Download - ICICI PRUDENTIAL MUTUAL FUND APPLICATION FORM

Sponsors: ICICI Bank Limited Regd. Office: Landmark, Race Course Circle, Vadodara 390 007, India; and Prudential plc (formerly known as Prudential Corporation Holdings Limited), Laurence Pountney Hill, London EC4ROHH, UK.

This Key Information Memorandum (KIM) sets forth the information, which a prospective investor ought to know before investing. For further details of the Schemes/Mutual Fund, due diligence certificate by AMC, Key Personnel, Investors’ rights & services, risk factors, penalties & pending litigations etc. investors should, before investment, refer to the Scheme Information Document and Statement of Additional Information available free of cost at any of the Investor Service Centres or distributors or from the website www.icicipruamc.com.The Scheme particulars have been prepared in accordance with Securities and Exchange Board of India (Mutual Funds) Regulations 1996, as amended till date, and filed with Securities and Exchange Board of India (SEBI). The units being offered for public subscription have not been approved or disapproved by SEBI, nor has SEBI certified the accuracy or adequacy of this KIM.

Investment Manager: ICICI Prudential Asset Management Company LimitedCorp. Office: 3rd Floor, Hallmark Business Plaza, Sant Dyaneshwar Marg, Bandra (East), Mumbai - 400 051, Tel: (022) 26428000, Fax: (022) 26554165.Central Service Office: 2nd Floor, Block B-2, Nirlon Knowledge Park, Western Express Highway, Goregaon (East), Mumbai - 400 063. Tel.: 022-26852000, Fax No.: 022-2686 8313.Regd. Office: 12th Floor, Narain Manzil, 23 Barakhamba Road, New Delhi 110 001.

Trustee: ICICI Prudential Trust LimitedRegd. Office: 12th Floor, Narain Manzil, 23 Barakhamba Road, New Delhi 110 001.

Name of the AMC : ICICI Prudential Asset Management Company LimitedName of the Mutual Fund : ICICI Prudential Mutual Fund

Key Information Memorandum & Common Application FormEquity Schemes:ICICI Prudential Tax PlanICICI Prudential FMCG FundICICI Prudential Growth PlanICICI Prudential Technology FundICICI Prudential PowerICICI Prudential Dynamic PlanICICI Prudential Discovery FundICICI Prudential Emerging S.T.A.R. (Stocks Targeted At Returns) FundICICI Prudential Infrastructure FundICICI Prudential Services Industries FundICICI Prudential Index FundICICI Prudential Indo Asia Equity FundICICI Prudential Focused Bluechip Equity Fund(Erstwhile ICICI Prudential Focused Equity Fund)ICICI Prudential Equity & Derivatives Fund – Wealth Optimiser PlanICICI Prudential Equity & Derivatives Fund – Income Optimiser PlanICICI Prudential Child Care Plan - Gift PlanICICI Prudential Child Care Plan - Study PlanICICI Prudential Banking & Financial Services FundICICI Prudential Target Returns FundICICI Prudential Equity Opportunities Fund(Erstwhile ICICI Prudential Fusion Fund - Series II)Balanced Schemes:ICICI Prudential Balanced FundDebt Schemes:ICICI Prudential Liquid PlanICICI Prudential Sweep PlanICICI Prudential Income PlanICICI Prudential Short Term PlanICICI Prudential Long Term PlanICICI Prudential Long Term Floating Rate PlanICICI Prudential Floating Rate PlanICICI Prudential Flexible Income PlanICICI Prudential Gilt Fund – Treasury PlanICICI Prudential Gilt Fund – Investment PlanICICI Prudential Gilt Fund – Treasury Plan - PF OptionICICI Prudential Gilt Fund – Investment Plan - PF OptionICICI Prudential Banking & PSU Debt FundICICI Prudential Ultra Short Term PlanICICI Prudential Medium Term PlanICICI Prudential Income Opportunities FundICICI Prudential Monthly Income PlanICICI Prudential Income Multiplier Fund Continuous offer for units at NAV based prices.

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INDEX

Cheques are to be drawn in favour of:

EQUITY FUNDS:

ICICI Prudential Equity & Derivative – Wealth Optimiser Plan

ICICI Prudential Equity & Derivative – Income Optimiser Plan

ICICI Prudential FMCG Fund

ICICI Prudential Child Care Plan - Gift Plan

ICICI Prudential Child Care Plan - Study Plan

ICICI Prudential Index Fund

ICICI Prudential Services Industries Fund

ICICI Prudential Power

ICICI Prudential Tax Plan

ICICI Prudential Technology Fund

ICICI Prudential Banking & Financial Services Fund

ICICI Prudential Infrastructure Fund

ICICI Prudential Focused Bluechip Equity Fund

ICICI Prudential Equity Opportunities Fund

ICICI Prudential Growth Plan

ICICI Prudential Indo Asia Equity Fund

ICICI Prudential Discovery Fund

ICICI Prudential Target Returns Fund

(An Open Ended Diversified Equity Fund. There is no

guarantee or assurance of returns)

ICICI Prudential Dynamic Plan

ICICI Prudential Emerging S. T. A. R. (Stocks Targeted At

Returns) Fund

BALANCED FUNDS:

ICICI Prudential Balanced Fund

DEBT FUNDS:

ICICI Prudential Floating Rate Plan

ICICI Prudential Income Plan

ICICI Prudential Income Opportunities Fund

ICICI Prudential Liquid Plan

ICICI Prudential Long Term Floating Rate Plan

ICICI Prudential Short Term Plan

ICICI Prudential Sweep Plan

ICICI Prudential Ultra Short Term Plan

ICICI Prudential Long Term Plan

ICICI Prudential Medium Term Plan

ICICI Prudential Banking & PSU Debt Fund

ICICI Prudential Flexible Income Plan

ICICI Prudential Monthly Income Plan

(An open-ended fund. Monthly income is not assured

and is subject to the availability of distributable surplus)

ICICI Prudential Gilt Fund - Treasury Plan

ICICI Prudential Gilt Fund - Investment Plan

ICICI Prudential Gilt Fund - Treasury Plan - PF Option

ICICI Prudential Gilt Fund - Investment Plan - PF Option

ICICI Prudential Income Multiplier Fund

Statutory Details: ICICI Prudential Mutual Fund (the Fund) was set up as a Trust sponsored by Prudential plc (through its wholly owned subsidiary namely Prudential CorporationHoldings Ltd) and ICICI Bank Ltd. ICICI Prudential Trust Limited (the Trust Company), a company incorporated under the Companies Act, 1956, is the Trustee to the Fund. ICICIPrudential Asset Management Company Ltd (the AMC). a company incorporated under the Companies Act, 1956, is the Investment Manager to the Fund. ICICI Bank Ltd andPrudential Plc (acting through its wholly owned subsidiary namely Prudential Corporation Holdings Ltd) are the promoters of the AMC and the Trust Company. Risk Factors:Mutual Funds and securities investments are subject to market risks and there is no assurance or guarantee that the objectives of the Schemes will be achieved. As with anysecurities investment, the NAV of the Units issued under the Schemes can go up or down, depending on the factors and forces affecting the capital markets. Past performanceof the Sponsors, AMC/Fund does not indicate the future performance of the Schemes of the Fund. The Sponsors are not responsible or liable for any loss resulting from theoperation of the Schemes beyond the contribution of an amount of Rs.22.2 lacs, collectively made by them towards setting up the Fund and such other accretions and additionsto the corpus set up by the Sponsors. Ranking Methodology: ICICI Prudential Mutual Fund has been voted as the Most Trusted Mutual Fund brand by Brand Equity MostTrusted Brands Survey 2009. For this purpose, 300 brands were considered by them. Each brand was evaluated on relatedness, perceived popularity, quality connotation,distinctiveness/ uniqueness of what it stands for, value for money that it offers and repurchase intent. Mutual Fund investments are subject to market risks. Please readStatement of Additional Information / Scheme Information Document carefully before investing. Past Performance is no guarantee of future of returns.

• Common Application Form, Registration-cum-Mandate Form for ECS (Debt Clearing)/

Standing Instruction/Direct Debit Facility and Instructions for filling up the forms ............................................ 3 - 13

• Key Scheme Features .................................................................................................................................................. 14 - 27

• Investment Strategy .................................................................................................................................................... 28 - 30

• Risk Mitigation Factors ...................................................................................................................................................... 31

• Scheme performance snapshot ................................................................................................................................... 32-38

• Tax benefits of investing in the Mutual Fund .................................................................................................................. 38

• Investor Information .......................................................................................................................................................... 38

o Declaration and Publication of Daily NAV .............................................................................................................. 38

o Investor Grievances Contact Details ....................................................................................................................... 38

o Unitholders’ Information .......................................................................................................................................... 38

• Branches / Transaction Points Addresses ................................................................................................................ 38 - 40

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Occupation [Please tick (�) ]

Address

Received from:

Signature, Stamp & DateApplication for Units of ICICI Prudential_______________________________________ Option :___________________________

Application No.

� �

COMMON APPLICATION FORMexcluding for ICICI Prudential Childcare Plan

(Please read the instructions before investing)

Application No.1 FOR EXISTING UNITHOLDERS [Refer to Instruction II(a)]

2 ABOUT YOU Date:

FolioNo.

Date of Birth (Mandatory)

D D M M Y Y Y Y

Overseas Address (in case of NRIs/FIIs)

City

State

Contact DetailsTel.(Res.)E-Mail

Tel.(Off.) Mobile

Name of First Applicant

Mr. Ms. M/s.

ZIP/P I N(Mandatory)

Country(Mandatory)

• Lumpsum Investment • Systematic Investment Plan (SIP).

SIP payment options: Bank Standing Instruction • Auto Debit (ECS) • Post Dated Cheques

Sub-broker CodeBroker Code Serial Number, Date & Time of Receipt

Upfront commission shall be paid directly by the investor to the AMFI registered Distributors based on the investors’ assessmentof various factors including the service rendered by the distributor.

Please tick (�) if you wish to receive Account Statement/Annual Report/other statutory information via physical documents instead of email.

3 BANK ACCOUNT DETAILS OF FIRST APPLICANT (Refer instruction No.III)

Bank Particulars (Name of the Bank)

Account Number

Branch Address

Account Type

City

If “Mandatory Details” are not provided,your application is liable to be rejected.NRENRO SavingsCurrent

9 DigitMICR code

IFSC Code(11 digit)

MA

ND

ATO

RY

Mailing Address (Please provide full address) (Mandatory)

Country

City(Mandatory)

State(Mandatory)

Status [Please tick (�)]

Minor

NRI/PIO

Resident Individual

HUF

Sole Proprietorship

Partnership Firm

Trust

Bank/FI

AOP/BoI

Club/Society

Company

FII

Others (Please specify)

_______________________

Name of Guardian (in case of minor) / Contact Person (In case of non-individual investors)

Mr. Ms.

P I N(Mandatory)

Mode of holding[Please t ick (� ) ]

Single

Anyone or Survivor

Joint

(Default option:Anyone or Survivor)

Professional

Business

Retired

Others (Please specify)

Housewife

Service

Student

PAN (Please attach proof)

KYC acknowledgement /Copy enclosed




Know Your Customer (KYC) (Please �)

1st Applicant

Guardian (in case 1stapplicant is minor)

2nd Applicant

3rd Applicant

PAN & KYC [Please refer the instruction Nos.II-b(4), V(l), X] (Mandatory)

APPLICANT DETAILS

Name of Third Applicant

Name of Second Applicant

Mr. Ms.

Mr. Ms.

If you have an existing folio with PAN validation & KYC validation (if applicable), please mention the folio number in the space providedand proceed to Step 4.

Communication: As a part of the Go Green initiative, Account Statement/Annual Report/other statutory information will be sent only by email to the above mentioned email ID.

ACKNOWLEDGEMENT SLIP(To be filled in by the investor)

ARN-33099

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6 YOUR CONFIRMATION/DECLARATION

4 INVESTMENT DETAILS (Refer Instruction No.IV) • PLANS, OPTIONS & SUB-OPTIONS (See the Key Features for Scheme specific options & sub-options)

Note: All future communications in connection with this application should be addressed to the nearest ICICI Prudential Customer Service Centre, quoting full name of the first

applicant, the application serial number, the name of the scheme, the amount invested, date and the place of the Customer Service Centre where application was lodged.

Cheque/DD No. Dated Amount (Rs.) Drawn on (Name of Bank & Branch)

The Trustee, ICICI Prudential Mutual Fund, I/We have read and understood the Scheme InformationDocument/Key Information Memorandum of the Scheme(s). I/We apply for the units of the Fund andagree to abide by the terms, conditions, rules and regulations of the scheme and other statutory requirements of SEBI, AMFI, Prevention ofMoney Laundering Act, 2002 and such other regulations as may be applicable from time to time.I/We confirm to have understood theinvestment objectives, investment pattern, and risk factors applicable to Plans/Options under the Scheme(s). I/we have not received norbeen induced by any rebate or gifts, directly or indirectly, in making this investment. I/We declare that the amount invested in the Schemeis through legitimate sources only and is not designed for the purpose of contravention or evasion of any Act, Regulations or any otherapplicable laws enacted by the Government of India or any Statutory Authority. I/We agree that in case my/our investment in the Schemeis equal to or more than 25% of the corpus of the plan, then ICICI Prudential Asset Management Co. Ltd.(the 'AMC'), has full right to refundthe excess to me/us to bring my/our investment below 25%. I/We hereby declare that I am/we are not US Person(s).I/We hereby declare that I/we do not have any existing Micro SIPs which together with the current application will result in a totalinvestments exceeding Rs.50,000 in a year.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 thedifferent competing Schemes of various Mutual Funds from amongst which the Scheme is being recommended to me/us.I/We interested in receiving promotional material from the AMC via mail, SMS, telecall, etc.If you do not wish to receive, please call on tollfree no. 1800 222 999 (MTNL/BSNL) or 1800 200 6666 (Others).

SIG

NA

TUR

E(S

)

*Cumulative – AEP Regular Option : Encashment of Units is subject to declaration of dividend in the respective Scheme(s). Please refer to instruction no. IV(c).

Second Applicant

Third Applicant

DD MM YYYY

[Please tick (�) the appropriate boxes, only if it is applicable to the scheme/plan in which you wish to invest]Growth/

Cumulative

NAME OF THE SCHEME (Please leave one box blank between words)

Dividend Transfer Plan (DTP) (Please refer to instruction No. IV (f): Scheme Name: _______________________________________________________ Option: ______________________________________

P R U D E N T I A LI C I C I

SIP TOP UP Amount Rs.______________________________ Frequency: Half Yearly Yearly

SUBSEQUENT SIP INSTALMENT DETAILS THROUGH PDCS InstallmentAmount Rs.Cheque Number From Cheque Number To

Start From

M M Y Y Y Y M M Y Y Y Y

Amount Paid (A) DD Charges (B) Amount Invested (C) = (A) + (B)

Cheque/DD No.

Bank Name

& Branch

NRO NRE

Rs. Rs.

D D M M Y Y FCNR

Rs.

PAYMENT DETAILS (LUMPSUM INVESTMENT / FIRST CHEQUE FOR SIP)

Cheque/DD Date Account Type (For NRI Investors)City

Dividend Payout

Dividend Reinvestment

Retail

Institutional

SIP TOP UP (Optional)

TOP UP Amount*:

Rs.________________________*TOP UP amount has to be in mul-tiples of Rs.500 only.

Standing Instruction/Direct Debit

ECS PDCs

SIP through

SIP Frequency[Please tick(��)]

Monthly

Quarterly(Default is Monthly)

DividendFrequencies: Daily Weekly Fortnighly Monthly Quarterly Half Yearly

5 NOMINATION DETAILS (Optional) • For Single nomination, please fill in the details below. • For multiple nominations, please use the form available separately.

Address of Guardian

Name of the Nominee Date of Birth (If nominee is minor)

D D M M Y Y Y YAddress of Nominee (Please provide full address)

Name of the Guardian (If nominee is minor) - Mnadatory

I/We hereby nominate the undermentioned Nominee to receive the amounts to my/our credit in event of my/our death. I/We also understand that all payments andsettlements made to such Nominee and signature of the Nominee acknowledging receipt thereof, shall be a valid discharge by the AMC / Mutual Fund / Trustees.

Signature of Guardian

Relationship with minor

Mr. Ms. M/s.

PIN Code

PIN Code

FOLIO No.: _________________________________

First Applicant

Trigger Please (�) (Trigger can be done only from ICICI Prudential Target Returns Fund – Growth sub-option)

Amounts/units to be triggered to Retail Option under (Please �): ICICI Prudential Floating Rate Plan– Plan A Plan B

Default Trigger Options: NAV appreciation: 20%; Scheme: ICICI Prudential Liquid Plan - Growth Option. *Cumulative - AEP Regular option: Encashment of units is subject to declaration of dividend into respective scheme(s).

ICICI Prudential Liquid Plan ICICI Prudential Short Term Plan ICICI Prudential Income Plan

ICICI Prudential Flexible Income Plan

Growth/Cumulative Dividend Pay-out Dividend Reinvestment

Sub-options (Please ��): Growth AEP*- Appreciation Regular

NAV appreciation (Please �) 12% 20% 50% 100% Trigger Amount Appreciation amount only All units

Micro SIPs Please (�) (Investment of equal to or less than Rs.50,000/- per annum under SIP registration) (Please refer instruction No. V(l))

1st Applicant

2nd Applicant

3rd Applicant

ID Card No. / Reference No.Photo Identifcation Document Type (Mandatory) (Only in case of PAN not provided)

AEP-Regular*

AEP-Appreciation

End to

SIP Date 7th 10th 15th 25th

Number ofCheques

Drawn onBank & Branch


AEP frequency :

TOP UP Frequency (Mandatory):Half Yearly Yearly

[In case o f Quar ter ly S IP, only Year lyfrequency is ava i lab le under SIP TOP UP.Please refer to the instruction V(k)]

� �

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2 ABOUT YOU Date:

� � �ACKNOWLEDGEMENT SLIP (To be filled in by the Investor) – ICICI Prudential Child Care Plan

Received from Mr./Ms./M/s. ______________________________________________________________________________

Address _______________________________________________________________________________________________

Signature, Stamp & Date

Application No.

Plans Amount (Rs.) D.D. Charges Amount Paid (Rs.) Cheque/D.D. No. Drawn on(Please tick) (A) (Rs.) (B) (C) = (A) + (B) and Date (Bank Name and Branch)

Study Plan

Gift Plan

Name of the Investor (Beneficiary Child)

Master Ms.


D D M M Y Y Y Y

Name of Parent/Legal Guardian

Mr. Ms.


D D M M Y Y Y Y

Name of the Applicant (if different from Parent/Legal Guardian) Date of Birth

D D M M Y Y Y Y

Overseas Address (in case of NRIs/FIIs)

State

Mailing Address (Please provide full address)

Country

ZIP(Mandatory)

Country(Mandatory)

City(Mandatory)

P I N(Mandatory)

State(Mandatory)

City(Mandatory)

Professional Business Retired

Housewife Service Student

Others (Specify)______________________

FOLIO NO._______________________

PAN* (Please attach proof)


Know Your Customer (KYC) (Please �)

PAN & KYC [Please refer the instruction Nos.II-b(4), V(h), XI] (Mandatory)

* Since the applicant is minor, Guardian’s/Parent’s PAN & KYC details have to be provided.

Status [Please tick (�)]

NRI/Non-Repatriable

Resident Indian

Others (Specify)___________

Parent’s/Guardian’s Occupation [Please tick (�)]

Please tick (�) if you wish to receive Account Statement/Annual Report/other statutory information via physical documents instead of email.

Communication: As a part of the Go Green initiative, Account Statement/Annual Report/other statutory information will be sent only by email to the above mentioned email ID.

Contact Details

Tel.(Res.)

E-Mail

Tel.(Off.) Mobile

ICICI Prudential Child Care Plan(Please read the instructions before investing)

Application No.1 FOR EXISTING UNITHOLDERS [Refer to Instruction II(a)] FolioNo.

Sub-broker CodeBroker Code Serial Number, Date & Time of Receipt


If you have an existing folio with PAN validation & KYC validation (if applicable), please mention the folio number in the space providedand proceed to Step 4.

Application Form for Resident Indians and NRIs (Minor Applicants Only)

• Lump sum Investment • Systematic Investment Plan (SIP).

SIP payment options: Bank Standing Instruction • Auto Debit (ECS) • Post Dated Cheques

(Application to be filled inBLOCK LETTERS in ENGLISH only.)

3 BANK ACCOUNT DETAILS OF THE APPLICANT (Refer instruction No.III)

Bank Particulars (Name of the Bank)

Account Number

Branch Address

Account Type

City

If “Mandatory Details” are not provided,your application is liable to be rejected.NRENRO SavingsCurrent

9 DigitMICR code

IFSC Code(11 digit)

MA

ND

ATO

RY

ARN - 33099

6Ver01/25/May/2010

� �

7 YOUR CONFIRMATION

4 INVESTMENT DETAILS UNDER ICICI PRUDENTIAL CHILD CARE PLAN (Refer Instruction No.IV)

The Trustee, ICICI Prudential Mutual Fund – I/We have read and understood the Scheme Information Document, Statement of Additional Information/Key InformationMemorandum and addendums of the Scheme. I/We apply for the units of the ICICI Prudential Child Care Plan and I/we agree to abide by the terms, conditions, rules andregulations of the scheme. I/We confirm to have understood the terms & conditions, investment objectives, investment pattern, fundamental objectives and risk factors applicableto the Plans and/or Options under the Scheme. I/We have understood the details of the scheme and I/we have not received nor been induced by any rebate or gifts, directly or indirectly, in making this investment.I/We agree to abide by the terms, conditions, rules, regulations and other statutory requirements of SEBI, AMFI, Prevention of Money Laundering Act, 2002 and such other regulations as may be applicable from timeto time. I/We declare that the amount invested in the Scheme is through legitimate sources only and is not designed for the purpose of contravention or evasion of any Act, Regulation, Rule, Notification, Directionsor any other applicable laws enacted by the Government of India or any Statutory Authority. I/We agree that in case my/our investment in the Schemeis equal to or more than 25% of the corpus of the plan, then ICICI Prudential Asset Management Co. Ltd., Investment Manager to the Scheme, has fullright to refund the excess to me/us to bring my/our investment below 25%. I/We hereby declare that I am/we are not US Person(s). I/We herebydeclare that I/we do not have any existing Micro SIPs which together with the current application will result in a total investments exceedingRs.50,000 in a year. The ARN holder has disclosed to me/us all the commissions (in the form of trail commission or any other mode), payable tohim for the different competing Schemes of various Mutual Funds from amongst which the Scheme is being recommended to me/us.I/We interested in receiving promotional material from the AMC via mail, SMS, telecall, etc.If you do not wish to receive, please call on tollfree no. 1800 222 999 (MTNL/BSNL) or 1800 200 6666 (Others).

DD MM YYYY

Plans [Please (�)] Amount Invested (A) DD Charges (B) Amount Paid (C) = (A) + (B)

Rs.

Cheque/DD No.

Cheque/DD Date

Bank Name & Branch

Rs.Rs.

Account Type (For NRI Investors)

Scheme Name

Study PlanICICI PrudentialChild Care Plan

Gift Plan

SIGNATURE OF PARENT OR LEGAL GUARDIAN

REGISTRAR

Computer Age Management Services Pvt. Ltd.New No 10. Old No. 178, Opp. to Hotel Palm Grove, MGR Salai (K.H.Road), Chennai - 600 034.

Note: All future communications in connection with this application should be addressed to the Customer Service Centre, quoting full name of Sole/First Applicant, theApplication Serial Number, the name of the Scheme, the amount invested, date and the place of the Customer Service Centre where application was lodged.

PAYMENT DETAILS FOR LUMP SUM INVESTMENT / DETAILS OF FIRST CHEQUE FOR SIP PAYMENT THROUGH PDCs (Refer to Instruction No.V)

I _____________________________________________________________________(guardian), do hereby assign the monies payable by ICICI Lombard General Insurance

Co. Ltd., in the event of my death, to _____________________________________________________(nominee) my __________________________________. I further

declare that his/her receipt shall be sufficient discharge by ICICI Lombard General Insurance Co. Ltd.

Dated this __________________________________ day of _________________ at ________________.

Name : _____________________________________________________________________________________________________

Address: ____________________________________________________________________________________________________

Signature of Parent/Legal Guardian

5 ASSIGNMENT FOR INSURANCE* [Please refer to the Instruction]

* Assignee should be a resident who has attained the age of majority.

SIP through (Please tick): Standing Instruction/Direct Debit ECS PDCs

NRO NRE

SIP TOP UP (Optional)

TOP UP Amount*: Rs.____________*TOP UP amount has to be inmultiples of Rs.500 only.TOP UP Frequency# (Mandatory):

Half Yearly Yearly

SIP Frequency [Please tick(��)] (Default is Monthly): Monthly Quarterly

SUBSEQUENT SIP INSTALLMENT DETAILS [To be filled in case of SIP through Post Dated Cheques (PDCs)]SingleInstallmentAmount

Rs.

ChequeDated 7th 10th 15th 25th

Number ofCheques

Cheque Number From Cheque Number To

Start From End toM M Y Y Y Y M M Y Y Y Y

Drawn onBank

Branch

# I n c a s e o f Q u a r t e r l y S I P, TOP UP frequency available will be Yea r l y.

Micro SIPs Please (�) (Investment of equal to or less than Rs.50,000/- per annum under SIP registration) (Please refer instruction No. V(h))

ID Card No. / Reference No.*Photo Identifcation Document Type (Mandatory)*

Required only in case of PAN not provided.

6 NOMINATION DETAILS (Optional) • For Single nomination, please fill in the details below. • For multiple nominations, please use the form available separately.

Address of Guardian

Name of the Nominee Date of Birth (If nominee is minor)

D D M M Y Y Y YAddress of Nominee (Please provide full address)

Name of the Guardian (If nominee is minor) - Mandatory

I/We hereby nominate the undermentioned Nominee to receive the amounts to my/our credit in event of my/our death. I/We also understand that all payments andsettlements made to such Nominee and signature of the Nominee acknowledging receipt thereof, shall be a valid discharge by the AMC / Mutual Fund / Trustees.

Signature of Guardian

Relationship with minor

Mr. Ms. M/s.

PIN Code

PIN Code

* Since the applicant is minor, Guardian’s/Parent’s identification details have to be provided.

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SIP TOP UP Amount Rs.__________________ Frequency: Half Yearly Yearly

Existing Folio No.

APPLICATION NO.:The Trustee,

ICICI Prudential Mutual Fund,

I/We have read and understood the contents of the Offer Document/Scheme InformationDocument of the following Scheme and the terms and conditions of the SIP Enrolment.

Scheme Name: ICICI PRUDENTIAL _____________________________________________________________________________

Plan/Option*: ____________________________________________ Sub-Option*: ______________________________________

*Refer to the “Key Features”on pages 14-27.

REGISTRATION CUM MANDATE FORM FOR ECS (Debt Clearing)/STANDING INSTRUCTION / DIRECT DEBIT

FACILITY SIP via ECS (Debit Clearing) in select cities or via Standing Instruction/Direct Debit in select banks / branches only.

D D M M Y Y

I/We, Mr./Ms./M/s. __________________________________________________________________________(Name as per the Bank record) hereby authorise ICICI Prudential Mutual Fund andtheir authorised service providers to debit from my/our Bank Account No. mentioned below (hereinafter referred as “funding account”) by ECS (Debit Clearing)/Direct Debit for collection of SIP payments/authorise the bank to record a Standing Instruction for debit to my bank account as mentioned below, as instructed by ICICI Prudential Mutual Fund.

Sole/FirstApplicant’s Name

Each SIP Amount: Rs. Rupees in words: _________________________________

______________________________________________________________________________________________________

TOP UP Amount*: Rs._____________________ TOP UP Frequency: Half Yearly Yearly* TOP UP amount has to be in multiples of Rs.500 only. [Please refer to Instruction No. C(6)]

SIP TOP UP(Optional)

(Tick to avail this facility)

SIGNATURE(S) OF BANK ACCOUNT HOLDER(S) AS IN BANK RECORDS (Mandatory)

Bank Name

Branch Name

Bank City

Account Number

9 Digit MICR Code

Account Type Savings Current NRE NRO Cash Credit

�(Please enter the 9 digit number that appears next to the cheque number). In case of At Par accounts, kindly provide the correctMICR number of the bank branch. MICR code starting and/or ending with 000 are not valid for ECS.

PARTICULARS OF BANK ACCOUNT

I/We hereby declare that the particulars given above are correct and express my willingness to make payments referred above through participation in ECS. If the transaction is delayed or not effected at all for reasonsof incomplete or incorrect information, I/We would not hold the user institution responsible. I/We will also inform ICICI Prudential Mutual Fund, about any changes in my bank account. I/We have read and understoodthe Scheme Information Document/Key Information Memorandum of the Scheme. I/We apply for the units of the Scheme and I/we agree to abide by the terms, conditions, rules and regulations of the scheme.

This is to inform I/we have registered for the RBI's Electronic Clearing Service (Debit Clearing) and that my payment towards my investment in ICICI Prudential Mutual Fund shall be made from my/our belowmentioned bank account with your bank. I/We authorise the representative carrying this ECS mandate Form to get it verified & executed. I/We authorise the bank to honour the instructions as mentioned in theapplication form. I/We also hereby authorise bank to debit charges towards verification of this mandate, if any.

I/We agree that AMC/Mutual Fund (including its affiliates), and any of its officers directors, personnel and employees, shall not be held responsible for any delay/wrong debits on the part of the bank for executingthe direct debit instructions of additional sum on a specified date from my account. If the transaction is not effected at all for reasons of incomplete or incorrect information, the user institution would not be heldresponsible. I/We agree to abide by the terms, conditions, rules and regulations of this facility. I/We confirm to have understood that the introduction of this facility may also give rise to operational risks and herebytake full responsibilty.

I/We undertake to keep sufficient funds in the funding account on the date of execution of standing instruction. I/We hereby declare that the particulars given above are correct and complete. If the transaction isdelayed or not effected at all for reasons of incomplete or incorrect information, I/we would not hold the Mutual Fund or the Bank responsible. If the date of debit to my/our account happens to be a non banking/business day as defined in the Scheme Information Document of the said Scheme of ICICI Prudential Mutual Fund, execution of the debit will happen as per the normal practice of the bank mandated by the investorand allotment of units will happen as per the Terms and Conditions listed in the Scheme Information Document of the Mutual Fund. I/We have read and understood the Scheme Information Document(s) of the Fund.I/We apply for the units of the scheme and I/we agree to abide by the terms, conditions, rules and regulations of the scheme. I/We confirm to have understood the terms & conditions, investment objectives,investment pattern, fundamental objectives and risk factors applicable to the Plans and/or Options under the Scheme(s). I/We agree to abide by the terms, conditions, rules and regulations of the Plan(s). I/We haveunderstood the details of the scheme and I/we have not received nor been induced by any rebate or gifts, directly or indirectly, in making this investment.

I/We hereby agree to avail the TOP UP facility for SIP and authorize my bank to execute the ECS/Standing Instruction/Direct Debit for a further increase in installment from my designated account. I/We agree that AMC/Mutual Fund (including its affiliates), and any of its officers directors, personnel and employees, shall not be held responsible for any delay / wrong debits on the part of the bank for executing the standing instructions ofadditional sum on a specified date from my account. If the transaction is not effected at all for reasons of incomplete or incorrect information, the user institution would not be held responsible. I/We agree to abide by theterms, conditions, rules and regulations of this facility. I/We confirm to have understood that the introduction of this facility may also give rise to operational risks and hereby take full responsibilty.

New Registration Cancellation

Change in Bank Account*[*Please provide a cancelled cheque]

Please tick (�)


Folio No./Application No.SIP Amount Rs.___________________

SIP Frequency: Monthly Quarterly

Scheme Name:___________________

Option:__________________________

Sub-Option:_____________________

Acknowledgement Stamp

Signature(s) as per ICICI Prudential Mutual Fund Records (Mandatory)

1st

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2nd

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3rd

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Authorisation of the Bank Account Holder for Auto Debit (ECS)/Standing Instruction/Direct Debit

Enclosed [please tick (�)]: Blank cancelled cheque Photocopy of Cheque [Please refer to Instruction No. C(5)]

SIP Frequency: Monthly Quarterly

(Default SIP frequency is Monthly)

In case of Quarterly SIP, only Yearly frequency isavailable under SIP TOP UP.

SIP Date:

7th 10th 15th 25th

SIP Start Month/Year

SIP End Month/Year

M M Y Y Y Y

M M Y Y Y Y

BA

NK

MA

ND

AT

E S

EC

TIO

N (

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Sub-broker Code Serial Number, Date & Time of Receipt


YOUR CONFIRMATION/DECLARATION:

I/We hereby declare that I/we do not have any existing Micro SIPs which together with the current application will result in a total investments exceeding Rs.50,000 in a year.

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 Fundsfrom amongst which the Scheme is being recommended to me/us.

�

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2nd

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3rd

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Broker Code

Date:

ARN - 33099

8Ver01/25/May/2010

TERMS AND CONDITIONS

A) SIP Payment through Electronic Clearing Service (Debit Clearing) of the Reserve Bank of India (RBI)

List Cities for SIP Auto Debit via ECS (Debit Clearing)

• Agra • Ahmedabad • Allahabad • Amritsar • Anand • Asansol • Aurangabad • Bangalore • Baroda • Belgaum • Bhilwara • Bhopal • Bhubaneshwar

• Bijapur • Bikaner • Burdwan • Calicut • Chandigarh • Chennai • Cochin • Coimbatore • Cuttack • Davangeree • Dehradun • Delhi • Dhanbad •

Durgapur • Erode • Gadag • Gangtok • Gorakhpur • Gulbarga • Guwahati • Gwalior • Hubli • Hyderabad • Indore • Jabalpur • Jaipur • Jalandhar

• Jammu • Jamnagar • Jamshedpur • Jodhpur • Kakinada • Kanpur • Kolhapur • Kolkata • Lucknow • Ludhiana • Madurai • Mandya • Mangalore

• Mumbai • Mysore • Nagpur • Nasik • Nellore • Panjim • Patna • Pondicherry • Pune • Raichur • Raipur • Rajkot • Ranchi • Salem • Shimla •

Shimoga • Siliguri • Solapur • Surat • Tirupati • Tirupur • Trichur • Trichy • Trivandrum • Udaipur • Udupi • Varanasi • Vijayawada (also covers

Guntur, Tenali & Mangalgiri) • Vishakhapatnam.

1. This facility is offered to the investors having bank accounts in the select cities mentioned above. The cities in the list may be modified/updated/

changed/removed at any time in future entirely at the discretion of ICICI Prudential Mutual Fund without assigning any reasons or prior notice.

If any city is removed, SIP instructions for investors in such cities via ECS (Debit) route will be discontinued without prior notice.

2. The bank account provided for ECS (Debit) should participate in local MICR clearing.

3. SIP auto debit is available only on specific dates of the month viz. 7th/10th/15th/25th. In case 7th/10th/15th/25th is a holiday, then next

business day. In case the Auto Debit does not take effect for three consecutive times then the SIP would be liable for cancellation.

4. Investors subsribing for SIP are required to submit SIP request at least 30 days prior to the date of first debit date and SIP start date shall

not be beyond 60 days for monthly SIP and 100 days for Quarterly SIP from the date of submission of SIP application.

The applicant will have the right to discontinue SIP at any time he or she so desires by providing a written request at the office of the ICICI

Prudential Mutual Fund Customer Service Centres. Notice of discontinuance should be received 30 days prior to the subsequent SIP date.

5. The investor agrees to abide by the terms and conditions of ECS facility of Reserve Bank of India (RBI).

6. Investor will not hold ICICI Prudential Mutual Fund, its registrars and other service providers responsible if the transaction is delayed or not

effected or the investor bank account is debited in advance or after the specific SIP date due to various clearing cycles for ECS.

7. ICICI Prudential Mutual Fund reserves the right to reject any application without assigning any reason thereof.

8. In case of “At Par” cheques, investors need to mentioned the MICR number of his actual bank branch.

B) SIP Payment through Standing Instruction/Direct Debit Facility

1. Standing Instruction/Direct Debit facility is offered to the investors having Bank Account with:

Nature of facility Banks

Standing instruction Axis Bank, HDFC Bank & ICICI Bank.

Direct debit IDBI Bank, Indusind Bank & Kotak Mahindra Bank.

Direct debit (Only Core Banking branches*) Bank of Baroda, Bank of India, Punjab National Bank & Union Bank of India.

* Please contact your local bank branch to confirm if it offers core banking facility.

2. The applicant will have the right to discontinue SIP at any time he or she so desires by providing a written request at the office of the ICICI

Prudential Mutual Fund Customer Service Centres. Notice of discontinuance should be received 30 days prior to the subsequent SIP date.

3. Standing Instructions incomplete in any respect are liable to be rejected.

4. SIP is liable for cancellation if direct debit fails for three consecutive times.

5. The Bank shall not be liable for, nor be in default by reason of, any failure or delay in completion of its obligations under this Agreement,

where such failure or delay in completion of its obligations under this Agreement, where such failure or delay is caused, in whole or in part,

by any acts of God, civil war, civil commotion, riot, strike, mutiny, revolution, fire, flood, fog, war, lightening, earthquake, change of Government

policies, unavailability of Bank's computer system, force majeure events, or any other cause of peril which is beyond the Bank's reasonable

control and which has effect of preventing the performance of the contract by the Bank.

C) General Instructions

1. Existing investors need to provide their folio number in this Standing Instruction or the Auto Debit form and need not to fill in the Common

Application Form.

For minimum application amount to be invested in SIP, risk factors, features etc. please refer to page nos. 14-27 of the Key Information

Memorandum.

2. If the investor selects multiple SIP frequencies or fails to choose any of them, the default SIP frequency will be Monthly.

3. ICICI Prudential Mutual Fund, its registrars and other service providers shall not be responsible and liable for any damages/compensation for

any loss, damage etc. incurred by the investor. The investor assumes the entire risk of using this facility and takes full responsibility.

4. For load structure of the schemes, please refer to the Key Features on page nos. 14-27.

5. In case of SIP with payment mode as ECS/Auto Debit, investors shall be required to submit a cancelled cheque or a photocopy of a cheque

of the bank account for which the debit mandate is provided.

6. SIP TOP UP Facility:

(a) Investors can opt for SIP TOP UP facility, wherein the amount of the SIP can be increased at fixed intervals.

(b) The TOP UP amount has to be in multiples of Rs.500 only.

(c) The frequency is fixed at Yearly and Half Yearly basis. In case the frequency is not selected, the TOP UP facility may not be registered.

(d) In case of Quarterly SIP, only the Yearly frequency is available under SIP TOP UP.

7. The investor hereby agrees to indemnify and not hold responsible, the AMC and its employees, the R&T agent and the service providers

incase his/her bank is not able to effect any of the payment instructions for whatsoever reason.

9Ver01/25/May/2010

I. GENERAL INSTRUCTIONSa) The application form is for Resident Investors/NRIs/FIIs and should be

completed in English in BLOCK Letters.b) The signature(s) should be in English or in any of the Indian languages

specified in the eighth schedule of the constitution of India. Thumbimpressions must be attested by a Magistrate or a Notary Public or a SpecialExecutive Magistrate under his/her official seal. Applications by minors shouldbe signed by their guardians. In case of HUF, the Karta should sign on behalfof the HUF.Signature mismatch cases: While processing the redemption / switch outrequest in case the AMC / Registrar come across a signature mismatch, thenthe AMC/ Registrar reserves the right to process the redemption only on thebasis of supporting documents (like copy of passport, driving licence etc.)confirming the identity of the investors. List of such documents may be notifiedby AMC from time to time on its website.

c) If you are a new investor and wish to apply for SIP through Auto Debit byway of Electronic Clearing Service (ECS) or Standing Instructions to your bankaccount you need to fill in the respective Form in addition to the CommonApplication Form.

d) The investors who wish to avail Systematic Withdrawal Plan (SWP) /Systematic Transfer Plan (STP) facilities must use separate transaction formsavailable in any of the ICICI Prudential Mutual Fund Customer Service Centres.

e) The application form number, the scheme name and the name of the applicantshould be mentioned on the reverse side of the instrument that accompaniesthe application.

f) The Application completed in all respects along with the cheque/demand draftmust be submitted to the nearest Customer Service Centre. Applicationsincomplete in any respect or not accompanied by a cheque or demand draftfor the amount payable are liable to be rejected and the money paid will berefunded without interest.

g) No receipt will be issued for the application money. The Customer ServiceCenters will stamp and return the acknowledgement slip in the applicationform, to acknowledge receipt of the application.

h) Overwriting on application forms/transaction slips: In case of corrections/overwriting on key fields (as may be determined at the sole discretion of theAMC) of the application forms/transaction slips, the AMC reserves the rightto reject the application forms/transaction slips in case the investor(s) has(ve)not countersigned in each place(s) where such corrections/overwriting has(ve)been made.

II. UNITHOLDERS INFORMATIONa) Existing Unitholders

If you have an existing folio with PAN validation & KYC validation (if applicable),please mention the Folio Number in Step 1 and proceed to Step 4 in theapplication form. Please note that the applicable details and mode of holdingwill be as per the existing folio.

b) New Applicant1. Name and address must be given in full (P.O. Box Address is not sufficient).

In case of NRI/PIO/FII investors an overseas address must be provided.2. Name of guardian must be mentioned if the investments are being made

on behalf of a minor. Date of Birth is mandatory in case of minor.Investments of the existing minor investor on minor attaining majority:Upon attaining majority, a minor has to write to the fund, giving hisspecimen signature duly authenticated by his banker as well his new bankmandate, PAN details, UIN details (if applicable as per prevalent SEBIGuidelines) in order to facilitate the Fund to update its records and permitthe erstwhile minor to operate the account in his own right.

3. In case of an application under Power of Attorney or by a limited company,body corporate, registered society, trust or partnership, etc. the relevantPower of Attorney or the relevant resolution or authority to make theapplication as the case may be, or duly certified copy thereof, along withthe Memorandum and Articles of Association / bye-laws must be lodgedalong with the application form.Power of Attorney (POA): In case an investor has issued Power ofAttorney (POA) for making investments, switches, redemptions etc. underhis folio, both the signature of the investor and the POA holder have tobe clearly captured in the POA document to be accepted as a validdocument. At the time of making redemption / switches the fund wouldnot be in a position to process the transaction unless, POA holder’ssignature is available in the POA or proof of identity alongwith signatureis produced along with the POA.

4. PAN is mandatory: As per SEBI Circular MRD/Dop/Cir/-05/2007 dated April27, 2007 Permanent Account Number (PAN) has been made the soleidentification number for all participants transacting in the securities market,irrespective of the amount of transaction, w.e.f. July 02, 2007. PAN ismandatory for all mutual fund investments w.e.f. 1st January, 2008.Accordingly, any application not accompanied with the PAN is liable to berejected. Please note that the PAN copy needs to be attested by any of thefollowing: (a) At the Mutual Fund office (verification with original to be doneby the person accepting the documents) (b) Your Financial Advisor (c) YourBank Manager (d) Gazetted Officer (e) Notarized Copy (f) Judicial Authority.

5. Applicants should indicate their status by ticking the appropriate box.Applications without a tick in the ‘Status’ box will be considered as investmentby “Others”. Those who select the status as “Others”, they should specify theirstatus in the space provided.

6. Applicants should specify the mode of holding. In case it is not mentioned,the default will be “anyone or survivor”. In the case of joint holders, the firstnamed holder shall receive all the Account Statements, dividend/redemption/refund warrants and any other correspondence sent from time to time.

7. Name of a contact person should be mentioned in case of the investment bya Company/Body Corporate/Partnership Firm/Trust/Foreign InstitutionalInvestors (FIIs)/Society/AOP/BOI.

8. Transactions without Scheme/Option Name: In case of fresh/additionalpurchases, if the name of the Scheme on the application form/transactionslip differs with the name on the Cheque/Demand Draft, then the AMC willallot units under the Scheme mentioned on the payment instrument.In case of fresh/additional purchases, if the Scheme name is not mentionedon the application form/transaction slip, then the units will be allotted under

the Scheme mentioned on the Cheque/Demand Draft. The Plan/Option thatwill be considered in such cases if not specified by the customer will bethe default option of the Scheme as per the Scheme InformationDocument. However, in case additional purchase is under the samescheme as fresh purchase, then the AMC reserves the right to allot unitsin the option under which units were allotted at the time of fresh purchase.

III. BANK DETAILSThe first Unitholder should provide the name of the bank branch, completeaddress of the branch, account type and account number, which is mandatory asper Securities Exchange Board of India circular IIAMRP/MF/CIR/07/826/98 datedApril 15, 1998. Applications without this information will be deemed to beincomplete.Please quote 9 Digit Code No. of your Bank and Branch corresponding to BankAccount details. (This number appears on every leaf of your cheque book afteryour cheque number). Please attach a blank “cancelled” Cheque or a clearphotocopy of a cheque issued by your bank verifying of the Code No. The AMCreserves the right to make dividend/redemption payments through ECS/NFT/RTGSwhere details is available.IV. INVESTMENT DETAILSa) Investor has to fill a separate form for each scheme that he wishes to invest in.b) Investor should select only one option (growth/dividend) and corresponding

sub-option (e.g. Reinvest/Payout/Dividend Transfer Plan in case of DividendOption) under the scheme(s) wherever applicable by ticking the appropriatebox.

c) Investor opting for AEP option (under Income Plan & Monthly Income Plan)are requested to choose either the AEP-Regular option or the AppreciationOption, Investor has the option of selecting either Monthly/Quaterly/Half Yearlysub option under the Appreciation Option.Incase investor has selected multiple options under AEP, the default optionwould AEP Regular option, and the default sub option underAppreciationOption would be Monthly sub option.

d) In case, the investor has not selected the option/sub-option for his investments,default option/sub-option as prescribed in the offer document of the relevantscheme will be applied.

e) For minimum application amount, please refer to table given on page 14-27.f) Dividend Transfer Plan:

1) An investor can avail this facility where by dividend declared will beautomatically invested into any open-ended schemes of ICICI PrudentialMutual Fund.

2) The amount to the extent of distribution, will be automatically investedon the ex-dividend date into the scheme selected by the investor at theNAV of that scheme.

3) This facility cannot be availed under Daily Dividend Plans and WeeklyDividend Plans.

V. SYSTEMATIC INVESTMENT PLAN (SIP)a) For SIP facility, please refer to the Key Scheme Features on page nos. 14-27.

And also refer Instruction No.VI(a) for mode of payment for SIP through PDCs.b) Investors opting for SIP need to fill the Common Application Form and tick

any of the payment option such as (i) SIP payment through Bank StandingInstruction/Direct Debit (ii) Auto Debit by way of Electronic Clearing Service(ECS) (iii) Post Dated Cheques (PDCs). If the payment option is Auto Debitthrough ECS or Standing Instruction to the Bank, investors also need to fillthe respective form.

c) The Second SIP installment amount and the subsequent SIP installmentamount should be of the same amount. However, the First SIP installmentneed not be of the same amount as Second and Subsequent SIP installmentsamount. This is applicable to investors opting for SIP through PDCs.

d) In case of SIP transaction where, the mode of payment is through StandingInstruction/Auto Debit facility (offered by select banks) or ECS, investors arenot required to do an initial purchase transaction for the minimum amount asapplicable. However, investors are required to submit SIP request at least30 days prior to the date of first installment.

e) Investors subsribing for SIP are required to submit SIP request at least 30 daysprior to the date of first debit date and SIP start date shall not be beyond 60days for monthly SIP and 100 days for Quarterly SIP from the date ofsubmission of SIP application.

f) In case of SIP with payment mode as ECS/Auto Debit, investors shall berequired to submit a cancelled cheque or a photocopy of a cheque of the bankaccount for which the debit mandate is provided.

g) For entry and exit load structure under the Schemes, please refer to the KeyScheme Features on page nos. 14-27.

h) Issue post dated cheques dated either 7th or 10th or 15th or 25th of the month.A credit confirmation will be sent to the unitholder indicating the new balanceto his or her credit in the account.1) For cheques drawn from locations as determined by ICICI Prudential Asset

Management Company Ltd. (the AMC) from time to time and notified onits website www.icicipruamc.comOption 1: The First SIP installment should be paid through a Demand Draftpayable at places where the Official Points of Acceptance of Transactionof the AMC are located. All the other installments should be through post-dated cheques for the SIP dates i.e. 7th or 10th or 15th or 25th of themonth.The SIP date selected by an Investor should fall at least 20 calendar days afterthe date of first SIP installment. Eg: if the first SIP installment is on January09, 2007, then the SIP date that can be selected by an investor for the secondand subsequent installments should fall after January 29, 2007.Option 2: In case all the installments (i.e. including the first Installment)are paid through post-dated cheques, the SIP forms along-with the post-dated cheques should be submitted at the Official Points of Acceptanceof Transactions of the AMC at least 20 calendar days before the start ofthe SIP. Post-dated cheques for all the installments (i.e. including the firstInstallment) should be dated the SIP dates only i.e. 7th or 10th or 15th or25th of the month.

2. For all SIP applications with Post Dated ChequesThe SIP date selected by an Investor should fall at least 20 calendar daysafter the date of first SIP installment. Eg: if the first SIP installment is on

INSTRUCTIONS FOR FILLING UP THE COMMON APPLICATION FORM

10Ver01/25/May/2010

INSTRUCTIONS FOR FILLING UP THE COMMON APPLICATION FORM (Contd.)January 09, 2007, then the SIP date that can be selected by an investor forthe second and subsequent installments should fall after January 29, 2007.

i) SIP Auto Debit via ECS (Debit Clearing) is available at the following 82 centres:• Agra • Ahmedabad • Allahabad • Amritsar • Anand • Asansol •Aurangabad • Bangalore • Baroda • Belgaum • Bhilwara • Bhopal •Bhubaneshwar • Bijapur • Bikaner • Burdwan • Calicut • Chandigarh •Chennai • Cochin • Coimbatore • Cuttack • Davangeree • Dehradun • Delhi• Dhanbad • Durgapur • Erode • Gadag • Gangtok • Gorakhpur • Gulbarga• Guwahati • Gwalior • Hubli • Hyderabad • Indore • Jabalpur • Jaipur •Jalandhar • Jammu • Jamnagar • Jamshedpur • Jodhpur • Kakinada • Kanpur• Kolhapur • Kolkata • Lucknow • Ludhiana • Madurai • Mandya • Mangalore• Mumbai • Mysore • Nagpur • Nasik • Nellore • Panjim • Patna • Pondicherry• Pune • Raichur • Raipur • Rajkot • Ranchi • Salem • Shimla • Shimoga •Siliguri • Solapur • Surat • Tirupati • Tirupur • Trichur • Trichy • Trivandrum• Udaipur • Udupi • Varanasi • Vijayawada (also covers Guntur, Tenali &Mangalgiri) • Vishakhapatnam.

j) Existing investors opting for SIP need to provide their Folio Number alongwith SIP details.

k) SIP TOP UP Facility: (a) Investors can opt for SIP TOP UP facility, wherein theamount of the SIP can be increased at fixed intervals. (b) The TOP UP amounthas to be in multiples of Rs.500 only. (c) The frequency is fixed at Yearly andHalf Yearly basis. In case the frequency is not selected, the TOP UP facilitymay not be registered. (d) In case of Quarterly SIP only Yearly frequency isavailable under SIP TOP UP.

l) MICRO SIP: Systematic Investment Plans (SIPs) where aggregate ofinstallments in a rolling 12 month period or in a financial year i.e. April to Marchdoes not exceed Rs 50,000 (to be referred as "Micro SIP" hereinafter).Micro SIP investors are required to submit any of the following PHOTOIDENTIFICATION documents along with Micro SIP applications as a proofof identification if the PAN is not provided:(1) Voter Identity Card; (2) Driving License; (3) Government/Defenseidentification card; (4) Passport; (5) Photo Ration Card; (6) Photo Debit Card(Credit card not included because it may not be backed up by a bank account)(7) Employee ID cards issued by companies registered with Registrar ofCompanies (database available in the following link of Ministry of Companyaffairs http://www.mca.gov.in/DCAPortalWeb/dca/MyMCALogin.do?method=setDefaultProperty&mode=31); (8) Photo Identification issued by BankManagers of Scheduled Commercial Banks / Gazetted Officer / ElectedRepresentatives to the Legislative Assembly / Parliament; (9) ID card issuedto employees of Scheduled Commercial / State / District Co-operativeBanks; (10) Senior Citizen / Freedom Fighter ID card issued by Government;(11) Cards issued by Universities / deemed Universities or institutes understatutes like ICAI, ICWA, ICSI; (12) Permanent Retirement Account No (PRAN)card isssued to New Pension System (NPS) subscribers by CRA (NSDL); (13)Any other photo ID card issued by Central Government/State Governments/Municipal authorities/Government organizations like ESIC/EPFO.Investors (including joint holders) will submit a photocopy of any one of theabove documents identified along with Micro SIP applications.Supporting document should be current and valid and copy shall be self attestedby the investor/attested by the ARN holder mentioning the ARN.Micro SIP application without the supporting document will liable to be rejected.The following transactions will not be covered as they are currently notconsidered either for PAN or KYC requirement: (1) Redemption (2) Switch (3)Systematic Transfer Plans (4) Systematic Withdrawal Plans (5) DividendReinvestments / Sweep transactions.This exemption will also not be applicable to normal purchase transactionsupto Rs. 50,000 which will continue to be subject to PAN requirement.This exemption will be applicable ONLY to investments by individuals(including NRIs but not PIOs), Minors, Sole proprietary firms and Joint holders.HUFs and other categories will not be eligible for Micro SIPs.In case the first Micro SIP installment is processed (as the cheque may bebanked), and the application is found to be defective, the Micro SIPregistration will be ceased for future installments. No refunds to be madefor the units already allotted. Investor will be sent a communication to thiseffect. However, redemptions shall be allowed.

VI. MODE OF PAYMENTa) The cheque/demand draft should be drawn in favour of “ICICI Prudential Liquid

Plan” or “ICICI Prudential Sweep Plan” or “ICICI Prudential Income Plan” or“ICICI Prudential Short Term Plan” or “ICICI Prudential Long Term Plan”or “ICICI Prudential Long Term Floating Rate Plan” or “ICICI PrudentialFloating Rate Plan” or “ICICI Prudential Flexible Income Plan” or “ICICIPrudential Gilt Fund – Treasury Plan” or “ICICI Prudential Gilt Fund –Investment Plan” or “ICICI Prudential Gilt Fund – Treasury Plan - PF Option”or “ICICI Prudential Gilt Fund – Investment Plan - PF Option” or “ICICIPrudential Banking & PSU Debt Fund” or “ICICI Prudential Ultra Short TermPlan” or “ICICI Prudential Medium Term Plan” or “ICICI Prudential IncomeOpportunities Fund” or “ICICI Prudential Child Care Plan - Gift Plan” or “ICICIPrudential Child Care Plan - Study Plan” or “ICICI Prudential Monthly IncomePlan” or “ICICI Prudential Income Multiplier Fund”or “ICICI Prudential BalancedFund” or “ICICI Prudential Tax Plan” or “ICICI Prudential FMCG Fund” or “ICICIPrudential Growth Plan” or “ICICI Prudential Technology Fund” or “ICICIPrudential Power” or “ICICI Prudential Dynamic Plan” or “ICICI PrudentialDiscovery Fund”or “ICICI Prudential Emerging S.T.A.R. Fund”or “ICICIPrudential Infrastructure Fund” or “ICICI Prudential Services Industries Fund”or “ICICI Prudential Index Fund”or “ICICI Prudential Indo Asia Equity Fund”or “ICICI Prudential Focused Bluechip Equity Fund” or “ICICI Prudential Equity& Derivatives Fund – Income Optimiser Plan" or "ICICI Prudential Equity &Derivatives Fund – Wealth Optimiser Plan" or “ICICI Prudential Banking &Financial Services Fund” or “ICICI Prudential Target Returns Fund” or “ICICIPrudential Equity Opportunities Fund”, as the case may be and crossed“Account Payee Only”.The cheque / demand draft should be payable at the centre where theapplication is lodged. The cheque / demand draft should be drawn on anybank which is situated at and is a member / sub-member of the Bankers’Clearing House. Cheques/ demand drafts drawn on a bank not participatingin the Clearing House will not be accepted.

b) Separate Cheque/Draft is required for each scheme invested.

c) Payments by Stockinvests, cash, postal orders, money orders and outstationcheques will not be accepted.

d) The Fund will bear the demand draft charges subject to maximum ofRs. 50,000/- per transaction for purchase of units by investors residing atlocation where the Asset Management Company (AMC’s) Customer ServiceCenters/Collection Centers are not located as mentioned in the table below:

Amount of Investment Rate of Charges of Demand Draft(s)

Upto Rs.10,000/- At actual, subject to a maximum of Rs. 50/-Above Rs.10,000/- Rs. 3/- per Rs. 1000/-Maximum Charges Rs. 50,000/-

However, the demand draft charges will not be reimbursed for ICICI PrudentialLiquid Fund, ICICI Prudential Short Term Plan, Prudential ICIC Gilt Fund –Treasury Plan and ICICI Prudential Floating Rate Plan.AMC reserves the right to refuse the reimbursement of demand draft charges,in case of investments made by the same applicant(s) through multipleapplications at its own discretion which will be final and binding on the investor.Investors residing at places other than where the AMC Customer ServiceCenters/ Collection Centers are located, are requested to make the paymentby way of demand draft(s) after deducting bank charges as per the ratesindicated in the above table. It may be noted that additional charges, if any,incurred by the investor over and above the levels indicated above will notbe borne by the Fund.No demand draft charges will be reimbursed by the Fund for purchase of Unitsby investors residing at such locations where the Customer Service Centers/Collection Centers of the AMC are located.

e) NRI/FII/PIO Investors1. Repatriation basis: Payments by NRIs / FIIs / Persons of Indian Origin

residing abroad, may be made either by way of Indian Rupee drafts orcheques by means of (i) inward remittance through normal bankingchannels; or (ii) out of funds held in NRE/FCNR account payable at parand payable at the cities where the Customer Service Centres are located.In case of Indian Rupee drafts purchased or cheques issued from NRE/FCNR Account, an account debit certificate from the bank issuing the draftconfirming the debit should also be enclosed.In case the debit certificate is not provided, the AMC reserves the right toreject the application of the NRI investors.

2. Non Repatriation basis: NRIs or people of Indian origin residing abroadinvesting on a non-repatriable basis may do so by issuing cheques/demanddrafts drawn on Non-Resident Ordinary (NRO) account payable at the citieswhere the Customer Service Centres are located.

VII. NOMINATION1. The nomination can be made only by individuals applying for / holding units

on their own behalf singly or jointly. Non-individuals including society, trust,body corporate, partnership firm, Karta of Hindu Undivided Family, holder ofPower of Attorney cannot nominate. If the units are held jointly, all joint holderswill sign the nomination form. Space is provided as a specimen, if there aremore joint holders more sheets can be added for signatures of holders of unitsand witnesses.

2. A minor can be nominated and in that event, the name and address of the guardianof the minor nominee shall be provided by the unit holder. Nomination can alsobe in favour of the Central Government, State Government, a local authority, anyperson designated by virtue of his office or a religious or charitable trust.

3. The Nominee shall not be a trust (other than a religious or charitable trust),society, body corporate, partnership firm, Karta of Hindu Undivided Family ora Power of Attorney holder. A non-resident Indian can be a Nominee subject tothe exchange controls in force, from time to time.

4. Nomination in respect of the units stands rescinded upon the transfer of units.5. Transfer of units in favour of a Nominee shall be valid discharge by the asset

management company against the legal heir.6. The cancellation of nomination can be made only by those individuals who

hold units on their own behalf singly or jointly and who made the originalnomination.

7. On cancellation of the nomination, the nomination shall stand rescinded andthe asset management company shall not be under any obligation to transferthe units in favour of the Nominee.”

8. Investors who want to make multiple nominations should give a seperaterequest to the AMC.

VIII. DIRECT CREDIT OF DIVIDEND/REDEMPTION: ICICI Prudential AMC hadentered into an arrangement with certain banks such as Citibank N.A., HDFC Bank,HSBC and ICICI Bank for direct credit of redemption and dividend proceeds, ifinvestors have a bank mandate with any of these banks. However, the Fund reservesa right to issue a payment instrument in place of this direct credit facility, and willnot be responsible for any delay on the part of the bank for executing the directcredit. The AMC may alter the list of the banks participating in direct creditarrangement from time to time/ withdraw direct credit facility from the banks, basedon its experience of dealing with any of such banks or add / withdraw the name ofthe bank with whom direct credit facility arrangements can be introduced/discontinued as the case may be.IX. E-MAIL COMMUNICATION: Delivering service through web/e-mail is a moreefficient delivery channel. When an investor has communicated his/her e-mailaddress and has provided consent for sending communication only through email,the Mutual Fund / Registrars are not responsible for email not reaching the investorand for all consequences thereof. The Investor shall from time to time intimatethe Mutual Fund/its transfer agents about any changes in the email address. Incase of a large document, a suitable link would be provided and investor candownload, save and print these documents. However, investor always has a rightto demand a physical copy of any or all the service deliverable and Fund wouldarrange to send the same to the investor. Account statements will be send viaemail by default to investors who have provided their email ID, unless specifiedotherwise. It is deemed that the Unitholder is aware of all the security risksassociated with online communication, including possible third party interceptionof the documents send via email.X. KNOW YOUR CUSTOMER (KYC) NORMS: With effect from February 1, 2008Investors in Mutual Funds investing Rs. 50,000/- and above are required to complywith Know Your Client (KYC) norms under the Prevention of Money Laundering Act2002 (PMLA). Copy of KYC acknowledgement is mandatory. Please refer AMFI’s orAMC’s website (www.amfiindia.com or www.icicipruamc.com) for details.

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Scholarship Scheme for Meritorious Students under the aegis of ICICIPrudential Young Students Education Trust:

For the benefit of the Unitholders under the Plans of the Scheme, the AMC hasinstituted a Scholarship Scheme. For this purpose, the AMC has set up a Trustunder the aegis of the ICICI Prudential Young Students Education Trust (ScholarshipTrust) with an initial corpus of Rs 500,000 from out of the resources of the AMC.AMC contributes each year, commencing from the second year of setting up ofthe above Trust, from out of AMC’s profits an amount equivalent to 0.10% ofaverage net assets of the Plans under this Scheme. The Scholarship Scheme isbeing administered by an eminent Board of Trustees (Trustees for ScholarshipScheme or Trustees). Under this Scholarship Scheme the eligible selected studentswill avail of financial assistance to defray a part of the expenses to be incurred bythem/their parents/lawful guardian, on tuition fees, cost of books, cost of hostelfees (in case of students residing in the hostels), cost of travel abroad (in case ofstudents securing admissions in accredited and recognized colleges/Universitiesabroad) and such other expenses which a student is required to bear as per theterms of admission applicable to the course/program to which he/she securedadmission. It is proposed to make available the scholarships of not overRs.100,000 each (to be paid in one installment or such other number ofinstallments as the Trustees may decide) to such students who secured admissionfor pursuing graduate/post graduate programs in the disciplines of Engineering/Management/ Accounting/ Law/ Medicine/ Life/ Physical/ Biological sciences/Mathematics/ Liberal Arts etc. and such other core disciplines which the Trusteesfor Scholarship Scheme feel appropriate. The Trustees for the above purpose willinvite applications through an advertisement and by sending a communicationthrough newsletter to all the applicants under the Scheme. The advertisement/communication will clearly specify the eligibility criteria, including the minimumcut off marks required for the preliminary screening of the applications. Basedon the shortlist prepared in the preliminary screening, the Trustees may conduct/hold a written test/interview (or both) and prepare a final list of candidates forparticipating in the scholarship scheme. Scholarships will be awarded to theeligible selected students based on the criteria laid down by the Trustees of theabove Trust for Scholarship Scheme.

The scholarships are being awarded commencing from one year after the dateof the allotment of Units under ICICI Prudential Child Care Plan.

As the Scholarship Scheme is primarily meant for the benefit of the Unitholder,the Trustee (to ICICI Prudential Mutual Fund), in consultation the Trustees forScholarship Scheme may impose such additional conditions, as deemednecessary, in regard to the term of investment holding of the Applicant in theFund. Such additional terms and conditions if stipulated will only be applicableto the Unitholders who receive Scholarships under the Scholarship Schemedetailed above.

Contributions by AMC towards corpus of Scholarship Scheme:As AMC intends to contribute each year out of its profits an amount equivalentto 0.10% of average net assets of the Plans under this Scheme to the ScholarshipTrust to institute a Scholarship Scheme for the benefit of the Unitholders underthe Plans, certain disclosure are being provided hereinbelow as prescribed bySEBI:

Details of Profit/(Loss) after Tax of AMC:(in Rupees ‘000)

31st March 31st March 31st March 31st March 31st March

2006 2007 2008 2009 2010

Profit/(Loss) after Tax 311,258 483,788 821,046 7,110 1,280,255

In the future years, if the AMC makes a loss, then the contributions to the corpusof the Scholarship Trust will be made by the AMC from it’s Share Capital andFree Reserves, after ensuring that the AMC complies with the net-worthrequirements in terms of the Regulations.

Personal Accident Insurance cover for the Resident Applicants :

The Fund has been providing Personal Accident Insurance cover to the ResidentApplicants under the Scheme from the date of allotment of Units. The AMC hasnegotiated with ICICI Lombard General Insurance Co. Ltd. the provisions of sucha cover under a Group Insurance Policy. The following are the broad featuresof the insurance cover. The Applicants/ Unitholders should note that completedetails of insurance cover would be advised to them along with the first AccountStatements to be sent to them.

Details of Personal Accident Insurance cover:

Parent/ Legal Guardian of Unitholder (as specified in the Application Form),resident in India, who has applied for the Units in the name of the BeneficiaryChild will be entitled for Personal Accident Insurance cover, on allotment of theUnits so applied for. In case of Corporate / other non-individual legal entitiesand juridical persons who are the Applicants under the Scheme, the insurancecover will be available to the Parent/Legal Guardian of the Beneficiary Child(Unitholder) whose name is stated in the Application form. For this purpose,Group Insurance Policy has been obtained from ICICI Lombard General InsuranceCo. Ltd. The Group Policy, subject to its various terms and conditions, isextended to the Applicants under the Plans accident insurance cover for deathby accident or Permanent Total Disability sustained due to accident. The saidinsurance cover will become operative from the date of allotment of Units underthe Plans till the Unit holder (Beneficiary Child) attains 18 years of age or theinvestment under the Plans is redeemed, which ever event occurs earlier. AnApplicant not resident in India (“Non-resident Applicant”) will not be coveredunder the accident insurance cover. Under the above Policy, the insurance coverthat will be available to the Applicant will, for the present, be equivalent to10 times the value of the Units (valued at the purchase price) outstandingagainst the name of the Unit holder subject to a maximum limit of Rs.5 lakhsper Unitholder. The said limit for the insurance cover may be changed by theTrustee by giving at least one month advance notice to all the Unitholders underthe Scheme. Such notice will be given by suitable display at the Investor ServiceCentres, communication through the newsletter of the AMC, providing

addendum to the offer document and by a display on the website of AMC. TheUnitholders will also be informed about the cost implication consequent to thechange in the limit of the insurance cover. The insurance cost together withother recurring expenses shall be within the overall limits prescribed under theRegulations. The changes in the limit for the insurance cover as stated abovewill be applicable to all new claims to be received by ICICI Lombard GeneralInsurance Co. Ltd., after the date on which the revision in the maximum limit iseffected.

The insurance premium in respect of this cover will be charged to the Scheme.

In the case of an accident resulting in death or permanent total disability of theResident Applicant, the Applicant or his/her legal representatives may file theclaim directly with the designated branch of the ICICI Lombard General InsuranceCo. Ltd. supported by all relevant documents as required by the Insurer andthe payment of the claim may be made to the said Applicant/ legalrepresentatives by the insurance company. All insurance claims will be settledin India and shall be payable in Indian Rupees only. Detailed guidelines/procedure relating to Personal Accident Insurance will be advised along withthe Account Statement.

The Trustee, the AMC, the Mutual Fund or their Directors, or their employeesshall not be liable for any claims (including but not limited to rejection ofany claim, non settlement, delays etc.) arising out of the insurance coverprovided to the Applicant.

Subject to what has been stated above, the AMC reserves a right to modify /annul the said insurance cover on a prospective basis. The AMC also reservesthe right to change the insurance company from time to time.

The cost of obtaining the insurance cover as indicated under the RecurringExpenses is indicative and may change from year to year.

Under the above Policy, the insurance cover that will be available to the Applicantwill, for the present, be equivalent to 10 times the value of the Units (valued atthe purchase price) outstanding against the name of the Unit holder subject toa maximum limit of Rs.5 lakhs per Unitholder.

As stated earlier, the AMC has negotiated with ICICI Lombard General InsuranceCo. Ltd. the provisions of such a cover under a Group Insurance Policy. NIA hasprovided certain standard exclusions that would be applicable to the saidinsurance cover and the same are as follows:

(1) The Personal Accident Insurance Cover will not be available for anApplicant who has completed 70 years.

(2) The Personal Accident Insurance Cover will not be available in case ofnatural death of an Applicant.

(3) Pregnancy Exclusion: The Personal Accident Insurance Cover shall notextend to cover death or disablement resulting directly or indirectlycaused by, contributed to or aggravated or prolonged by childbirth orfrom pregnancy or in consequence thereof.

(4) War Exclusion: The Personal Accident Insurance Cover shall not extendto cover death or disablement due to or arising out of or directly orindirectly connected with or traceable to War, Invasion, Act of foreignenemy, Hostilities, civil war, Rebellion, Revolution, Insurrection, Mutiny,Military or Usurped Power Seizure, Capture, Arrests, Restraints andDetainment of all.

(5) Nuclear Exclusion: The Personal Accident Insurance Cover shall not extendto cover death or disablement, injury or disease directly or indirectlycaused by or contributed to by or arising from ionising radiation orcontamination by radioactivity from any nuclear fuel or from any nuclearwaste from combustion of nuclear fuel including combustion resulting fromany self-sustaining process of nuclear fission.

It may be noted that the complete details of insurance cover would be advisedto Applicants/ Unitholders along with the first Account Statements to be sent tothem.

The availability of the insurance cover per folio is explained by way of an illustrationas follows:

For an Applicant who makes an initial investment of Rs. 20,000 the insurancecover available will be as follows:

The available insurance cover would be 10 times investment subject to amaximum of Rs. 5,00,000. In the present illustration, the amount of cover wouldbe Rs. 2,00,000 (Ten times the investment of Rs. 20000). Let us say that thisApplicant makes an additional investment of Rs. 50,000. The additional amountof insurance cover available to the Applicant will be Rs. 3,00,000, being the balanceadditional cover available, which taken with the then existing cover aggregatesto Rs. 5,00,000.

Further, the insurance cover at any point will be valued based on the purchaseprice of the Units. For example, if A subscribed to the 1000 Units at NAV of Rs.10 under folio X of the Plan on 1st January 2001, then the Personal Accident coveravailable to A under folio X will be for Rs. 1,00,000. Subsequently, assuming thatthe NAV moved up to Rs. 15 and the said investor redeemed Rs. 12,000 worth ofUnits, the redemption translates to 800 Units, out of 1,000 Units originallysubscribed to. The insurance cover to be cancelled works out to Rs. 80,000 (being8/10th of Rs. 1,00,000) and the balance cover available to A under folio X will beRs. 20,000.

Note: Please note that the details mentioned in the above illustration are onlyto explain how the insurance cover is calculated. The NAVs used in the aboveillustration are hypothetical.

Assignment Clause

The assignee of the insurance policy of the Parent/Legal Guardian need to haveattained the age of majority as on the date of investment in the Scheme. A minorcannot be appointed as an assignee for the insurance policy.

Birth date of the Unitholder and Parent/Legal Guardian is mandatory. Nonsubmission of birth date may lead to rejection of the Application Form.

SCHOLARSHIPS UNDER ICICI PRUDENTIAL CHILD CARE PLAN

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I. GENERAL INSTRUCTIONS

a) The application form is for Resident Investors/NRIs/FIIs and should be completed in Englishin BLOCK Letters.

b) The signature(s) of the Parent/Legal Guardian should be in English or in any of the Indianlanguages specified in the eighth schedule of the constitution of India. Thumb impressionsmust be attested by a Magistrate or a Notary Public or a Special Executive Magistrate underhis/her official seal. In case of HUF, the Karta should sign on behalf of the HUF.

Signature mismatch cases: While processing the redemption / switch out request in casethe AMC / Registrar come across a signature mismatch, then the AMC/ Registrar reservesthe right to process the redemption only on the basis of supporting documents confirmingthe identity of the investors. List of such documents would be notified by AMC from time totime on its website.

c) The assignee of the insurance policy of the Parent/Legal Guardian need to have attained the ageof majority as on the date of investment in the Scheme. A minor cannot be appointed as anassignee for the insurance policy.

d) Parent/Legal Guardian who has completed the age of 70 years as on the date of the investmentswill not be covered under the insurance policy.

e) Birth date of the Unitholder and Parent/Legal Guardian is mandatory. Non submission of birth datemay lead to rejection of the Application Form.

f) Main Application Form – For one time investment or the investment via SIP through PDCs,you need to fill in only the Main Application Form.

g) The application form number, the scheme name and the name of the applicant should bementioned on the reverse of the instrument that accompanies the application.

h) The Application completed in all respects along with the cheque/demand draft must besubmitted to the nearest Customer Service Center. Applications incomplete in any respector not accompanied by a cheque or demand draft for the amount payable are liable to berejected and the money paid will be refunded without interest.

i) No receipt will be issued for the application money. The Customer Service Centres will stampand return the acknowledgement slip in the application form, to acknowledge receipt of theapplication.

j) Tax Status of the investor: For all fresh purchases, in case the investor has not selected/incorrectly selected the tax status in the application form, the AMC shall update the tax statusbased on Permanent Account Number/Bank account details or such other information of theinvestor available with the AMC for the purpose of determining the tax status of the investor.The AMC shall not be responsible for any claims made by the investor/third party on accountof updation of tax status.

k) Overwriting on application forms/transaction slips: In case of corrections/overwriting onkey fields (as may be determined at the sole discretion of the AMC) of the application forms/transaction slips, the AMC reserves the right to reject the application forms/transaction slipsin case the investor(s) has(ve) not countersigned in each place(s) where such corrections/overwriting has(ve) been made.

l) Processing of Systematic Investment Plan (SIP) cancellation request(s): The AMC willendeavour to have the cancellation of registered SIP mandate effected within 30 days fromthe date of acceptance of the cancellation request from the investor. The existing instructions/mandate will remain in force till such date that it is confirmed to have been cancelled.

m) Submission of separate forms/transaction slips of Systematic Withdrawal Plan (SWP)/Systematic Transfer Plan (STP) facilities: Investors who wish to opt for SystematicWithdrawal Plan/Systematic Transfer Plan facility have to submit their request(s) in a separatedesignated forms/transaction slips. In case, if AMC do not receive such requests in separatedesignated forms/transaction slips, it reserves the right to reject such request(s).

n) As per the Regulations, the Fund shall despatch redemption proceeds within 10 Businessdays of receiving the redemption request. Investors are advised to refer to the sections titled“Suspension of sale and redemption of units” and “Right to limit Redemption”. The defaultoption for payment of redemption/dividend proceeds would be Direct Credit into their bankaccount (in case the investor has provided his bank mandate as one of the banks participatingin direct credit arrangement and if he fails to specify the mode of payment).

o) Where as a result of a redemption/switch arising out of excess holding by an investor beyond25% of the net assets of the scheme in the manner envisaged under specified SEBI circulars,such redemption/switch will not be subject to exit load.

II. UNITHOLDERS INFORMATION

a) Existing Unitholders: Investors already having an account in any of the ICICI Prudentialschemes, and making investments in ICICI Prudential Child Care Plan, should provide theirFolio Number in Step 1. The names of the applicants, mode of holding etc. will be as perthe folio number provided. Existing unitholders may directly proceed to Step 4.

b) New Applicant

1. Name and address must be given in full (P.O. Box Address is not sufficient). In case ofNRI/PIO/FII investors an overseas address must be provided.

2. Name of guardian must be mentioned if the investments are being made on behalf of aminor. Date of Birth is mandatory in case of minor.

Investments of the existing minor investor on minor attaining majority: Upon attainingmajority, a minor has to write to the fund, giving his specimen signature dulyauthenticated by his banker as well his new bank mandate, PAN details, UIN details (ifapplicable as per prevalent SEBI Guidelines) in order to facilitate the Fund to update itsrecords and permit the erstwhile minor to operate the account in his own right.

3. In case of an application under Power of Attorney or by a limited company, body corporate,registered society, trust or partnership, etc. the relevant Power of Attorney or the relevantresolution or authority to make the application as the case may be, or duly certified copythereof, along with the Memorandum and Articles of Association / bye-laws must be lodgedalong with the application form.

Power of Attorney (POA): In case an investor has issued Power of Attorney (POA) formaking investments, switches, redemptions etc. under his folio, both the signature ofthe investor and the POA holder have to be clearly captured in the POA document to be

accepted as a valid document. At the time of making redemption/ switches the fundwould not be in a position to process the transaction unless, POA holder’s signature isavailable in the POA or proof of identity alongwith signature is produced along with thePOA.

4. PAN is mandatory: As per SEBI Circular MRD/Dop/Cir/-05/2007 dated April 27, 2007Permanent Account Number (PAN) has been made the sole identification number for allparticipants transacting in the securities market, irrespective of the amount of transaction,w.e.f. July 02, 2007. PAN is mandatory for all mutual fund investments w.e.f. 1st January,2008. Accordingly, any application not accompanied with the PAN is liable to be rejected.Please note that the PAN copy needs to be attested by any of the following: (a) At theMutual Fund office (verification with original to be done by the person accepting thedocuments) (b) Your Financial Advisor (c) Your Bank Manager (d) Gazetted Officer (e)Notarized Copy (f) Judicial Authority.

5. Applicants should indicate their status by ticking the appropriate box. Applicationswithout a tick in the ‘Status’ box will be considered as investment by “Others”. Thosewho select the status as “Others”, they should specify their status in the space provided.”

6. Applicants should specify the mode of holding. In case it is not mentioned, the default willbe “either or survivor”. In the case of joint holders, the first named holder shall receive allthe Account Statements, dividend/redemption/refund warrants and any other correspondencesent from time to time.

7. Name of a contact person should be mentioned in case of the investment by a Company/Body Corporate/Partnership Firm/Trust/Foreign Institutional Investors (FIIs)/Society.

III. BANK DETAILS: The first Unitholder should provide the name of the bank branch, completeaddress of the branch, account type and account number, which is mandatory as per SecuritiesExchange Board of India circular IIAMRP/MF/CIR/07/826/98 dated April 15, 1998. Applicationswithout this information will be deemed to be incomplete.

Please quote 9 Digit Code No. of your Bank and Branch corresponding to Bank Accountdetails. In case of At Par accounts, kindly provide the correct MICR number of the bankbranch. (This number appears on every leaf of your cheque book after your cheque number).Please attach a blank “cancelled” Cheque or a clear photocopy of a cheque issued by yourbank verifying of the Code No.

IV. INVESTMENT DETAILS

a) Investor has to fill in a separate form for each Plan under the Scheme that he wishes to investin.

b) Minimum Application Amount:

For lump sum investment: Rs. 5,000/- and in multiples of Re. 1/-

Minimum additional amount: Rs. 1,000/- and in multiples thereof.

For Monthly SIP: Rs. 1,000/- + 5 post-dated cheques for a minimum of Rs.1000/- each.

For Quarterly SIP: Rs. 5,000/- + 4 post-dated cheques for a minimum of Rs.5000/- each.

V. SYSTEMATIC INVESTMENT PLAN (SIP)

a) Investor opting for SIP and wish to make payment through Post Dated Cheques (PDCs) needsto select the nature of payment and fill in the respective columns under the heading“Investment Details under ICICI Prudential Child Care Plan” in the Main Application Form. Ifthe payment option is Auto Debit through ECS or Standing Instruction to the Bank, investorhas to fill the respective form along with the main application form.

b) The First SIP installment amount and the Second SIP installment amount need not be of thesame amount. However, the Second and Subsequent SIP installments must be of the sameamount.

c) Issue post dated cheques dated either 7th or 10th or 15th or 25th of the month. A creditconfirmation will be sent to the unitholder indicating the new balance to his or her credit inthe account.

d) SIP Auto Debit via ECS (Debit Clearing) is available at the following 81 centres:

• Agra • Ahmedabad • Allahabad • Amritsar • Asansol • Aurangabad • Bangalore • Baroda• Belgaum • Bhilwara • Bhopal • Bhubaneshwar • Bijapur • Bikaner • Burdwan • Calicut• Chandigarh • Chennai • Cochin • Coimbatore • Cuttack • Davangeree • Dehradun •Delhi • Dhanbad • Durgapur • Erode • Gadag • Gangtok • Gorakhpur • Gulbarga •Guwahati • Gwalior • Hubli • Hyderabad • Indore • Jabalpur • Jaipur • Jalandhar • Jammu• Jamnagar • Jamshedpur • Jodhpur • Kakinada • Kanpur • Kolhapur • Kolkata • Lucknow• Ludhiana • Madurai • Mandya • Mangalore • Mumbai • Mysore • Nagpur • Nasik •Nellore • Panjim • Patna • Pondicherry • Pune • Raichur • Raipur • Rajkot • Ranchi •Salem • Shimla • Shimoga • Siliguri • Solapur • Surat • Tirupati • Tirupur • Trichur •Trichy • Trivandrum • Udaipur • Udupi • Varanasi • Vijayawada (also covers Guntur, Tenali& Mangalgiri) • Vishakhapatnam.

e) Existing investors opting for SIP need to provide their Folio Number along with SIP details.

f) SIP TOP UP Facility: (a) Investors can opt for SIP TOP UP facility, wherein the amount ofthe SIP can be increased at fixed intervals. (b) The TOP UP amount has to be in multiples ofRs.500 only. (c) The frequency is fixed at Yearly and Half Yearly basis. In case the frequencyis not selected, the TOP UP facility may not be registered. (d) In case of Quarterly SIP, onlySIP TOP UP Yearly frequency is available.

g) Investors subsribing for SIP are required to submit SIP request at least 30 days prior to thedate of first debit date and SIP start date shall not be beyond 60 days for monthly SIP and100 days for Quarterly SIP from the date of submission of SIP application.

The applicant will have the right to discontinue SIP at any time he or she so desires byproviding a written request at the office of the ICICI Prudential Mutual Fund Customer ServiceCentres. Notice of discontinuance should be received 30 days prior to the subsequent SIPdate. The investor will cease to be a part of the SIP on receipt of the written request.

h) MICRO SIP: Systematic Investment Plans (SIPs) where aggregate of installments in a rolling12 month period or in a financial year i.e. April to March does not exceed Rs 50,000 (to bereferred as "Micro SIP" hereinafter).

Micro SIP investors are required to submit any of the following PHOTO IDENTIFICATIONdocuments along with Micro SIP applications as a proof of identification if the PAN isnot provided:

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(1) Voter Identity Card; (2) Driving License; (3) Government/Defense identification card;(4) Passport; (5) Photo Ration Card; (6) Photo Debit Card (Credit card not included becauseit may not be backed up by a bank account) (7) Employee ID cards issued by companiesregistered with Registrar of Companies (database available in the following link of Ministryof Company affairs http://www.mca.gov.in/DCAPortalWeb/dca/MyMCALogin.do?method=setDefaultProperty&mode=31); (8) Photo Identification issued by Bank Managers ofScheduled Commercial Banks / Gazetted Officer / Elected Representatives to theLegislative Assembly / Parliament; (9) ID card issued to employees of ScheduledCommercial / State / District Co-operative Banks; (10) Senior Citizen / Freedom FighterID card issued by Government; (11) Cards issued by Universities / deemed Universitiesor institutes under statutes like ICAI, ICWA, ICSI; (12) Permanent Retirement AccountNo (PRAN) card isssued to New Pension System (NPS) subscribers by CRA (NSDL);(13) Any other photo ID card issued by Central Government/State Governments/Municipalauthorities/Government organizations like ESIC/EPFO.

Investors (including joint holders) will submit a photocopy of any one of the above documentsidentified along with Micro SIP applications.

Supporting document should be current and valid and copy shall be self attested by theinvestor/attested by the ARN holder mentioning the ARN number.

Micro SIP application without the supporting document will liable to be rejected.

The following transactions will not be covered as they are currently not considered eitherfor PAN or KYC requirement: (1) Redemption (2) Switch (3) Systematic Transfer Plans (4)Systematic Withdrawal Plans (5) Dividend Reinvestments / Sweep transactions.

This exemption will also not be applicable to normal purchase transactions upto Rs. 50,000which will continue to be subject to PAN requirement.

This exemption will be applicable ONLY to investments by individuals (including NRIs butnot PIOs), Minors, Sole proprietary firms and Joint holders. HUFs and other categories willnot be eligible for Micro SIPs.

In case the first Micro SIP installment is processed (as the cheque may be banked),and the application is found to be defective, the Micro SIP registration will be ceasedfor future installments. No refunds to be made for the units already allotted. Investorwill be sent a communication to this effect. However, redemptions shall be allowed.

VI. SYSTEMATIC TRANSFER PLAN (STP): Systematic Transfer Plan (STP) is an option where inthe Unitholders of Study Plan can opt to transfer a fixed amount at regular intervals and providestanding instructions to the AMC to switch the same into the Gift Plan. No exit load will be chargedon the amount transferred from Study Plan to Gift Plan.

VII. MODE OF PAYMENT

a) The cheque/demand draft should be crossed “Account Payee Only” and drawn in favour of“ICICI Prudential Child Care Plan - Gift Plan” or “ICICI Prudential Child Care Plan - StudyPlan”. The Cheque/Demand Draft should be payable locally at the centre where the applicationis lodged.

b) Separate Cheque/Draft is required for each Plan i.e. Gift Plan and Study Plan.

c) Payments by Stock invest and outstation and/or postdated cheques will not be accepted.The Fund will bear the demand draft charges subject to maximum of Rs. 50,000/- pertransaction for purchase of units by investors residing at location where the AssetManagement Company (AMC's) Customer Service Centers/ Collection Centers are not locatedas mentioned in the table below:

Amount of Investment Rate of Charges for Demand Draft(s)

Upto Rs.10,000/- At actual, subject to a maximum of Rs. 50/-Above Rs.10,000/- Rs. 3/- per Rs. 1000/-Maximum Charges Rs. 50,000/-

AMC reserves the right to refuse bearing of demand draft charges, in case of investmentsmade by the same applicant(s) through multiple applications at its own discretion which willbe final and binding on the investor.

Investors residing at places other than where the AMC Customer Service Centers/ CollectionCenters are located, are requested to make the payment by way of demand draft(s) afterdeducting charges as per the rates indicated in the above table. It may be noted that additionalcharges, if any, incurred by the investor over and above the levels indicated above will notbe borne by the Fund.

No demand draft charges will be borne by the Fund for purchase of Units by investors residingat such locations where the Customer Service Centers/Collection Centers of the AMC arelocated.

The Trustee shall have absolute discretion to accept/reject any application for purchase ofUnits, if in the opinion of the Trustee, increasing the size of Scheme's Unit capital is not inthe general interest of the Unitholders, or the Trustee for any other reason believes it wouldbe in the best interest of the Schemes or its Unitholders to accept/reject such an application.

d) NRI/FII/PIO Investors

1. Repatriation basis:

Payments by NRIs/FIIs/Persons of Indian Origin residing abroad, may be made either byway of Indian Rupee drafts or cheques by means of (i) inward remittance through normalbanking channels; or (ii) out of funds held in NRE/FCNR account payable at par andpayable at the cities where the Customer Service Centres are located.

In case of Indian Rupee drafts purchased or cheques issued from NRE/ FCNR Account,an account debit certificate from the bank issuing the draft confirming the debit shouldalso be enclosed.

In case the debit certificate is not provided, the AMC reserves the right to reject theapplication of the NRI investors.

2. Non Repatriation basis

NRIs or people of Indian origin residing abroad investing on a non-repatriable basis maydo so by issuing cheques/demand drafts drawn on Non-Resident Ordinary (NRO) accountpayable at the cities where the Customer Service Centres are located.

3. For minor applicant, if the Parent/ Legal Guardian is non-resident in India and thebeneficiary child is resident in India or vice versa the redemption proceeds will not berepatriated out side India. The said proceeds will be payable only to a non-repatriationbank account.

VIII. NOMINATION

1. The nomination can be made only by individuals applying for / holding units on their ownbehalf singly or jointly. Non-individuals including society, trust, body corporate, partnershipfirm, Karta of Hindu Undivided Family, holder of Power of Attorney cannot nominate. If theunits are held jointly, all joint holders will sign the nomination form. Space is provided as aspecimen, if there are more joint holders more sheets can be added for signatures of holdersof units and witnesses.

2. A minor can be nominated and in that event, the name and address of the guardian of theminor nominee shall be provided by the unit holder. Nomination can also be in favour of theCentral Government, State Government, a local authority, any person designated by virtue ofhis office or a religious or charitable trust.

3. The Nominee shall not be a trust (other than a religious or charitable trust), society, bodycorporate, partnership firm, Karta of Hindu Undivided Family or a Power of Attorney holder. Anon-resident Indian can be a Nominee subject to the exchange controls in force, from time totime.

4. Nomination in respect of the units stands rescinded upon the transfer of units.

5. Transfer of units in favour of a Nominee shall be valid discharge by the asset managementcompany against the legal heir.

6. The cancellation of nomination can be made only by those individuals who hold units on theirown behalf singly or jointly and who made the original nomination.

7. On cancellation of the nomination, the nomination shall stand rescinded and the assetmanagement company shall not be under any obligation to transfer the units in favour of theNominee.”

8. At the time when the unitholder is still a minor, the parent/legal guardian can change thenominee by submitting the necessary documents and that the latest application would overrideall other nominations made in the past.

IX. DIRECT CREDIT OF DIVIDEND/REDEMPTION: ICICI Prudential AMC had entered into anarrangement with certain banks such as ICICI Bank, HDFC Bank, Citibank N.A. and HSBC for directcredit of redemption and dividend proceeds, if investors have a bank mandate with any of thesebanks. However, the Fund reserves a right to issue a payment instrument in place of this directcredit facility, and will not be responsible for any delay on the part of the bank for executing thedirect credit. The AMC may alter the list of the banks participating in direct credit arrangement fromtime to time/ withdraw direct credit facility from the banks, based on its experience of dealing withany of such banks or add / withdraw the name of the bank with whom direct credit facilityarrangements can be introduced/ discontinued as the case may be.

X. COMMUNICATION VIA ELECTRONIC MAIL (E-MAIL): It is hereby notified that wherever theinvestor(s) has/have provided his/their e-mail address in the application form or any subsequentcommunication in any of the folio belonging to the investor(s), the Fund/Asset Management Companyreserves the right to use Electronic Mail (e-mail) as a default mode to send various communicationwhich include account statements for transactions done by the investor(s). The investor(s) mayrequest for a physical account statement by writing or calling the Fund's Investor Service Centre/Registrar & Transfer Agent. In case of specific request received from investor(s), the Fund shallendeavour to provide the account statement to the investor(s) within 5 working days from the receiptof such request. The Fund shall comply with SEBI Circular No. IMD/CIR/12/80083/2006 datedNovember 20, 2006 with respect to despatch of the account statement.

XI. KNOW YOUR CUSTOMER (KYC) NORMS: With effect from February 1, 2008 Investors inMutual Funds investing Rs. 50,000/- and above are required to comply with Know Your Client(KYC) norms under the Prevention of Money Laundering Act 2002 (PMLA). Copy of KYCacknowledgement is mandatory. Please refer AMFI’s or AMC’s website (www.amfiindia.com orwww.icicipruamc.com) for details.

INSTRUCTIONS FOR FILLING UP THE CHILD CARE PLAN APPLICATION FORM

Download - ICICI PRUDENTIAL MUTUAL FUND APPLICATION FORM

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