Reliance Capital Asset Management Limited

A Reliance Capital Company

APP No.:

AUTO DEBIT MANDATE FORM

For Bank of Baroda/Bank of India/Punjab National Bank/Syndicate Bank/Kotak Mahindra Bank/
Centurion Bank of Punjab/Citibank NA/Vijaya Bank/Bank of Rajasthan
Application to be submitted at least 21 working days before the commencement of SIP Leave one box blank between two words.
TO BE FILLED IN CAPITAL LETTERS. PLEASE ( ) WHICHEVER IS APPLICABLE
REGISTRATION CUM MANDATE FORM FOR AUTODEBIT (Debit clearing)
New SIP Registration - by existing investor New SIP Registration - by new investor (Al so attach the new appl icati on form duly filled & signed)
I/We as per the details below hold an account with your branch as per the particulars stated below.
APPLICANT DETAILS

Folio No.
Name of Sole/1st holder PAN No. M A N D A T O R Y KYC : Yes / No
Name of 2nd holder PAN No. M A N D A T O R Y KYC : Yes / No
Name of 3rd holder PAN No. M A N D A T O R Y KYC : Yes / No

SCHEME NAME__________________________________ Option______________________ Plan_________________SIP Amount

Frequency (Please ) Monthly (default) or Quarterly SIP Date 2 10 18 28

Enrollment Period: From: M M Y Y To: M M Y Y

BANK ACCOUNT DETAILS
1st/Sole Accountholder Name as in Bank Records

2nd Accountholder Name as in Bank Records

3rd Accountholder Name as in Bank Records

A/c. Type SB Current NRO NRE FCNR Account No.

Co r e B a n k i n g A c c o u n t N u m b e r M a n d a to r y
Bank M a n d a t o r y
Branch
Address
Branch
City

PIN 9 Digit MICR Code* IFSC Code

*Mandatory : Please enter the 9 digit number that appears after your cheque number / MICR code starting and / or ending with 000 are not valid for ECS.
DECLARATION
I/We wish to inform you that I/we have registered with Reliance Mutual Fund through their authorised Service Provider(s) and representative for my/our payment to the
above mentioned beneficiary by debit to my/our above mentioned bank account. For this purpose I/we authorised Service Provider(s) and representative to raise a debit
on my/our above mentioned account with your branch. I/We hereby authorize you to honor all such requests received through authorised Service Provider(s) and
representative to debit my/our account with the amount requested, for due remittance of the proceeds to the beneficiary. I/We undertake to keep sufficient funds in the
funding account on the date of execution of standing instruction. I hereby declare that the particulars given above are correct and complete. If the transaction is delayed or
not effected at all for reasons of incomplete or incorrect information, I would not hold the Mutual Fund or the authorised Service Provider(s) and representative
responsible. If the date of debit to my/our account happens to be a non business day as per the Mutual Fund or a Bank holiday, execution of the SIP will happen on the
next working day and allotment of units will happen as per the Terms and Conditions listed in the Offer Document of the Mutual Fund. The above mentioned Bank shall not
be liable for, nor be in default by reason of, any failure or delay in completion of this service, 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 above mentioned Banks reasonable control and which has the effect of preventing the
performance this service by the above mentioned Bank. I/We shall not dispute or challenge any debit, raised under this mandate, on any ground whatsoever. I/We shall
not have any claim against the Bank in respect of the amount so debited pursuant to the mandate submitted by me/us. I/We shall keep the Bank and authorised Service
Provider(s) and representative, jointly and or severally indemnified from time to time, against all claims, actions, suits, for any loss, damage, costs, charges and expenses
incurred by the Bank and authorised Service Provider(s) and representative, by reason of their acting upon the instructions issues by the above named authorized
signatories/beneficiaries. This request for debit mandate is valid and may be revoked only through a written letter withdrawing the mandate signed by the authorized
signatories/beneficiaries and acknowledged at your counters and giving reasonable notice to effect such withdrawal.
SIGNATURE/S AS PER RELIANCE MUTUAL FUND (MANDATORY) SIGNATURE/S AS PER BANK RECORDS (MANDATORY)
Sole/ 1 st applicant/ Sole/ 1 st applicant/
Guardian Guardian
Authorised Signatory Authorised Signatory
2 nd applicant / 2 nd applicant /
Authorised Signatory Authorised Signatory

3 rd applicant 3 rd applicant
Authorised Signatory Authorised Signatory

Place : Date: D D M M Y Y Y Y Place : Date: D D M M Y Y Y Y

FOR OFFICE USE ONLY (Not to be filled in by Investor)

Recorded on Scheme Code

Recorded by Credit Account Number

Bank use Mandate Ref. No. Customer Ref. No.
 TERMS AND CONDITIONS
1. This facility is offered only to the investors having bank accounts in 11. Allotment of units would be subject to realisation of credit.
(For Bank of Baroda/Bank of India/Punjab National Bank/Syndicate
12. An investor can opt for Monthly or Quarterly frequency.
Bank/Kotak Mahindra Bank/Centurion Bank of Punjab/Citibank NA/
(monthly for SIP Insure
Vijaya Bank/Bank of Rajasthan ).
13. SIP is available to investors in the following Scheme(s) of Reliance
2. Please submit the following documents atleast 21 working days
Mutual Fund:
before the first SIP date for ECS (Debit Clearing):
New Investors: Equity/Sectoral Schemes: “Reliance Growth Fund” OR “Reliance Vision
(a) Application Form with Auto Debit/ECS Mandate Form. Fund” OR “Reliance Equity Opportunities Fund” OR “ Reliance Index
Fund” OR “ Reliance NRI Equity Fund” OR “ Reliance Banking Fund” OR
(b) The initial investment amount cheque should be issued from the
“Reliance Pharma Fund”OR “Reliance Media and Entertainment Fund”
same bank account which is to be debited under ECS/Auto Debit for
OR “ Reliance Diversified Power Sector Fund” OR “ Reliance Tax Saver
SIP installments.
(ELSS) Fund” OR “ Reliance Equity Fund” OR “Reliance Regular Savings
(c) In case the first cheque is issued from an account which is Fund” OR "Reliance Equity Advantage Fund" OR "Reliance Natural
different from ECS Auto Debit Account, then a photo copy/cancelled Resources Fund" OR "Reliance Quant Plus Fund".
cheque from ECS Debit Account (as mentioned on the application
Debt Funds : “Reliance Income Fund” OR “Reliance Medium Term Fund”
form should be submitted along with other requirements.
OR “Reliance Floating Rate Fund”OR “Reliance NRI Income Fund” OR
Existing Investors: “Reliance Short Term Fund” OR “Reliance Monthly Income Plan”.
(a) SIP Enrolment Form & Auto Debit/ECS Mandate Form. The above list is subject to change from time to time. Please contact
the nearest Designated Investor Service Centre (DISC) of Reliance
3. The cities in the list may be modified/updated/changed/removed at
Mutual Fund or Karvy Computershare Pvt. Ltd for updated list.
any time in future entirely at the discretion of Reliance Mutual Fund /
Reliance Capital Asset Management Limited without assigning any 14. Minimum investment amount
reasons or prior notice. If any city is removed, SIP instructions for
Monthly SIP Option - 60 instalments of Rs. 100/- each or 12
investors in such cities via ECS (Debit) route will be discontinued
instalments of Rs. 500/- each or 6 instalments of. Rs. 1,000/- each
without prior notice. In such a case, the AMC at its sole discretion
and in multiples of Re. 1/- thereafter.
may accept post dated cheques (PDC’s) form the investors for the
balance period. For SIP Insure minimum 36 installment of Rs. 1000/- each

4. SIP Auto debit / ECS facility is available only on specific dates of the Quarterly SIP Option - 12 instalments of Rs. 500/- each or 4
month i.e. 2nd or 10th or 18th or 28th. instalments of Rs. 1,500/ each and in multiples of Re. 1/- thereafter.
The first SIP instalment date should be later or on 28th March, 2008.
5. The investor agrees to abide by the terms and conditions of ECS/Auto
However, only one SIP transaction per month/quarter per Folio/Account
Debit facility of Reserve Bank of India (RBI)/Banks.
is permitted.
6. Investor will not hold Reliance Mutual Fund / Reliance Capital Asset
15. During NFO, SIPs will be accepted only through ECS/Auto Debit to the
Management Limited, its registrars and other service providers
investor’s bank account.
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 16. The applicable NAV for the 1st installment (in respect of the 1st
to various clearing cycles of ECS / local holidays. cheque) will be as per the date & time at which the same has been
received at DISC of RCAM / Karvy. If the date of the subsequent SIP
7. Reliance Mutual Fund / Reliance Capital Asset Management Limited,
cheque / installment is a non-transaction day for the scheme, then the
its registrars and other service providers shall not be responsible nor
units shall be allotted on the next / following transaction day.
liable for any damages/compensation for any loss, damage etc.
incurred by the investor. The investor assumes the entire risk of using 17. Please write the SIP Form number / the first applicant’s name on the
this facility and takes full responsibility. reverse of the cheque accompanying the SIP Form.

8. Reliance Mutual Fund / Reliance Capital Asset Management Limited 18. Payments may also be accepted by direct debit to applicant’s bank
reserves the right to reject any application without assigning any account by Auto Debit (for selected banks only). For this purpose, the
reason thereof. applicant are required to give a standing instructions in the prescribed
form to the bankers to debit their bank accounts at periodic intervals
9. Please read the Key Information Memorandum and Offer Document
and credit the subscription proceeds to Reliance Mutual Fund’s bank
of respective Scheme(s) for Applicable NAV, Risk Factors, Load and
account. Please contact the nearest DISC for details of banks offering
other information.
this facility.
10. You can discontinue this facility by giving fifteen days written
19. The Unit holders can choose to opt out from the SIP at any point of
notice to any of our Investor Service Centres. time by submitting a written request to the nearest DISC. Such request
for discontinuation should be received at least 15 days prior to the next
due date of the SIP. On receipt of such a request, the SIP will be
discontinued for the folio.

Express Building, 4th Floor, 14 E Road

Churchgate, Mumbai 400 020

Call : 30301111 Toll free: 1800-300-11111

www.reliancemutual.com