religare nifty etf application form
TRANSCRIPT
8/6/2019 Religare Nifty ETF Application Form
http://slidepdf.com/reader/full/religare-nifty-etf-application-form 1/6
Religare Nifty Exchange Traded Fund(An Open Ended Exchange Traded Fund)
ew Fund Oer Opens : 23rd May, 2011 Closes : 6th June, 2011
Key Information Memorandum (KIM) sets forth the information, which a prospective investor ought to know before investing. For further details of the Scheme/Mutual Fund, due diligence certicate by the AMC, Key Personnel, investors’ rights & servi
tors, 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 distribm the website www. religaremf.come Scheme particulars have been prepared in accordance with Securities and Exchange Board of India (Mutual Funds) Regulations, 1996, as amended till date, and led with Securities and Exchange Board of India (SEBI). The units beingpublic subscription have not been approved or disapproved by SEBI, nor has SEBI certied the accuracy or adequacy of this KIM.claimer of National Stock Exchange of India Ltd. (NSE)to be distinctly understood that the permission given by NSE should not in any way be deemed or construed that the Scheme Information Document has been cleared or approved by NSE nor does it certify the correctness or completeness of any of the contents of the drarmation Document. The investors are advised to refer to the Scheme Information Document for the full text of ‘Disclaimer Clause of NSE’.”
estmentjective
To generate returns which closely correspond to the returnsgenerated by securities as represented by S&P CNX Nifty Index,subject to tracking error, if any.
However, there is no assurance or guarantee that the investmentobjective of the Scheme will be achieved. The Scheme does notassure or guarantee any returns.
set Allocationttern of theheme
Instruments Indicative Allocation(% of total assets)
Risk Prole
Minimum MaximumHigh/
Medium / Low
Securitiescovered byS&P CNX
Nifty*
95 100 High
Debt andMoney MarketInstruments
0 5Low to
Medium
*Exposure to equity derivatives of the index itself or itsconstituent stocks may be undertaken when equity shares areunavailable, insucient or for rebalancing in case of corporateactions for a temporary period. The maximum derivative positionwill be restricted to 10% of the net assets of the Scheme. Thecumulative gross exposure through equity, debt and derivativepositions shall not exceed 100% of the net assets of the Scheme,subject to provisions of SEBI circular dated August 18, 2010 w.r.t.investment in derivatives. However, fully hedged positions in thesame security will be excluded while calculating aggregate assetallocation of the Scheme.
The Scheme may engage in short selling of securities inaccordance with the framework relating to short selling andsecurities lending and borrowing specied by SEBI from time totime.
estmentategy of the
heme
The Fund will follow a passive investment strategy and willinvest in companies comprising the S&P Nifty Index in thesame weights as in the Index with an endeavor to track thebenchmark index with as low tracking error as possible. TheFund may, for a temporary period, take exposure to derivativesof the index or its constituent stocks when equity shares areunavailable, insucient or for rebalancing in case of corporateactions and when it makes economic benet for the fund. TheFund in order to meet liquidity and expense requirementsmay also invest in debt and money market instruments.• Equity and Equity Related Instruments: Equity share is a
security that represents ownership interest in a company.It is issued to those who have contributed capital in settingup an enterprise. Equity Related Instruments are securitieswhich give the holder of the security right to receive EquityShares on pre agreed terms. It includes convertible bonds,convertible debentures, equity warrants, convertiblepreference shares, etc.
• Exchange Traded Fund: A scheme whose units are listed onthe Exchange and can be bought/sold at a price, which maybe close to the NAV of the scheme.
• Security selection criteria: In terms of investment objectiveand asset allocation pattern of the Scheme, the fundmanager will invest 90% and more of net assets of theScheme in the securities which are constituents of S&PCNX Nifty Index in the same proportion as the securitieshave in the underlying Index.
k Prole of theheme
Mutual Fund Units involve investment risks including thepossible loss of principal. Please read the SID carefully for detailson risk factors before investment. Scheme specic Risk Factors
are summarized below:• Equity and equity related instruments by nature arevolatile and prone to price uctuations on a daily basisdue to macro and micro economic factors. The value ofequity and equity related Instruments may uctuate dueto factors aecting the securities markets such as volumeandvolatilityinthe capitalmarkets interestrates currency
defensive measures. The AMC does not attempt toindividually select stocks or take defensive positions indeclining markets.
• “Tracking Error” isdenedas thestandarddeviationof thedierence between daily returns of underlying Index andNAV of Unitsof theScheme. The fundmanagermaynotbeableto investcorpusof theSchemein securitiesexactlyinthe same proportionas inthe underlying Indexdue tocertain factors such asroundingo,feesand expensesofthe Scheme, corporate actions, cash balance, changestothe underlying Index and regulatory policies which mayaect AMC’s ability to achieve close correlation with theUnderlying Index. The Scheme’s returns may thereforedeviatefromthoseofitsUnderlyingIndex.
• Risksassociatedwithinvestingin xed incomeandmoneymarket instruments involveinterest - raterisk, credit risk,
liquidityormarketabilityrisk,re-investmentrisketc.• Risksassociatedwiththeuseofderivativesaredierentfromor possibly greaterthan, the risksassociatedwith investingdirectly in securities and other traditional investments.Derivative products are leveraged instruments and canprovidedisproportionategains as wellas disproportionatelossesto theinvestor.Otherrisks include risk ofmispricingor improper valuationand theinabilityof thederivativetocorrelateperfectlywith underlyingassets,rates andindices,illiquidityriskwherebytheSchememaynotbeabletosellorpurchasederivativequicklyenoughatafairprice.
• RisksassociatedwithtradingofUnitsonStockExchange(s)involve absence of prior active market, trading in Unitson Stock Exchange(s) may be halted because of marketconditionsor for other reasons, theUnits of the SchememaytradeaboveorbelowtheirNAVetc.
Risk Mitigation Strategies:
Ty pe of Ri sk M ea su re s t o m it iga te ri skVolatility TheSchemeisapassivelymanagedscheme
and hence, volatility risk will be lesser ascomparedtoactivelymanagedschemes.
Concentration The Scheme will invest in securities whichare constituents of underlying Index inthe same proportion as the securities
have in the underlying Index. Hence,concentration risk will be the same as thatof underlying index, subject to trackingerror.
L iq ui di ty T he S ch em e w il l i nv es t i n se cu ri ti es wh ic hare constituents of S&P CNX Nifty Index inthe same weightage as that of Index. As perdata from NSE, constituents of Index havegood liquidity in the market. Therefore, theScheme does not envisage liquidity risk.
Options None.
ApplicableNAV (after theScheme opens forrepurchase andsale)
1. Subscription / Redemption of Units directly withMutual Fund
Cut o timing f or subscriptions: 1. Inrespectof validapplicationsreceivedupto 3.00p.m.
onaBusinessDaybytheFundalongwithalocalchequeora demanddraftpayableat parattheOcial Points
of Acceptancewherethe applicationis received, theclosingNAVofthedayonwhichapplicationisreceivedshallbeapplicable.
2 . I n r es pe ct o f v al id a pp li ca ti on s r ec ei ve d a ft er 3 .0 0p.m. ona BusinessDay bythe Fund along witha localchequeor ademanddraftpayableat parat theOcial
PointsofAcceptancewheretheapplicationisreceived,t he c lo si ng N AV o f t he n ex t B us in es s d ay s ha ll b eapplicable.
3 . I n r es pe ct o f v al id a pp li ca ti on s w it h a n o ut st at io ncheques or demand drafts not payable at par at theOcialPointsof Acceptance where theapplication is
MinimumApplicationAmount/ Numberof Units
During New Fund Oer Period:
Rs. 10,000/- per application and in multiples of Re.1/- the
In case of investors opting to switch into the Scheexisting scheme(s) of Religare Mutual Fund (sucompletion of lock in period, if any) during the NFO peminimum amount is Rs. 10,000/- per application and inof Re. 0.01/- thereafter.
On Ongoing Basis:Subscription / Redemption of Units directMutual Fund
Authorized Participants and Large Investors can subredeem the Units of the Scheme directly with Mutual Fin Creation Unit size. The number of units of the Schinvestors can subscribe/redeem directly with Mutuaexchange of Portfolio Deposit and Cash Component Units and in multiples thereof at NAV based prices.
In addition to above, Authorized Participants and Large can also subscribe or redeem the Units of the Scheme inUnit size for cash directly with the Mutual Fund.Each Creation Unit consists of 10,000 units of Religare The Mutual Fund may from time to time change the sCreation Unit in order to equate it with marketable lounderlying instruments.If there are no quotes on the secondary market on Nconsecutive trading days, the Unit holder can redeeof Religare Nifty ETF directly with the Mutual Fund spayment of exit load of 1%.
Further, if the average discount of the bid price to the iNAV over a period of 30 trading days is greater than 3%holder can redeem Units of Religare Nifty ETF directlyMutual Fund for a period of 3 consecutive trading dayto payment of exit load of 1%. The intimation of the samdisplayed on our website (www.religaremf.com).Purchase / Sale of Units on NSE
There is no minimuminvestment,althoughUnitsare pusold in round lots of 1 Unit at t he price quoted on NSE.
Despatch of Repurchase(Redemption)Request
Within 10 working days of the receipt of the redemptioat the authorised centre of Religare Mutual Fund.
Benchmark Index S&P CNX Nifty IndexDividend Policy The Trustees may declare thedividend subject to ava
distributablesurpluscalculatedinaccordancewithSEBIRegThe actual declaration of dividend and frequency thinter-alia, depend onavailability of distributablesurpluscin accordance with SEBI (MF) Regulations and the detheTrusteesshallbe nalin thisregard. There isno assguaranteetotheUnitholdersastotherateofdividendnodividendwillbe paidregularly.On paymentof dividend,ththeUnits undertheScheme will fall to theextentof thepayoutandapplicablestatutorylevies,ifany.
Name of the FundManager
Mr. Pranav Gokhale
Name of theTrustee Company
Religare Trustee Company Limited
Performance of thescheme
This Scheme is a new scheme and does not have any perftrack record.
Expenses of theScheme
(i) Load StructureDuring the New Fund Oer Period and an Ongoing OeEntry Load: NilIn terms of SEBI Circular No. SEBI/IMD/CIR No. 4/1dated June 30, 2009, no entry load will be charged on padditional purchase / switch-in.The upfront commission, if any, on investment madinvestor shall be paid by the investor directly to the Dibased on his assessment of various factors including threndered by the Distributor.Exit Load: Nil** For redemption in Creation in Unit SizeHowever, if there are no quotes on the secondary mNSE for 5 consecutive trading days, the Unit holder caUnits of Religare Nifty ETF directly with the Mutual Fun
eme Re-opens for continuous sale and repurchase : Within 10 Business Days from the NFO closure date
ame of Asset Management Company : Religare Asset Management Company Limited Name of Mutual Fund: Religare Mutual Fund
KEY INFORMATION MEMORANDUM CUM APPLICATION FORM
Oer for Units having face value of Rs. 10 each and will be issued at a premium equivalent to dierence between theallotment price and face value during the New Fund Oer and continuous oer for Units at NAV based prices.
8/6/2019 Religare Nifty ETF Application Form
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Notes: Contd...
1. Religare Mutual Fund is a Mutual Fund registered
with Securities and Exchange Board of India (SEBI)
and hence the entire income of the Mutual Fund will
be exempt from income tax in accordance with the
provisions of Section 10 (23D) of the Income-tax Act, 1961.
2. The Scheme being an equity oriented scheme, no additional
tax under section 115R of the Income-tax Act, 1961 is payable
on income distribution, if any, made by the Scheme.
3. As per Section 10(38) of the Income-tax Act, 1961, any long
term capital gain arising from the sale of units of an equity
oriented fund where such transaction of sale is chargeable
to STT, is exempt from tax.
4. Unit holders of the Scheme will be charged securities
transaction tax (STT) @ 0.25% on value of redemption of
units.
Further, investors are advised to refer to the details in the
Statement of Additional Information and also independently
refer to their tax advisors.
ily Net Assetlue (NAV)blication
The NAV will be declared on all the Business Days and will be
published in 2 newspapers. NAV can also be viewed on www.
religaremf.com and www.amindia.com. Investors can also call
at 1800 209 0007.
For Investor
Grievances Please
Contact
Unit holders’
Information
Accounts Statement: The account statement/ allotment
advice reecting new or additional subscription and / or
redemption / switch of Units will be sent by post / courier /
electronic mail to the Unit holder within 5 Business Days from
the date of closure of NFO and from the date of transaction.However, during ongoing oer period, the Mutual Fund shall
endeavour to despatch the account statement / allotmentadvice within 3 Business Days from the date of transaction.
In addition to allotment advice, unitholders will also receivedemat statement from Depository Participant reecting his/her
holding of Religare Nifty ETF.
Annual Financial Results: The annual report or an
summary thereof will be mailed (e-mailed if opted / req
to all Unit holders not later than four months from the
closure of the relevant accounting year (i.e. 31st Mar
year) and full annual report shall be available for inspe
the Head Oce of the Mutual Fund and a copy shall b
available to the Unit holders on request on payment of
fees, if any. The annual report of the Scheme can also b
on www.religaremf.com and www.amindia.com.
Half Yearly Disclosures: The Mutual Fund and A
before the expiry of one month from the close of e
year i.e. 31st March and on 30th September, publish a c
statement of the Scheme portfolio and unaudited
results in one national English daily newspaper and in a
newspaper published in the language of the region w
Head Oce of the Mutual Fund is situated. The Mut
may opt to send the portfolio to all Unit holders in lie
advertisement (if applicable). The portfolio statem
the unaudited nancial results will also be displayed o
religaremf.com and www.amindia.com.
Date: May 03 , 2011
INSTRUCTIONS TO FILL THE FORM
Name and Address of
Registrar
Karvy Computershare
Pvt. Ltd.
Unit: Religare Mutual Fund,
Karvy Plaza, H No. 8-5-296,
Street no.1, Banjara Hills,Hyderabad - 500 034.
Tel No.: +91 040 2331 2454
Email: religare.care@
karvy.com
Religare Asset Management
Company Ltd. (Investment
Manager for Religare Mutual
Fund)
3rd Floor, GYS Innity,
Paranjpe ‘B’ Scheme,
Subhash Road, Vile Parle (East),
Mumbai - 400 057.
Tel. No.: +91-22-67310000
Fax No.: +91-22-28371565
E-mail : [email protected]
Website: www.religaremf.com
GENERAL INSTRUCTIONS(a) Please read the Statement of Additional Information, Key Information
Memorandum and the Scheme Information Document (SID) containing theterms of oer carefully before investing. In the SID, your attention is particularlydrawn to the risk factors of investing in the scheme and also the sections “Whocannot invest” and “Important note on anti-money laundering, KYC & investorprotection”.
(b) All applicants are deemed to have accepted the terms subject to which the oer isbeing made and bind themselves to the terms upon signing the Application Formand tendering the payment.
(c) Application Form should be lled legibly in ENGLISH in BLOCK letters usingBlack or Dark Blue ink. Incomplete application forms are liable to be rejected.Please refer to the checklist to ensure that the requisite details and documentshave been provided in order to avoid unnecessary delays and / or rejection of yourapplication.
(d) Please strike out any section that is not applicable. Cancellation/ white-ink on anyof the mandatory information should be countersigned.
(e) Applicant can make application by lling in “Application Form” and submittingthe Application Form at any of the Ocial Points of Acceptance (as per listprovided in the application form) OR Applicant can make application by lling in“Application Supported by Blocked Amount Form” (‘ASBA Application Form’)and submitting the same at the designated SCSB Branches.
(f) Incomplete Applications are liable for rejection, either at the collection pointitself or subsequently after detailed scrutiny/ veri cation at the back o ce ofthe Registrars.
APPLICATION THROUGH ASBA FACILITYPursuant to SEBI circular vide ref no. SEBI/IMD/CIR No. 18/198647/2010 dated March 15,2010, an investor in addition to existing method of application for units of the Schemecan subscribe to the units of the scheme during New Fund Oer (NFO) through ASBAfacility. ASBA is an application containing an authorization given by the investor toblock the application money in his specied bank account towards the subscription ofunits oered during NFO of scheme(s) of Religare Mutual Fund. For an investor whoapplies through ASBA facility, the application money towards the subscription of unitswill be debited from his specied bank a ccount only if his/her application is selected forallotment of units. Investor can submit the ASBA Application Form with Self CertiedSyndicate Bank (SCSB). SCSB are banks which oers the facility of applying throughASBA process. The list of SCSBs with details of controlling branches is available onhttp://www.sebi.gov.in, http://www.nseindia.com and http://www.bseindia.com. TheApplicant intending to invest in the scheme through ASBA Application Form musthave beneciary account with the Depository Participant of NSDL/ CDSL and will berequired to mention the same in application form. Only those applications where thedetails are matching with the Depository records will be treated as valid applicationsand allotted units accordingly. If the details mentioned in ASBA Application Form areincorrect / incomplete or are not matching with the Depository records the applicationwill be rejected.(a) Self Certied Syndicate Bank (SCSB): SCSBisabankwhichoersthefacilityofapplying
throughtheASBAprocess.ThecurrentlistofSCSB’sasavailableonSEBIwebsiteisasfollows: •AxisBankLtd •State BankofHyderabad •CorporationBank•State BankofTravancore•IDBI BankLtd •State BankofBikanerand Jaipur• YesBankLtd •PunjabNationalBank• Syndicate Ban k • Deutsche Ban k • Un ion Ban k of In dia • HDFC Bank Ltd •Ban k ofBaroda •ICICIBankLtd.•Vijaya Bank•BankofMaharashtra •State BankofIndia •AndhraBank• HSBCLtd.• KotakMahindra BankLtd.• BankofIndia •CitiBank• IndusInd Bank•Allahabad Bank• KarurVysya BankLtd • The FederalBank• IndianBank• CentralBankofIndia •OrientalBankofCommerce •Standard Chartered Bank•JPMorganChaseBank,N.A•NutanNagrikSahakariBankLtd.•UCOBank•CanaraBank.•UnitedBankofIndia•SouthIndianBank•IndianOverseasBank•TamilnadMerchantileBankLtd.•CityUnionBankLtd.•BNPParibas•The Kalupur CommercialCo.opBank Ltd. For the complete listof SCSBswith details of controlling/designated branchespleaserefer to websites : http://www.sebi.gov.in , http://www.nseindia.com and http://www.bseindia.com.
(b) Investors Demat Account details:
• It is m andatoryto provide Demat A ccount details in A SBA A pplican tion Formasthe units willbe credited inthe DematAccountspecied inASBA Application
Form.• A pp li ca nt s ho ul d e ns u re t h at t he D e ma t A cc ou nt s s pe ci e d i n t he A S BA
ApplicationFormare active i.e. notfrozenorsuspended.
• A pplican tton ote thatin case th e DP-ID,beneciaryaccountn o.orPA N providedinthe ASBAApplicationFormare incorrector donot matchwiththe recordsofDepositories(NSDL orCDSL),the applicationswillbe rejected.
(c) Bank Account details:
• Applicants should provide Bank Account details from which the applicationamountis tobe blocked alongwithBank & Branchname and applicationamount.
• A pp li ca nt s ho ul d ma in ta in s u ci en t b al an ce i s t he B an k A cc ou nt i n w hi chapplicationamountis tobe blocked. Incase ofinsucientfundsin the speciedBankAccountthe applicationisliable tobe rejected.
• A pplican tcan m ak e application f or m axim um upto 5 A SBA A pplication sf rom asingle BankAccount witha Bank.
APPLICANT INFORMATION(a) Name should be written in full and in the same sequence as it appears in your
demat account / depository records.(b) In case investment is ‘On behalf of Minor’:
I. Name of the Guardian must be mentioned if the investments are beingmade on behalf of the minor. Guardian in the folio on behalf of minor shouldeither be a natural guardian (i.e. father or mother) or a Court appointed legalguardian. A document evidencing the relationship should be submitted ifthe same is not available as part of the documents stated in point 3 below.
II. The minor shall be the rst and sole holder. There shall not be any joint
holder where minor is the rst holder.III. Date of birth of minor along with the photocopy of following supportingdocuments shall be mandatory while investing on b ehalf of minor:(a) Birth certicate of the minor; or(b) School leaving certicate / Mark sheet issued by Higher Secondary
Board of respective states, ICSE, CBSE etc.; or( ) P t f th i
possess his / her own PAN, the PAN of his / her father or mother or the guardian, as thecase may be, should be quoted. In the absence of this, your application will be rejected.However, applicants resident in the state of Sikkim, Central Government, StateGovernment, ocials appointed by the courts e.g. ocial liquidator, court receiver etc.(under the category of Government) are exempted from the mandatory requirementof PAN for transacting in securities market. This would be subject to collectingnecessary documentary evidence by the AMC / Fund to verify the veracity of the claim.
5. BANK ACCOUNT DETAILSAs per SEBI Guidelines, it is mandatory for the Sole / First Applicant to provide the bankaccount details in the application form.The bank details should be same as those registered with the DP. In case of anydiscrepancy, the bank details as per the depository records will be nal. Applicationsreceived without the bank details will be deemed to be incomplete and liable for
rejection. The Mutual Fund reserves the right to hold the redemption proceeds in casethe requisite details are not submitted. To enable verication of the bank mandate details and ensure expeditious clearing, the
9-digit MICR (Magnetic Ink Character Recognition) number appearing to the right ofthe cheque number on the bottom white strip of the cheque leaf should be provided.IFSC is a 11 digit alpha numeric character set given by some of the banks on the cheques.IFSC will help to secure transfer of redemption and dividend payouts via the variouselectronic mode of transfers that are available with the banks.In addition to the above, investors are also requested to enclose a cancelled cheque leaf(or copy thereof) where investment instrument is not from the same bank account as ismentioned in the Application Form.The Bank Account details of the investors making application through ASBA facilityshall be same as available in the records of their Depository Account linked to investorsDemat Account.
6. INVESTMENT DETAILS(a) Investors applying through ASBA should ensure that the amount of applicatio n
matches with the amount to be blocked in the Bank Account.(b ) For minimum application amount please refer to the Scheme Features.
7. MODE OF PAYMENTPayment can be made in any of the following modes :(a) Payment should be made by way of a single cheque / demand draft* (multiple
cheques will not be accepted) and must be payable locally at the Ocial Point(s)of Acceptance where the application is lodged. The cheque / demand draft shouldbe drawn favouring the Scheme e.g. Religare Nifty Exchange Traded Fund , andcrossed “Account Payee Only”. Please mention the application no. and applicant
name on the reverse of the Cheque/Draft tendered with the application.In order to avoid fraud and prevent misuse of payment instruments, investorsare advised to draw payment instrument (i.e. cheque, demand draft, pay orderetc.) favouring either “Religare Nifty Exchange Traded Fund A/c First Investorname” or “Religare Nifty Exchange Traded Fund Permanent AccountNumber of the First investor”. *Units will be allotted for amount net of DD charges, at Rs. 10/- per unit. The Fund / AMC will not entertain any request for refund of DD charges.Payment can also be made by Electronic Funds Transfer (EFT) by way of directcredit / RTGS / NEFT to Scheme Collection Account by clearly mentioning thename of the investor and application number.
(b) Outstation Cheques or Outstation Drafts/Cash/Money Order/Postal Order/ Postdated Cheques will not be accepted.
(c) The Fund is not obliged to represent dishonoured cheque or inform the investor / investor’s agent about it.
(d) NRI / FII / PIO Investors : Repatriation Basis
Payments by NRIs / Persons of Indian Origin (PIO) residing abroad / FII may bemade either by way of Indian Rupee drafts or cheques by means of (i) inwardremittance through normal banking channels; or (ii) out of funds held in NRE / FCNR account payable at par and payable at the cities where the Ocial Points ofAcceptance are located.In case of Indian Rupee drafts purchased abroad or subscription through NRE/ FCNR Account, an account debit certicate from the bank issuing the draftconrming the debit / Foreign Inward Remittance Certicate (FIRC) should also
be enclosed.In case the debit certicate / FIRC is not provided, the AMC reserves the right toreject the application of the NRI investors.Non Repatriation BasisNRIs or people of Indian origin residing abr oad investing on a non-repatriable basismay do so by issuing cheques / demand drafts drawn on Non-Resident Ordinary(NRO) account payable at the cities wher e the Ocial Points of Acceptance arelocated.
(e) Restrictions on acceptance of Third Party Payment for subscription to units ofscheme.Application with Third Party Payments for subscriptions to Scheme will not beaccepted except in following cases:a) Payment by Parents/Grand-Parents/Related Persons on behalf of a minor
in consideration of natural love and aection or as gift for a value notexceeding ` 50,000/- . However, this restriction will not be applicable forpayment made by a guardian whose name is registered in the records ofMutual Fund in that Folio.
b) Payment by employer on behalf of employee(s) through payroll deductions;c) Custodian on behalf of a Foreign Institutional Investor (FII) or a client.
* ‘Related Person’ means any person investing on behalf of a minor inconsideration of natural love and aection or as a gift.
‘Third-Party Payment’ means a payment made through instruments issued froma bank account other than that of bank account of rst named applicant/investoror a joint bank account where the rst named unit holder/investor is not a one ofthe joint holders of bank account from which payment is made.
In each of the exceptions mentioned above, investors is required to attachfollowing mandatory documents without which application for subscription tounits will be rejected:
a) KYC of all the investors (guardian in case of minor) and KYC of person making thepayment i.e. parent, related person, employee, custodian.
b) Third Party Declaratio n from the investors and the person making the payment(Third Party)
acknowledged copy of the instruction to bank stating the account numdebited.Demand draft, pay order, banker’s cheque purchased against cash of Rsor more will not be accepted. Such purchase application (for amount les50,000) should be accompanied with a banker’s certicate stating theName, bank account number and PAN as per bank record, if available, is The bank account number mentioned in the certicate/ instructionsthe bank account which is registered with the Fund or the rst named /investor should be one of the holders of the said bank account.Please refer to Statement of Additional Information for a facility of muAccounts registration in a folio.Certicate from Bank should be signed by the authorised person of tbank mentioning his name, employee code, contact details and bank se
8. E-MAIL COMMUNICATIONAccount Statement/Allotment Advice, Annual Report, other information esent to unitholders by e-mail. If you have an e-mail address you can choose te-mail communication from us in lieu of printed documents.Please furnish your e-mail ID and indicate the nature of communication yoreceive over email.When an investor has communicated his / her e-mail address and hasconsent for sending communication only through email, the Fund / Registraresponsible for email not reaching the investor and for all consequences thinvestor shall from time to time intimate the Fund / its transfer agents about anin the email address. In case of a large document, a suitable link would be proinvestor can download, save and print these documents. However, investor a right to demand for a physical copy of any or all of the service deliverables anwould arrange to send the same to the investor.
9. SWITCH TRANSACTIONS DURING NFOInvestors opting to switch into this scheme from existing schemes of ReligaFund are required to ll this form and submit the same along with switch transat any of the OPA of RAMC.
10. NOMINATION DETAILSSince the units of the Scheme will be issued in electronic (demat) mode, nodetails provided to the DP shall be applicable.
11. DEMATERIALIZATIONAs theunitsof theScheme will be issuedin Demat form, applicantsmustethesequenceof namesas mentionedin theapplicationformmatcheswithtbeniciary account held with the Depository Participant. Names, address
KYCdetailsmentionedin theapplicationform willbe veriedagianstDeposOnly those applicationswherethedetails arematchedwiththedepositorydtreatedasvalidapplications.Ifthedetailsmentionedintheapplication(othertApplications) are incomplete/incorrect, not matched with the depositoryapplicationshallbetreatedasinvalidandshallbeliabletoberejected .
12. DIRECT CREDIT OF REDEMPTION/DIVIDEND PROCEEDSTheFund will givedirect creditfor redemption/dividendproceedsinto thebankaccountlinkedtothebeneciaryaccountwiththeDepositoryParticipantinstructionwill be adequate dischargeof theFund towardsthe said paymethecreditis noteected by theUnit holder’sbankerfor anyreason,the Funtheright tomake thepaymentby a cheque/DemandDraft. Ifthe direct/electris delayedor noteectedor creditedto a wrongaccount, on account of inincorrect information, theFund willnot be held responsible. If however, yoreceiveachequepayout,pleasetickinthespaceprovidedintheapplication.
13. PREVENTIO N OF MONEY LAUNDERING AND KNOW YOUR CUSTOMETo ensure appropriate identication of the investor and with a view totransactions for the prevention of money laundering as prescribed by the Pof Money Laundering Act, 2002, the AMC reserves the right to:(a) Scrutinize and verify the identity of the investor, Unitholder, person m
payment on behalf of the investor and the source of the funds invesinvested in Religare Mutual Fund;
(b) Reject any application;(c) Prevent further transactions by a Unitholder;(d) To mandatorily redeem the units held by the Unitholder at the appli
prevalent at the time of such redemption and;
(e) Report cases to the Specied Director appointed by the Central Gopertaining to a single transaction exceeding Rs.10 lacs or series of traintegrally connected or remotely connected or related to each othervalued below the prescribed value of Rs. 10 lacs within a month.
14. KNOW YOUR CUSTOMER (KYC) REQUIREMENTSKYC is mandatory for applicants for subscription in the schemes of ReligaFundThe a pplicants for the purpose of KYC Compliance shall include (a) their cPower of Attorney (PoA) holder in case of investments through a PoA; (b) eapplicants in case of investments in joint names; and (c) guardian in case of invon behalf of minor.The applicants residing in Sikkim shall not be required to submit KYC Acknowlealongwith application. Such applicants should submit proof of address of state to the AMC and such address should be mentioned in the applicatioaddress of the applicant. The address proof submitted to AMC should be seby the investor or attested by the ARN holder mentioning the ARN number oby any competent authority.CDSL Ventures Limited (‘CVL’) has been appointed by the mutual fund icomplete KYC formalities on their behalf and hence investors need to subdetails only once for completion of KYC formalities across these mutual frequirements can be completed by lling up the prescribed form and submsame along with the other requisite documents / proofs to CVL through a dPoint of Service (PoS). For detailed process and list of PoS, please visit our webreligaremf.com. Any subsequent change in address, Pin Code, Country, NOccupation, Income Details, Date of Birth, Proof of Identity must be commto CVL through a PoS. KYC Compliant investors need to ensure that any address details is registered with CVL before redeeming units. Registrar wupon address change requests directly received from KYC Compliant inveexisting investor data for investor address (both Indian and foreign), pin codnationality, occupation, income details, date of birth, document providedof identity will be overwritten by the Registrar with data obtained from CVL
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Application No :
Sub-Broker Code
Key Partner / Agent Information
Distributor / Broker ARN
ARN -
Fo O Us O
Religare Nifty Exchange Traded Fund
(An Open Ended Exchange Traded Fund)
Application No :Acknowledgement Slip (To be lled by the Applicant)
Signature, Stamp & Date
Mr. / Ms. / M/s.
Drawn on Bank / BranchDated D D M M Y Y Y Y
Received from
an application for Units of Religare Nifty Exchange Traded Fund Date
Amount (Rs.) Along with Cheque / DD No.
D D M M Y Y Y Y
Upfo ommissio sa b paid di b ivso o AMFI gisd Disibuos basd o ivsos’ assssm of vaious faos iudig svi dd b disibuo.
APPLICATION FORM
Please read instructions before lling the For
NFO Opens : 23rd May, 2011 Closes : 6th June, 2011
1. Appia’s Psoa Dais
FIRST / SOLE APPLICANT *** (Mandatory for MinoDate of Birth
PAN** Enclosed copy of (please3 ) PAN Card KYC Compliance Proof *
GUArDIAn (if Sole / First applicant is a Minor) CONTACT PERSON (in case of Non-individual Investors only)
Name
PAN** Enclosed copy of (please3 ) PAN Card KYC Compliance Proof*
*** Relation Father Mother Court appointed Guardian
Nationality
Contact Details
Status (please3 ) Individual Partnership Company Society / Club HUF NRI / FII
Trust Minor Body Corporate Others (Please specify)
Occupation
(please3 )Private Sector Service Public Sector / Government Service Business Professional Agriculturist Retired
Housewife Politically Exposed Person Forex Dealer Others (Please specify) ____________________________
PAN** Enclosed copy of (please3 ) PAN Card KYC Compliance Proof*
THIRD APPLICANT
PAN** Enclosed copy of (please3 ) PAN Card KYC Compliance Proof*
* KYC through CVL is mandatory for all investors except for investors residing in Sikkim (Please refer instruction no. 14) ** Copy of PAN Card is mandatory for all investors (including Joint Holders, Guardian in case of Minor and NRIs). Pleasubmit photocopy of PAN Card (along with the original) for verication, which will be returned across the counter. (Please refer instruction no. 4) *** For documentation please refer instruction no. 3.
Date of Birth
Date of Birth
SECOND APPLICANT Date of Birth
MobileI/We wish to receive updates via SMS on my mobile (Please3 )
Phone Oce Residence
(No joint holder where minor is First holder)
(No joint holder where minor is First holder)
Fax
Country of Residence
Mailing Address [Please provide full address. P.O. Box Address is not sucient. Indian Address in case of NRIs / FIIs] Ovsas Addss (Mandatory in case of NRI / FII )
City
State
City
State
PIN
Country
PIN
Name
Name
PAN** Enclosed copy of (please3 ) PAN Card KYC Compliance Proof *
POA HOLDER DETAILS (If the investment is being made by a Constituted Attorney please furnish the details of POA Holder)
Name
Name
Mr. / Ms. / M/s.
Mr. / Ms. / M/s.
Mr. / Ms. / M/s.
Mr. / Ms. / M/s.
Mr. / Ms. / M/s.
I/we wish to receive Account Statements/Allotment Advice, Annual Reports and other statutory
well as other information documents by email in lieu of physical documents Yes No(Where the investor has not specied any choice or has applied for both the choices, the application will be processas if the investor has opted for default choice i.e. Yes )
D D M M Y Y Y Y
D D M M Y Y Y Y
D D M M Y Y Y Y
D D M M Y Y Y Y
Impoa: Appia mus su a squ of ams as miod i appiaio fom mas wi a of bia aou d wi Dposio Paiipa. I as odispa, appiaio is iab o g jd.
Please Note : All purchases are subject to realisation of cheques / demand drafts.
25682
ARN-25682
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6. Declaration & Signature(s)
The Trustees, Religare Mutual FundHaving read and understood the contents of the Statement of Additional Information / Scheme Information Documentof the Scheme , I / We hereby apply to the Trustees of Religare Mutual Fund for units of the Scheme as indicated aboveand agree to abide by the terms, conditions, rules and regulations of the Scheme. I / We have understood the details ofthe Scheme and I / We have not received nor have been induced by any rebate or gifts, directly or indirectly, in making thisinvestment. The Distributor has disclosed to me/us all the commissions (in the form of trail commission or any other mode),payable to him for the dierent competing Schemes of various Mutual Funds from amongst which the Scheme is beingrecommended to me/us. I / We hereby authorise Religare Mutual Fund, its Investment Manager and its Agents to disclosedetails of my / our investment to my / our bank(s) / Religare Mutual Fund’s Bank(s) and / or Distributor / Broker/ InvestmentAdvisor and to verify my / our bank details provided by me / us. I / We hereby declare that the particulars given above arecorrect. If the transaction is delayed or not eected at all for reasons of incomplete or incorrect information, I/We wouldnot hold Religare Asset Management Company Ltd. (Investment Manager to Religare Mutual Fund), their appointed serviceproviders or representatives responsible. I / We hereby declare that the amount being invested by me/us in the Scheme ofReligare Mutual Fund is derived through legitimate sources and is not held or designed for th e purpose of contravention ofany Act, Rules, Regulations or any statute or legislation or any other applicable laws or any Notications, Directions issued by
any governmental or statutory authority from time to time.Applicable to NRIs only :I/We conrm that I am / we are Non-Residents of Indian Nationality /Origin and that the funds are remitted from abroadthrough approved banking channels or from my /our NRE / NRO / FCNR Account. I / We conrm that the details provided byme / us are true and correct.(Please3 ) Yes No If NRI (Please3 ) Repatriation basis Non-Repatriation basis
Sole / First Applicant / Guardian / POA
SecondApplicant
Third Applicant
Date PlaceD D M M Y Y Y Y
2. Ivsm Dais
Scheme Name
(Cheque / DD should be drawn in favour of the Schem
Religare Nifty Exchange Traded Fund
Get In tOUchReligare Mutual Fund3rd Floor, GYS Innity, Paranjpe ‘B’ Scheme, Subhash Road, Vile Parle (East), Mumbai - 400 057.T +91 22 67310000 F +91 22 28371565
call : 1800-209-0007 > sms ‘Ivs’ o 56677 > www.igamf .om
DP ID # DP Name Beneciary Account No.I N
5. Bank Account Details (Mandatory As Per SEBI Guidelines) (Refer Instruction no
(# Not applicable in case of CDSL).
Account Type (please3 ) Current Savings NRE NRO FCNR OthersAccount No.
Bank Name
Branch Address City
MICR Code
(9 digit No. next to your Cheque No.)
PINNEFT/RTGS/IFSC Code
(11 digit character code appearing on cheque leaf)
3. Payment Details (Refer Instruction no
4. Demat Account Details (Mandatory) (Refer Instruction no
Investment Amt. (Rs.)
Net Amt. (Rs.)
Bank / Branch
Cheque / DD No.
A/c. No.
Applicable in case of Third Party Payment: Payment on behalf of. Please ( 3 )
Enclosed copy of KYC Compliance Proof
Name of the Person making Payment
PAN
Account Type ( 3 ) Current Savings NRE NRO FCNR Others ________
Mode of Payment ( 3 ) Cheque DD Fund Transfer
Minor Client Employee
( Please refer instruction no. 7 )
DateDD charges, if any (Rs.) D D M M Y Y Y Y
Ivsos a qusd o povid Ba Aou dais id wi Dma aou. I as of dispa, ba dais as p dposio ods wi b a.
Please ( 3 ) NSDL CDSL
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For NFO & On going Sales for large investors and Authorized Participants.
or list of Ocial Points of Acceptance of Kar vy for Ongoing Transactions, please refer our website: www.religaremf.com
OTAK MAHINDRA BANK - Collection Centres For NFO Only
ARVY COMPUTERSHARE PVT. LTD. – Collection Centres For NFO Only
Agra: Shriram Hospital M.G.Road, Agra - 282003. n Ahmedabad: Ground Floor, Chandan Housepp. Abhijeet III, Near Mithakali Six Roads, Navrangpura, Ahmedabad - 380006. n Allahabad: 2.
ardar Patel Marg Civil Lines Allahabad - 211001. n Amritsar: 10 , Kennedy Avenue, The Main Malload, Amritsar - 143001. n Anand: P.M.Chambers, Mota Bazar, Vallab Vidya Nagar, Anand - 388120.
Ankleshwar: Shop # 11,12, 12 A , Narmada Arcade, Old Naitonal Highway, No. 8, Ankleshwar - 393002.Aurangabad: CTS No. 12995, Kandi Towers, Near Rokadiya Hanuman Colony, Jalna Road, Aurangabad
431001.n Bangalore: 10/7 , Umiya Land Mark, Next to Chancery Hotel, Lavelle Road, Bangalore - 560001.Baroda: Panorama Building, R.C. Dutt Road, Alkapuri, Vadodara - 390015. n Bavaga: Bhavna
onstruction Company, Plot No. 2108/A, G.R.Sterling Centre, Waghwadi Road, Bhavnagar - 364001.Bhopal: 214, Bhagwan Complex, Zone 1 , M P Nagar, Bhopal - 462016. n Bhubaneshwar: 184,
round Floor, Janpath, Bhubaneswar - 751001. n Chandigarh: SCO 153-154-155, Madhya Marg, Sector- C, Chandigarh - 160009. n Chennai: ‘Capitale’, Ground Floor, 555, Anna Salai, Chennai - 600018.Cochin: Ground Floor, Kumarapillai Estate, M G Road, Cochin - 682031. n Coimbatore: 727, Avinashi
oad, Skanda Square, Coimbatore - 641018. n Dhanbad: Ground Floor, Ward No. 18, Ramson Arcade,hastri Nagar, Dhanbad - 826001. n Guwahati: 4th Floor, Ganapati Enclave, G S Road, Uluvari, Opp.ura Service Station, Guwahati - 781007. n Hyderabad: Pavani Jewel Tower, Ground Floor, Somajiguda,yderabad - 500089. n Indore: 580 , M.G.Road, Indore - 452001.n Jaipur: 57, Krishna Tower, Sardar
atel Marg, C-Scheme, Jaipur - 302001.n Jalandhar: Midas Corporate Park, G T Road, Jalandhar - 144001.Jamshedpur: Gayatri Enclave, K. Road, S. Town, Bistupur, Jamshedpur - 831001. n Jodhpur: Bombay
otor Building, Bombay Motor Circle, 87/B-2 Chopasani Road, Jodhpur - 342003. n Jorhat : Dr. KCey's Building, Gar Ali Road, Junction of Rupahi Ali and Gar Ali Road, Jorhat - 785001. n Kanpur: 17/03,he Mall, Meghdoot Hotel Building, Kanpur - 208001. n Kolhapur: Shop No. B4-B8, Royal Prestige, Sai
Extension, City Survey No. 11127, E Ward, Raja Rampuri Road, Kolhapur - 416001. n Kolkatta: AHouse15, Parkstreet, Kolkatta - 700016. n Lucknow: 3GF, Speed Building, Shahanazaf Road, Luc- 226001. n Ludhiana: SCO 120, Ground Floor, Feroze Gandhi Market, Ludhiana - 141001. n Ma1-AWest Perumal Maistry Street, Madurai - 625001. n Mehsana: Rajendra Estate, Opp. Gayatri TeState Highway, Mehsana - 384002. n Moradabad: Sri Ganapati Complex, Near Ekta Dwar, Opp MSchool, Civil Lines, Moradabad - 244001. n Morbi: Shop No 5-8, Ground Floor, Silver Plaza, Ram CSavsar Plot, Morbi - 363641. n Mumbai: 5 C/ II, Mittal Court 224, Nariman Point, Mumbai - 40n Nagpur: Ground Floor, 345 Shree Mohini Complex, Kingsway, Nagpur - 440001. n Nashik:No.1, Payas, Opp. B Y K College, Thatte Nagar Road, Nasik - 422005. n New Delhi: Ground Ambadeep,14, K.G. Marg, New Delhi-110001 n Panjim: Ground Floor, Hotel Park Plaza, OppMaidan, Panjim - 403001. n Patiala: Ground Floor, SCO 116-119, New Leela Bhavan, Patiala1 - 4n Patna: Shop No 3,4,5, Ahmad Husain Complex, Exhibition Road , Gandhi Maidan, Patna - 800001.n
Bakre Avenue, FP NO 226/3, Bhandarkar Road, Pune - 411004.n Rajkot: Nath Complex, Ground FlooRace Course, Dr. Yagnik Road, Rajkot - 360007.n Salem: Plot No 12 , S No. 98, Bharathi Street, AlagapSalem - 636001.n Surat: Ground Floor, Kotak House, KG Point, Ghod Dod Road, Surat - 395007.n TB-17, Aishwaryam Buildin g, Sasthiri Road, Thillai Nagar,Trichy - 620017.n tivadum S I Properties, GFloor, White Haven Vellayambalam,Trivandrum - 695010.n Valsad: Shop Nos. 3-6, Sai KevalJalaramValsad - 396001. n Varanasi: D-37/37 Spice, KCM Cineplex Complex, Godowlia Chowk, Varanasi - 2n Vijayawada:40-1-48/1, M.G.RoadLabbipet, Vijayawada - 520010.n Visnagar:1st Floor, Rajkamal CoNear Railway Station, Visnagar - 384315. n Udaipu: Trimurti Heights, 8-C Bank Street , MadhUdaipur - 313004.
Ajmer: 1-2, II Floor, Ajmer Tower, Kutchary Road, Ajmer - 305 001. Tel. No:. 0145-2628055, 0145-2628065.Aligarh: 1st Floor, Kumar Plaza, Aligarh - 202001. Tel. No.: 0571-3200210. n Bhagalpur: 2nd Floor,
handralok Complex, Ghantaghar, Radha Rani Sinha Road, Bhagalpur - 812001. Tel. No.: 0641-3200584.Bokaro: B-1, 1st Floor, Near Sona Chandi Jewellers, City Centre, Sector - 4, Bokaro Steel City - 827 004
harkhand).Tel. No . 06542 - 233330/32/30. n Cuttack: Dargha Bazar, Opp. Dargha Bazar Police Station,uxibazar, Cuttack - 753001. Tel. No. 0671-2613906. n Durgapur: MWAV-16, Bengal Ambuja Complex,nd Floor, City Centre, Durgapur - 713 216. Tel. No.: 0343 - 6512111. n Gorakhpur: Above V.I.P. House,
Ajdacent A.D. Girls Inter College, Bank Road, Gorakhpur- 273 001. Tel. No.: 0551-3200444, 0551-3240551-2346519.n Jabalpur: 43, Naya Bazar, Opposite Shyam Talkies, Jabalpur (M.P.) 482 001.Tel No- 3204376.n Jamnagar: 108 Madhav Plaza, Opp SBI Bank , Near Lal Bangalow, Jamnagar - 361001.T0288-2556260, 0288-2556562. n Meerut: 1st Floor, Medi Centre Complex, Opp. ICICI Bank, HapurMeerut - 250 002Tel No. 0121-3202163, 0121-3252943.n Ranchi: Commerce Towers, 3rd Floor, Roo307, Beside Mahabir Towers, Main Road, Ranchi - 834 001Tel no. 0651 - 2331 320.
ELIGARE ASSET MANAGEMENT COMPANY LIMITED - For NFO and Ongoing Basisist of Collection Centres / Ocial Points of Acceptance
CHECKLIST (Please ensure the following)
ease ensure that :
Application Form is complete in all respect. Name, address & contact details are mentioned in full and signed by all applicants.Bank account details are entered completely and correctly and are same as registered with DP.
Permanent Account Number (PAN) for all applicants is mentioned and necessary documents are enclosed, otherwise your application will be rejected.
The cheque / demand draft should be drawn favouring the name of the scheme & crossed as “ Account Payee Only”, dated and duly signed.
Application Number and applicant’s name is mentioned on the reverse of each cheque / Demand Draft.Demat A/C details are lled correctly in the form.
Details of applicants provided matches exactly with those in the Depository.ccompanying documents
ease submit the following documents with your application (where applicable). All documents should be original / true copies by a Director / Trustee / Company Secretary / Authorised Signatory.
Documents Idividuas Companies Societies PartnershipFirms
Ivsmsthrough PoA
Trust NRI Fll(
Resolution / Authorisation to invest 3 3 3 3 3
List of Authorised Signatories with Specimen signature(s) 3 3 3 3 3 3
Memorandum & Articles of Association 3
Trust Deed 3
Bye - Laws 3
Partnership Deed 3
Overseas Auditors’ Certicate 3
Notarised Power of Attorney 3
Foreign Inward Remittance Certicate, in case payment is made by
DD from NRE / FCNR a/c, where applicable3
Certied True Copy of PAN 3 $ 3 3 3 3 3 3 3
KYC Acknowledgement 3 $ 3 3 3 3 3 3 3
Demat Account Details 3 3 3 3 3 3 3 3
For FII’s, copy of the SEBI registration certicate should be provided. $ Compulsory except for residents of Sikkim.
Agra: Block No.30, Shop No.126, Sanjay Place, Agra - 282002. Tel. No.: 0562 - 6459171.n Ahmedabad* :nit No.201, 2nd Floor, Megha House, Mithakali Si x Roads, Law Garden, Ellisbridge, Ahmedabad - 380006.el. No.: 079 - 40231500.n Allahabad: Shop No. 4, Anant Raj Plaza, Main M. G. Road, Civil Lines, Allahabad
11001. Tel. No.: 0532 - 6455816. n Bangalore* : 305, 3rd Floor, Prestige Meridien II, Citibank, 30, M. G. Road,angalore - 560001. Tel No.: 080 - 42941000. n Baroda: Unit No.101/102, 1st Floor, Siddharth Complex, R.
Dutta Road, Baroda-390019. Tel. No.: 0265 - 6643386. n Bhopal: MF- 6, A Block, Mansarovar Complex,oshangabad Road, Bhopal - 462016. Tel. No.: 0755 - 4289632.n Bhubaneshwar (Orissa): 3rd Floor Varhaomplex, Plot no-111, Master Canteen Square,Unit-3, Bhubaneshwar - 751001. Tel. No.: 0674 - 6532062.Chandigarh* : Second Floor, SCO No. 359 - 360,Near G K International Hotel, Sector 35-B, Chandigarh
60 022. Tel. No.: 0172 - 6451315. n Chennai* : “Challa Mall”, 11 & 11A, 3rd Floor, Sir Thegaraya Road, T.agar, Chennai – 600017. Tel. No.: 044 - 64502422. n Coimbatore: Aiswarya complex, Door No:6/8, Ground Floor, T V Samy Road West, R S Puram, Coimbatore - 641002.Tel. No.: 0422 - 6457815.
Dehradun: EBD Business Centre,Post Box-248,49,Rajpur Road,Dehradun 248 001. Tel. No.: 0135
6453212. n Delhi* : Vanadana Building, 10th Floor, 11, Leo Tolstoy Marg, Connaught Place, Newelhi - 110 001. Tel. No.: 011 - 43789000. n Goa: Advani Business Centre, Oce No. CU2, Neelkamalrcade, Atmaram Borkar Road, Above Federal Bank, Panjim - 403001. Tel. No.: 0832-6650402.
Guwahati: Religare Insurance Broking, Oce No. 6, Ground Floor, Mayur Gardens, G. S. Road, AC Bus Stop, Guwahati – 781005. Tel. No.: 0361 2343050 n Hyderabad* : TSR Towers,Tower B-1,
ot No.6-3-1090, Raj Bhavan Road, Somajiguda, Hyderabad - 500082. Tel. No.: 040 - 66468863.Indore: Room No. 216, 2nd Floor, Starl it Tower, Y. N. Road, Indore - 4 52001. Tel. No.: 0731 - 4 257351.Jaipur: 2nd Floor, ‘Brij Anukampa’, Ashok Marg, C-Scheme, Jaipur - 302 001. Tel. No.: 0141 - 6451086.Jalandhar: 514-A ,5th Floor, Grand Mall, BMC Chowk, Adjoining Radisson Hotel, Jalandhar 144001.
el. No.: 0181- 4686870. n Jamshedpur: Shop No - 16, Bharat Business Centre, Ground Floor, Bistupur,
Jamshedpur -831011. Tel. No.: 0657-2756186. n Kanpur* : 1st Floor, KAN Chambers, 14/113 Civil Kanpur-208001. Tel. No.: 0512-6451658.n Kochi: Door No. CC 40/377,3rd Floor, Jos Annexe, Jos JunM.G.Road, Kochi-682016. Tel. No.: 0484-6453727. n Kolkatta* : 124, LORDS, 1st Floor, 7/1Lord SinhaKolkata-700071. Tel. No.: 033-44031000. n Kota: 315, OldDhan Mandi, Gandhi Chowk, Kota - 324006. T9983349808. n Lucknow* : 403, 4th Floor. Ratan Square, 20-A Vidhan Sabha Road, Lucknow - 22Tel. No.: 0522-3292022. n Ludhiana* : 301, 3rd Floor, SCO No.18, Feroze Gandhi Market, Opp.LudStock Exchange, Ludhiana 141001. Tel. No.: 0161- 6543354. n Madurai: Shop No. I, 1st Floor, 16North Veli Street, A. R. Plaza, Madurai-625001. Tel. No.: 0452-6460114. n Mumbai (Nariman PoOce No. 17, 1st oor,Jolly Maker Chambers II, Nariman Point, Mumbai 400021. Tel. No.: 022-43416n Mumbai (Vile Parle)* : 3rd Floor, GYS Innity,Paranjpe”B” Scheme, Subhash Road, Vile Parle (E), M- 400 057. Tel. No.: 022-67310000. n Mumbai (Ghatkopar)* : Sai Infotech, 408, 4th Floor, Patel CGhatkopar (E), Mumbai 400 077. Tel. No.: 022-67417465 n Nagpur: C/o Religare Securities LimiteHouse, Opp. Patwardhan High School, Sitabuldi, Nagpur-440012 Tel. No.: 712-6463962 . n Nasik: S
Modern Point, Shop No. SF 1 8, Sharanpur Road, Opposite Police Parade Ground, Nashik - 422 005. T0253-3012050.n Patna*:306, 3rd Floor, “Grand Plaza” Fraser Road, Patna - 800 001. Tel. No.: 0612-6550Pune*: 6th Floor, Matrix IT Park, CTS No. 4/1, Final Plot No. 64 /A of the Town Planning Scheme, SangamShivaji Nagar, Pune-411005. Tel. No. : 020-30513994..n Raipur: Shop No. T, 2nd Floor, DM Plaza, NeBrigade Chowk, Chotapara, Raipur- 492001. Tel. No.: 0771-4056046.n Surat: 110, Jolly Plaza, AthwCircle, Govt. Near Girls Polytechnic College, Athwagate Circle, Surat 395 001. Tel. No.: 0261-645n Varanasi: 3rd oor, Kubner Complex, D-58/2, Rathyatra, Varanasi-221010. Tel. No.: 0542-327n Vijaywada: 3rd Floor,Vasantha Plaza,40-1-126,M.G.Road,Benz Circle, Vijaywada - 520010. Te0866 - 6454945
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Received from
ASBA Form Dated Amount to be Blocked (Rs.)
SCSB (Bank & Branch) Bank Account No.
Date of submission
Mr. / Ms.
D D M M Y Y Y Y
D D M M Y Y Y Y
SCSB Branch Stamp & Code
ARN -ScSB Ba Sia no.
APPlIcAtIOn SUPPOrteD BBlOckeD AMOUnt (ASBA) FOrM
Please read instructions before lling the For
Application No :
2. Dais of Ba Aou fo Boig of Fuds
Bank Account Number Bank Name
Bank Address
Amount to be blocked(Rs. in gures)
Amount to be blocked(Rs. in words)
1. Appia’s Psoa Dais (in BLOCK LETTERS)
SOLE/FIRST APPLICANT SECOND APPLICANT THIRD APPLICANT
PAN
Name
4. Dma Aou Dais (Mandatory)
5. Declarations & Signatures
PlaceDate D D M M Y Y Y Y
I N
General Declaration:
The Trustees, Religare Mutual FundHaving read and understood the contents of the Statement of Additional Information / Scheme Information Document of the Scheme , I / We hereby apply to the Trustees of Religare Mutual Fund for units of the Schemeas indicated above and agree to abide by the terms, conditions, rules and regulations of the Scheme. I / We have understood the details of the Scheme and I / We have not received nor have been induced by any rebate orgifts, directly or indirectly, in making this investment. The Distributor has disclosed to me/us all the commissions (in the form of trail commission or any other mode), payable to him for the dierent competing Schemes ofvarious Mutual Funds from amongst which the Scheme is being recommended to me/us. I / We hereby authorise Religare Mutual Fund, its Investment Manager and its Agents to disclose details of my / our investment to my
/ our bank(s) / Religare Mutual Fund’s Bank(s) and / or Distributor / Broker/ Investment Advisor and to verify my / our bank details provided by me / us. I / We hereby declare that the particulars given above are correct. If thtransaction is delayed or not eected at all for reasons of incomplete or incorrect information, I/ We would not hold Religare Asset Management Company Ltd. (Investment Manager to Religare Mutual Fund), t heir appointedservice providers or representatives responsible. I / We hereby declare that the amount being invested by m e/us in the Scheme of Religare Mutual Fund is derived t hrough legitimate sources and is not held or designed for thepurpose of contravention of any Act, Rules, Regulations or any statute or legislation or any other applicable laws or any Notications, Directions issued by any governmental or statutory authority from time to time.ASBA Authorizations:1) I/We hereby undertake that I/We am/are an ASBA applicant(s) as per the applicable provisions of the SEBI (Issue of Capital and Disclosure Requirements) Regulations, 2009. 2) In accordance with ASBA process providedin the SEBI (Issue of Capital and Disclosure Requirements) Regulations, 2009, I/We authorize (a) the SCSB to do all acts as are necessary to make an application in the NFO of the Scheme of Religare Mutual Fund, includinguploading of application details, blocking the amount to the extent mentioned above in the “Details of Bank Account for Blocking of Funds” or unblocking of funds in the bank account maintained with the SCSB specied in theform, transfer of funds to the nominated Religare Mutual Fund Bank Account on receipt of instruction from the Registrar to the New Fund Oer after nalisation of allotment entitling me/us to receive Units on such transferof funds. (b) Registrar to the Religare Mutual Fund to issue instructions to the SCSB to remove the block on the funds in the bank account specied in the ASBA Form, upon allotment and to transfer the requisite money toReligare Mutual Fund’s nominated Bank account. 3) In case the amount available in the bank account specied in the ASBA Form is insucient for blocking the amount equivalent to the application money, the SCSB shall rejecthe application. 4) If the DP ID, Beneciary ID or PAN furnished by me/us in the ASBA Form is incorrect or incomplete, the appliacation shall be rejected and Religare Asset Management Company Ltd. (Investment Manager tReligare Mutual Fund), their appointed service providers and the SCSBs representatives shall not be liable for losses, if any.Applicable to NRIs only :I/We conrm that I am / we are Non-Residents of Indian Nationality /Origin and that the funds are remitted from abroad through approved banking channels or from my /our NRE / NRO / FCNR Account. I / We conrm that thedetails provided by me / us are true and correct.
NFO Opens : 23rd May, 2011 Closes : 6th June, 2011
Acknowledgement Slip (To be lled by the applicant)
ReligareNifty Exchange Traded Fund (An Open Ended Exchange Traded Fund)
Application No :NFO Opens : 23rd May, 2011 Closes : 6th June, 2011
Upfront commission shall be paid directly by the investor to the AMFI registered Distributors based on the investors’ assessment of various f actors including the service rendered by the distributor.
Appias mus su a squ of ams as miod i appiaio fom mas wi a of bia aou d wi Dposio Paiipa.
Sub-Broker CodeDistributor / Broker ARN
Please ( 3 ) NSDL CDSL
DP ID # DP Name Beneciary Account No.
(# Not applicable in case of CDSL).The investors shall receive payments of Dividend/Redemption proceeds in the Bank Account linked to the Demat A/c as mentioned above.
Religare Nifty Exchange Traded Fund
(An Open Ended Exchange Traded Fund)
3. Ivsm Dais
Amount^ (i rs.) ISIN
INF205K01DA9
^Amou mus b qua o amou o b bod as mio d i poi 2 abov.
Signature of Applicant Signature of Bank Account Holders
?
(to b sigd as p mod of opaio of Ba Aou miod i poi 2 abov)
? ??
25682
ARN-25682