Individual KYD
Individual KYD
"Please note that the KYD Application Form and overleaf instructions should be printed on the same page (back to back). If printed separately then both the pages should be attached and signed by the applicant."
Please fill this form in ENGLISH and in BLOCK LETTERS (All Information as applicable in Sections A, B and C below is mandatory)
Gender
Male
Female
Father's Name
2. Date of Birth
Please affix most recent colour photograph 30mm x 40 mm Sign across the photograph
Resident Individual
Non-Resident
4. Permanent Account Number (PAN) (MANDATORY) Please tick ( ) Copy of PAN Card attached
B. Address and Bank details (Please see guidelines B1 to B3 overleaf) 1. Permanent Address / Contact details of Applicant
2. Proof of address to be provided by Applicant. Please submit ANY ONE of the following valid documents & tick ( ) against the document attached. Latest Telephone Bill Latest Electricity Bill Passport Driving License Latest Bank Passbook Latest Bank Account Statement Latest Demat Account statement Voter Identity Card Ration Card Registered Lease / Sale Agreement of residence For NRIs - Any other document attested by local authority. 3. Bank Details (Please see guidelines B3 overleaf) Bank Details Name of Bank Branch Account Number MICR / NEFT Account Type C. Other Details SB Current Any Other (Please Specify)
1. Names of Mutual Funds with which empanelled (applicable to existing ARN holders)
2. Occupation Details Please tick ( ) Insurance Agent Postal Agent Corporate Deposit Agent
Stock Broker
DECLARATION
I hereby confirm that I have read and understood the Instructions mentioned overleaf and apply to Computer Age Management Services Pvt. Ltd. (CAMS) for compliance of Know Your Distributor (KYD) procedure for marketing Mutual Fund Products and I agree to abide by the terms, conditions, rules, regulations and other statutory requirements applicable with regard to marketing Mutual Fund Products. I hereby declare that the particulars given herein are true, correct and complete to the best of my knowledge and belief, the documents submitted along with this application are genuine. I hereby undertake to promptly inform CAMS / AMFI/ the mutual fund of any changes to the information provided hereinabove and agree and accept that CAMS, the respective Mutual Funds, are not liable or responsible for any losses, costs, damages arising out of any actions undertaken or activities performed by them on the basis of the information provided by me as also due to my not intimating / delay in intimating such changes. I hereby authorize CAMS / AMFI to disclose, share, remit in any form, mode or manner, all / any of the information provided by me to the Mutual Funds/ Statutory Bodies/ Regulators including all changes, updates to such information as and when provided by me. I hereby agree to provide any additional information / documentation that may be required, in connection with this application. I hereby confirm that this is a unique KYD application.
SIGNATURE OF APPLICANT
Place : Date :
Name and Employee Number of Receiver Self Certified Document copies received, verified with originals
KYD Ref.
CHECKLIST
(Before submitting this form, please go through the following checklist)
1. 2. 3. 4. 5. 6. Please Please Please Please Please Please ensure that the form is completed in all respects and signed by you. affix your recent photograph and sign across the photograph. attach a copy of your PAN card as proof of Identity Document. This should be a photocopy plus original for verification. attach a Proof of address Document. This should be a photocopy plus original for verification. attach a proof of bank details. This should be photocopy plus original for verification. submit a photocopy of the duly completed KYD Application Form.
For assistance or enquiries please approach the Point of Service where you had submitted your KYD Application Form.
Visakhapatnam : 47/ 9 / 17, 1st Floor, 3rd Lane, Dwaraka Nagar, Andhra Pradesh, Visakhapatnam - 530 016. Tel.: (0891) 329 8397, 329 8374, 254 0175
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