Request for Change in Broker

Internal Code for

Distributor Name & ARN Code SUB Broker ARN EUIN
Employee/Sub Broker
ARN-9992 ARN-
Prudent CAS 132873 92836 E-220983
I/WE hereby confirm that the EUIN box has been intentionally left Blank by me /us as this transaction is executed without any
interaction or advice by the employee/relationship managers/sales Person of the above distributor/ sub broker or notwithstanding the
Advice of in-appropriateness, if any, provided by the Employee/ relationship managers/sales Person of the above distributor/sub broker

Signature _____________________________ _____________________________ ___________________________

( ) ( ) ( )
1st Holder 2nd Holder 3rd Holder

Date: _________________

To, _________________Mutual Fund

_________________

First Unit Holder Name:_________________________________________________________________

Subject: Change of my Existing Advisor/Broker

With reference to above subject and SEBI circular dated 11th Dec'09 vide circular no. SEBI/IMD/CIR No./13/187052/2009, I hereby instruct you
to change my existing advisor/broker for the following mentioned Folio nos. with your Fund, for all past, present and future investments, from
92836
My existing broker to Prudent Corporate Advisory Services Ltd (ARN-9992) with a Sub Broker Code: ____________. Please note that this
change should be applied to all future installments of SIPs/STPs, if any.

Henceforth, I will use Prudent Corporate Advisory Services Ltd (ARN-9992) for all Portfolios related advice as well as various services related to
my investment through following folio.

Folio No. Scheme Name

You are requested to effect this change with immediate effect under intimation to us.

Thanking you.
Regards,

Signature _______________________ _______________________ _______________________

( ) ( ) ( )
1st Holder 2nd Holder 3rd Holder
_____________________________________________________________________________________________________________________

Acknowledgement Slip
We acknowledge the receipt of the request for Change of Broker in ARN-9992 Prudent Corporate Advisory Services Ltd [subject to scrutiny &
other verifications]
92836
Investor Name:___________________________________________, Partner Code- __________________ Date of Receipt-________________

Mutual Fund: ___________________________________________ , Folio No:___________________________________________________