r Diitiibiftoi's ARN/ RiA, C6de1,,,:.. Sub-Brokert Name & Code ElJlN,ri ri'. FOLIO].NCi;'r'ri:,':'.

,rr r,r'l
DATEI::::

INA200014140 5170438t53 .,,1 It

"By mentioning RIA code, l/We authorize you to share with the lnvestment Adviser the details of my/our transactions in the scheme(s) of Kotak Mahindra Mutual Fund.
"l/We hereby confirm that the EUIN box has been intentionally left blank by me/us as this transaction is ex€
person of the distributor/sub broker.

Sole/First Holder se(ond Holder Third Holder

(Io be signed by All Unitholders if mode of operaiion is 'Joint')

tlie distributor.

NAME OF SOLE/ FIRST HOLDER:

SIEMENS INFORMATION SYSTEMS LIMITED EMPLOYEES PROVIDENT FUND
NAME OF SECOND HOLDER:

NAME OF THIRD HOLDER :

PAN AAATS,I796D

LEI Number (Legal Entity ldentifier) - For Non individuals only Valid till

PURCHASE :: ::::: t:rt''R€fdi.:G}i;.[{iit I']

scheme KOTAK BLUECHIP FUND option (Please v ) n IDCW [g> o Payout OR O Reinvestment
FreQuencY
plan DIRECT $cw
Itr Growth
Plan your Life Gcal. ,ou .rn ,.rign ,ho *i"stment for your life3 important milestones. tlvou p#*'iri",liu Xoiro Education Ll chitd weddinq ff, Retirement
Payment Mode il orv (one Time Bank Mandate) il Cheque il DD / Pay order S nrcsl
- il
rurrr Funds Transfer

lnvesrmenr . Rs. 7250000 Chq./ DD No./ UTR No.i UMRN No. dated-l-l-
Ll ntr1r Et a N[/. t..t [, tTE.r.'\
(Please mention your folio on the face of your investment cheque)

We hereby confirm having initiated the Transfer/RTGS for transfer of Rs. 7250000 from our account no. 00031 1 10000527
with HDFC BANK LIMITED Bank to your account no. 09582540007624 with
KOTAK MAHINDRA BANK LIMITED Bank.
r. , r'rll,.lrllrl,l,l, ,
Refei Checklist,lll
' 'lSWlTCtl:,.,::,,.:
From: Scheme plan _
Option (Please v )
[: IDCW I]8 O payout oR C Reinvesrment
IDCW Frequency
To: Scheme Plan
il Growth
fl IDCW Il8 C Payout OR O Reinvestmenr
All Units Free from Exit Load (v
OR ut( IDCW Frequency
il Growth
lmportant Alert: I,n case there is any change to your KYC information please update the same by using the prescribed 'KYC Change Request Form' and submit the same at the
Point of Seruice of any KYC Registration Agency.

Please ensure you submit supporting documents evidencing the accuracy of the demat account details mentioned below. Bank details of DP will overwrite
the existing details. ln case you wish to hold units in demat, please fill this section. Please note that you can hold units in demat for all open ended schemes
(except ETFs and IDCW options having IDCW frequency of less than a month).

fi r,rsor- [ cosr- HDFC BANK.,LTMTTED 1N300476 ,,r,,. 40066662i-,.,r1i. i:r.i i:ii::.ir,irr,i fli].

Payout OR C Reinvestment
All Units Free from Exit Load ( v

lf the balance in the scheme/planis /ess than the requested amount/ units of redemption request, then the redemption transaction shall be processed for all available units in
the scheme/ plan.
lf you have opted to redeeml switch-out 'All units Free from Exit Load', then the same shall be processed only on FIFO basis.

The redemption should be processed into the following bank account as per the payout mechanism indicated by me/us:

lmportant Note: lfthe ba.lk account nentioned
oah k accoun L deta ils are not lilled above OR ino
the " Default" bank account reqistered for
a risinq to the unitholde(s) due to the credit r
from those already registered in your folio, prescribed supporting documents have to be submitted. lf
.supportinq docu"nents are subm jtted for a new bank account, Lhe redempt'on will be p.ocessed into
'1
[k Mutual l-u'd o' Kolak Mahindra Asser ManagementCompany Ltd. will not be liable Ior a-y loss
k\nto any of rhe bank accoqF registered wrrh uilor the aloreiaidaolio