants and the mode of operation of the adviser.
account is not indicated, the same would be treated as “Any one or c. If the investment is being made on behalf of a minor applicant, the
Survivor”. Guardian needs to comply with KYC requirements.
In case of Non-Individual Applicants : d. If the investment is being made by a Constituted Attorney on behalf of
a. SEBI has mandated identification of Ultimate Beneficial Owners for an applicant, the Attorney needs to comply with KYC requirements.
non-individual investors other than listed companies (and majority 7. Address & Contact Information:
owned subsidiary of such companies).
a. Please furnish your full address with postal code in the Application
If the applicant investing is not the ultimate beneficiary owner, please Form. PO Box Number is not sufficient
also fill up the Declaration For ‘Ultimate Beneficiary Ownership’ form
to furnish details of such person(s). b. Please note that your address on our records would be automatically
updated with your address appearing in the records of the KRA. If your
b. The Foreign Account Tax Compliance Act (FATCA) of the USA, address in the application form is different from what appears in the
stipulates identification of US account holders and reporting of records of the KRA, please ensure that your latest address is updated
details related to US Account Holders to the Inland Revenue Service in the records of the KRA.
(IRS) in the U.S. India has agreed to sign the Inter-Governmental
Agreement with USA which inter alia includes reporting of holdings c. Please provide the Mobile Number and E-Mail Address of the Sole
and transactions in specified US Accounts. Accordingly, certain / First Applicant in case of of Individual Applicant and Key Contact
additional information are being sought from investors. Non-Individual Person in case of Non-Individual Applicants in the form. This would
investors also need to indicate if they qualify under any of the heads help us seamlessly communicate with you on your investments.
of classification stipulated under FATCA. 8. Permanent Account Number (PAN): Furnishing of PAN is mandatory for
3. Investments by Minor Applicants: If the Sole/First applicant is a minor all applicants except where specific dispensation is provided under law.
i.e. below 18 years of age: 9. Demat Account: If you wish to hold your investments in the Dematerialised
a. Payment for investment by means of Cheque, Demand Draft or mode, please provide the name and DP ID of your Depository Participant
any other mode shall only be accepted from the bank account of and your Beneficiary Account Number. Please also attach a copy of the
the minor or from a joint account where the minor is one of the holders Client Master that you may have received from your Depository Participant.
with the guardian. Please ensure that the sequence of names in the application form
b. details of Guardian for the minor applicant needs to be provided matches the sequence in which the Demat account is held. If the
sequence of names does not match with the Demat account details
c. the relationship of the Guardian with the Applicant needs to be provided therein,the Units will not be transferred to the Demat Account
indicated in the form and the Units will be held in the physical mode.
d. proof of date of birth of the applicant and the relationship of the Please note that this is an additional facility offered to unit holders who
guardian with the applicant needs to be provided wish to hold units in the dematerialised mode. This is not a mandatory
e. the Guardian’s PAN needs to be provided requirement and unit holders can continue holding units physically
f. the Guardian needs to comply with applicable KYC requirements. with the mutual fund. If you do not wish to hold your mutual fund units
in the dematerialised form, please strike off this section.
Please further note that joint applicants are not permitted where the
Sole / First applicant is minor. Please also note that a minor cannot If the demat account details in the application form are incomplete/incorrect
be a joint applicant in a folio. or does not match with the records of the Depository, units would be
allotted and held physically in the Fund’s books and an Account Statement
4. Investments by Attorneys: Where the investment is being made by a confirming the unit allotment would be sent to you..
Constituted Attorney on behalf of the applicant,
10. Bank Account:
a. the name and PAN of the POA Holder needs to be provided in the
form a. Please furnish your complete Bank Account details to be registered
against your folio for redemption / IDCW payments.
b. a notarized copy of the Power of Attorney duly signed by the Applicant
& the Constituted Attorney needs to be attached with the application. b. If your investment cheque is not being issued from the Bank Account
Alternatively, the original POA can be submitted which will be returned indicated in the Section tiltled “ Bank Account Information” please
after verification. attach an original cancelled cheque leaf of this account for
verification. If the cheque leaf does not have your name pre-printed,
c. nomination on behalf of an applicant signed by an attorney would not please additionally provide an extract of your bank statement or
be registered. passbook duly attested evidencing the correctness of your bank
d. The Fund House reserves the right to hold redemption proceeds in details or a letter from your bank confirming your bank details.
case the requisite documents are not submitted. c. Electronic Payments: We offer electronic payment of redemptions
5. Micro Investments: As per AMFI notification and guidelines issued on and IDCWs. To avail this facility please furnish :
July 4, 2009, SIPs or lumpsum purchases by eligible investors in a rolling • IFSC - This is a 11 character code. If you don’t see this printed on
12 month period or in a financial year not exceeding Rs. 50,000 shall your cheque leaf, please ask your Bank for the same ;
be exempt from the requirement of PAN. From January 1, 2012, KYC is
mandatory for all holders of Micro investments. • MICR Code – This is a 9 digit number appearing next to your
cheque number ;
a. The exemption of PAN requirement is only available to individuals.
• CBS Bank Account Number – Most banks have now implemented
b. In case of investments held jointly, the first holder must not possess a core-banking solutions leading to a change in Account Number
PAN. of customers. Please provide your latest core banking Account
c. Eligible investors may invest through SIP or lumpsum purchase Number.
without providing PAN subject to the threshold amount as mentioned d. We offer the facility to register multiple bank accounts against your
above. investments. If you wish to avail this facility, please ask for a Multiple
d. Eligible investors should attach a copy of KYC acknowledgment letter Bank Details Registration Form.
quoting PAN exempt KYC Reference No. (PEKRN) along with the e. If your units are held in the Dematerialised Form, please note that
application form. your Bank Account Details appearing in the Depository’s records
6. KYC (Know Your Customer): would be considered for redemption / IDCW payments.
a. KYC is mandatory for investment in mutual funds and all applicants 11. Nomination: You can appoint upto a maximum of 3 nominees for your
need to comply with this requirement. investments. Please note the following with respect to nomination.
b. With effect from 1st February 2017, any individual customer who is a. The nomination can be made only by individuals applying for/holding
new to KRA system and whose KYC is not registered or verified in units on their own behalf singly or jointly. Non-individuals including
the KRA system, needs to fill in new KYC form viz., “CKYC Form” society, trust, body corporate, partnership firm, karta of Hindu
to comply with the KYC requirements. For more information on KYC undivided family, holder of Power of Attorney cannot nominate. If the
requirements, please visit our web site (www.lntmf.com) or speak to units are held jointly, all joint holders will sign the nomination form.
your investment adviser.
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b.
A minor can be nominated and in that event, the name and address of f. Payments made by Cash/Money Order/Postal Order, Non-MICR
the guardian of the minor nominee shall be provided by the unitholder. cheques Outstation cheques are not accepted. Post dated cheques
Nomination can also be in favour of the Central Government, State will not be accepted except for investment made under Systematic
Government, a local authority, any person designated by virtue of his investment Plan.
office or a religious or charitable trust. g. Third Party Payments for investments are not accepted except in the
c. The Nominee shall not be a trust, other than a religious or charitable below cases :
trust, society, body corporate, partnership firm, karta of Hindu
• Payment by employer on behalf of employees under SIP or lump
undivided family or a Power of Attorney holder. A Non-Resident Indian
sum subscription through Pay Roll deductions or deductions out
can be a Nominee subject to the exchange controls in force, from time
of expense re imbursements.
to time.
d. Nomination in respect of the units stands rescinded upon the transfer • Custodian on behalf of an FII or Client made by Custodian.
of units. • Payment by an AMC to its empanelled distributor on account
e. Transfer of units in favour of a nominee shall be valid discharge by the of commission/incentive etc. in the form of Mutual Fund units
asset management company against the legal heir. through SIP or lump sum/one time subscription.
f. The cancellation of nomination can be made only by those individuals • Payment by a Corporate to its Agent/Dealer/Distributor on account
who hold units on their own behalf singly or jointly and who made the of commission or incentive payable for sale of its goods/services
original nomination. in the form of Mutual Fund units through SIP or lump sum/one time
g. On cancellation of the nomination, the nomination shall stand subscription.
rescinded and the asset management company shall not be under h. Note: Effective February 1, 2021, units will be allotted only upon
any obligation to transfer the units in favour of the Nominee. receipt of subscription amount by the Fund House for utilisation
For more details on Nomination, please refer the Statement of Additional irrespective of any scheme category/investment amount. Net
Information (SAI). Asset Value (NAV) will be applied based on realization of funds
for all purchases including systematic transactions registered
12. Investment & Payment Details:
prior or post February 1, 2021.
a. Please mention the name of the Scheme where you plan to make
13. Signatures: All signatures should be in English or any other Indian
your investment and your preferred option. If you do not indicate your
Language. Thumb impressions should be from the left hand in case
preferred option, your application would be processed based on the
of males and right hand in case of females. All such thumb impressions
terms & conditions set out in the Scheme Information Document.
need to be attested by a Magistrate, Notary Public or Special Executive
b. If there is a difference in the scheme name between application form Magistrate under his/her official seal.
and investment cheque issued, scheme on the application form will be
14. Employees Unique Identification Number (EUIN): If you are making this
considered for processing.
investment based on an investment advise received from your distributor,
c. If you are not investing through a Distributor, please suffix “Direct Plan” please quote the Employees Unique Identification Number (EUIN) of your
after the scheme name. relationship manager in the Application Form.
d. Your investment cheque should be crossed “Account Payee only” If your distributor has, however, not given you any advice pertaining to
and drawn favouring the scheme name where the investment is in a the investment or your investment decision is not withstanding the advice
specific scheme. provided by your distributor regarding inappropriateness of the scheme vis-
e. Please ensure that the investment cheque issued by you complies à-vis your investment needs, the EUIN box may be left blank. In this case,
with CTS 2010 requirements stipulated by the Reserve Bank of India. please sign in the space provided in the respective section to confirm your
The words “CTS 2010” should appear on the face of the cheque. acceptance to the declaration stated therein.
Serial Documents Individuals NRIs Investments through Companies Trusts Societies Partnership
Constituted Attorney Firms
1 Signed A/c Payee cheque/draft favouring the scheme
2 KYC acknowledgment
3 Copy of cancelled cheque ( Required where pay out
bank details are different from the instrument bank)
4 Proof of Date of Birth (For Minor investments)
5 Third Party declaration where applicable
6 FIRC where payment is made through a DD from NRE/
FCNR A/c where applicable
7 Client Master List (Required for crediting units in Demat
Account)
8 Notarised Power of Attorney
9 Resolution/Authorisation to invest
10 List of authorized Signatories with Specimen Signatures
11 MOA & AOA( Not required if the KYC status is
VERIFIED)
12 Trust Deed
13 Bye Laws
14 Partnership Deed
15 FATCA Declaration
All documents numbered 8-14 should be originals or true copies certified by the Director/Trustee/Company Secretary/Authorised Signatory/Notary Public/
Partner as applicable.
call 1800 4190 200 or 1800 2000 400 email [email protected] www.lntmf.com
Please note our lines are open from 9 am to 6 pm, Monday to Friday and 9 am to 1 pm on Saturday.
Mutual Fund investments are subject to market risks, read all scheme related documents carefully. CL08022