Account Statement

FOLIO NUMBER : 910120611971 CAN : Statement Date : 19 Jul 2022

SHIVAGOUDA SHIDAGOUDA PATIL First Holder Second Holder Third Holder Guardian/POA
PAN/PEKRN AAFPP8508F AAFPP6002N
1102-A
KIN
Vrushali-Villa Co-Op Hou Soc Ltd
Bld No-88 Tilak Nagar Chembur KYC Status Verified Verified
Mumbai 400089 FATCA/CRS Status Compliant Compliant
Maharashtra
India UBO
Mobile : 9821245481 First Nominee Second Nominee Third Nominee
Email ID : SSPATIL.RBG@GMAIL.COM
Nominee Name REENA S PATIL

Nominee Relationship DAUGHTER

Name Of Guardian
Joint Holder 1 : SAVITA SHIVAGOUDA PATIL
POA Registration N
Joint Holder 2 :
Tax Status INDIVIDUAL IFSC NICB0000011
DP/CLID :
Mode of Holding ANYONE OR SURVIVOR Bank A/c No. XXXXXXXXXXX2369
Form 15G/H : No UTI Infrastructure Technology And Bank Name NEW INDIA COOPERATIVE
Intermediary/RIA/PMRN
Services Ltd / BANK LIMITED

Intermediary/RIA/PMRN Code ARN-4483 / NA Account Type SAVINGS

Sub ARN / Sub Broker Code NA / NA Payout Mode Electronic
EUIN E019750 Multiple Bank Reg No

ACCOUNT SUMMARY

Scheme Name NAV Units Investment Paid (Rs) IDCW Market Value (`)
Value(`) Paid (`) Re-invested (`)
Axis Quant Fund Regular Growth (QFGPG) - : ISIN : INF846K011A2 9.9600 4,999.750 50,000.00 49,797.51

Total 50,000.00 0.00 0.00 49,797.51

Axis Quant
<font size="2" Fund
color="white" Regular
face="arial Growth(
narrow"><b>Axis QF-GP)
Quant Fund Regular Growth( QF-GP)</b></font> ISIN : INF846K011A2 NAV as on 18 Jul 2022 (`) 9.96

Transaction Type Date NAV Stamp Duty STT Amount in Price in Units Balance
(`) (`) (`) Units
Gross Initial Purchase-Offline 01/07/2021 50,000.00
Stamp Duty 2.50
Net Initial Purchase-Offline 01/07/2021 10.0000 49,997.50 10.0000 4,999.750 4,999.750
NEW PURCHASE WITH CHEQUE

Investment Cost ( `) : 50,000.00 Market Value( `) : 49,797.51

Locked Units : 0.000 Lien Units : 0.000 Free Units : 4999.750
Intermediary/RIA/PMRN : UTI Infrastructure Technology And EUIN No. : E019750
Services Ltd / NA

EXIT LOAD ##
Axis Quant Fund Regular Growth( QF-GP)
Entry Load: NA. Exit Load : If redeemed / switched-out within 12 months from the date of allotment - For 10% of investment: Nil For remaining investment: 1% w.e.f., 01/07/2021

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Folio NO. : 910120611971
Name : SHIVAGOUDA SHIDAGOUDA PATIL Statement Date : 19 Jul 2022

## For applicable load structure, refer the SID. For any further information or to report any discrepancy EasyCall™ us on 81086 22211
anytime between 8 am to 8 pm on a working day & 9 am to 6 pm on Saturday and Sunday or write to us at customerservice@axismf.com
#To know the folio balance, give a missed call on 921 20 100 33 from your registered mobile no.

This is a computer generated statement and does not require any signature.

Folio NO. : 910120611971 Name : SHIVAGOUDA SHIDAGOUDA PATIL CAN :

Tax Status : INDIVIDUAL PAN : AAFPP8508F KYC Status : Verified FATCA status : Compliant
Intermediary/RIA/PMRN : ARN-4483 / UTI Infrastructure Technology Sub ARN : NA EUIN : E019750 Mode of holding : ANYONE OR
And Services Ltd / SURVIVOR
Scheme Option Date

ADDITIONAL PURCHASE REQUEST REDEMPTION REQUEST SWITCH REQUEST

I/We would like to purchase Units of the above I/We would like to redeem Units of the above I/We would like to switch Units of the above
mentioned scheme. mentioned scheme. mentioned scheme.
(`) (in figures) (`) (in figures) Units or
(`) (in words) (`) (in words) (`) (in figures)
PAYMENT OPTIONS or Units (`) (in words)
Cheque/ DD RTGS/ NEFT Transfer to (scheme name)
or Entire Units (please tick)
Instrument No. Plan
Please note:if the balance in your folio is less than this
Bank Name Option Growth
redemption request,all units or entire balance shall be IDCW
Branch redeemed. IDCW Reinvest Payout
Bank Account Type
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
I/We have read and understood the contents of the SID/ SAI of the
advice by the employee/relationship manager/sales person of the above distributor/sub broker or notwithstanding the advice of
Scheme(s).I/ We have not received nor have been induced by any
in-appropriateness, if any, provided by the employee/relationship manager/sales person of the distributor/sub broker.
rebate or gifts, directly or indirectly in making this investment. The
money invested in the schemes is through legitimate sources and is
not in contravention of any prevailing laws.

Note: In case there is any change in your KYC information please update the same by using the prescribed 'KYC Change Request Form' and submit the same at the Point of Service of any KYC Registration Agency.

Signatures of
First Holder Second Holder Third Holder
Holders
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