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Account Statement Statement Date : 22 Oct 2018

* Folio No. : 51517471389


* Please quote this folio number for future correspondence / transactions.

MANDAKINI TRIPATHI ID No : 2982464061 Unique Client Code :MFUTIB0003


Date Of Birth : Please Provide Category : RESIDENT INDIAN
C/O H.N. VERMA
410, PATAMBER NAGAR Mode of Holding : ANYONE OR SURVIVOR Status : INDIVIDUAL
UNNAO Bank Account No : Savings/XXX853 Pay Mode : Warrant
UP Bank Name : DENA BANK
PIN : 209801
MICR No : Please Provide IFS Code : Please Provide
Mobile No : Please Provide
Email ID : please provide
Financial Advisor : Prem Kumari Verma ( ARN-8841 )
Joint holder 1 : DEVI PARASAD TRIPATHI Sub ARN Code : Sub Code : EUIN :

Nominee : Rachna Tripathi


Please update your records with: Mobile No / Email ID

Holder PAN KYC Status/KIN FATCA


Primary Holder Please Provide No No You can send your request for Account Statement 24x7 with either your Folio no., or PAN or Email ID
2nd Holder Please Provide No (provided PAN and Email ID is registered in the Folio) by logging on to UTI Mutual Fund's website
www.utimf.com. The service is available with a drop down option of "Request for SoA" under the heading
3rd Holder
"Customer Service".
Guardian
Status as on 31-01-2018: NAV Rs. 34.5795, Units 1485.639, Value Rs.51372.650
UTI Mastershare Unit Scheme-Regular Dividend Plan PAYOUT ISIN : INF189A01038
Tr.Date Transaction Type Amount (`) NAV(`) Load Price (`) Number of Units Balance Units
(`)

Opening Balance 1,485.639


05/11/2014 Dividend Pay Out (2.7500000) 4,085.51 1,485.639
16/11/2015 Dividend Pay Out (2.8000000) 4,159.79 1,485.639
08/11/2016 Dividend Pay Out (3.0000000) 4,456.92 1,485.639
16/10/2017 Dividend Pay Out (3.5000000) 5,199.74 1,485.639
For subscriptions received w.e.f. June 4th, 2018, applicable Exit load: Redemption / Switch out within 12 months from the date of allotment – (i) NIL for upto 10% of the allotted Units (ii) 1.00 % for beyond 10% of the allotted Units.Redemption / Switch out after 12 months
from the date of allotment – NIL
NAV ` 31.9738 (as on 19 Oct 2018) Amount Invested ` 45,000.00 Total Div Paid ` 49,174.69 Current value ` 47,501.52
Local UFC Address : UTI FINANCIAL CENTRE;16/77, CIVIL LINES, KANPUR -208 001 UTTAR PRADESH TEL: 7518801914

Folio No. : 51517471389 Sub ARN : PAN KYC Status


Name : MANDAKINI TRIPATHI Code Primary Holder Please Provide No

Mode of Holding : ANYONE OR SURVIVOR Sub Code :


2nd Holder Please Provide No
Bank Details : Savings/XXX853 / DENA BANK / UTHRATHIA BAZAR,LUCKNOW / EUIN :
226001 3rd Holder
Financial Advisor : Prem Kumari Verma ( ARN-8841 ) RM code :
Guardian
Upfront commission shall be paid directly by the investor to the AMFI registered Distributors based on the investors’ assessment of various factors including the service rendered by the distributor

UTI Mastershare Unit Scheme-Regular Dividend Plan PAYOUT Balance Units : 1,485.639
Nature of Transactions : (Please tick & fill up relevant details)
Purchase / Additional Purchase : I/we would like to purchase units of the above mentioned scheme for Amount ` (in fig) (in words)
Cheque/DD Number dated Drawn on Bank
Branch Bank A/c type (Please tick) Savings Current NRO NRE
Switch : I/we would like to switch All units or Partial units units or ` (amount in figures) (in words)
from above mentioned Scheme to Plan Option Growth Dividend Payout Dividend Reinvestment
Redemption : I/we would like to redeem All units or Partial units units or ` (amount in figures)
(in words) from above mentioned Scheme . I/We furnish MICR & IFS code to facilitate electronic payments.

MICR NO IFSC
I/We have understood the contents of the Offer document and addenda issued till date and apply to the Trustee of UTI Mutual Fund as indicated above. I/ We agree to abide by the terms and conditions, rules and regulations of the scheme as on the date of investment. I/ We undertake to
confirm that the applicant/unit holder is empowered to invest/ disinvest and the signatories have necessary authorization to invest/disinvest on behalf of applicant/ unit holder. I/We undertake to confirm that this investment has been duly authorized by appropriate authorities in terms of all
relevant documents and procedural requirements. I/ We have not received nor been induced by any rebate or gifts, directly or indirectly in making investment. * I/ We confirm than we are Non residents of Indian Nationality/ Origin and that the funds are remitted from abroad through approved
banking channels or from my/ our funds from my/ our NRE/ NRO account. I/ We undertake to provide further details of source of funds and any such other relevant document, if called by UTI Mutual Fund. *Appliable to NRIs.
The ARN holder has disclosed to me/us all the commissions (in the form of trial commission or any other mode), payable to him for the different competing Schemes of various Mutual Funds from amongst which the Scheme is being recommended to me/us.
*EUIN: I/We hereby confirm that the EUIN box has been intentionally left blank by me/us as this is an "execution-only" transaction without any interaction or advice by the employee/relationship manager/sales person of the above distributor or notwithstanding the
advice of in-appropriateness, if any, provided by the employee/relationship manager/sales person of the distributor and the distributor has not charged any advisory fees on this transaction.

SIGNATURE(S)
First Account Holder Second Account Holder Third Account Holder
CA : KARVYMFS--10/22/2018 6:28:42 PM / LA: Prerma42-22.10.18-8 Page 1 of 1