TFI0068543

I N T E R N A T I O N A L

FIDELITY ONLINE REGISTRATION FORM

(To be separately furnished for each Unit Holder listing all Folios including Folios held in the capacity of Guardian to minor Unit Holders)

Please read Guidance Notes carefully. Please sign on all the pages as indicated in Guidance Notes All Sections to be completed legibly in English in black/dark coloured ink and in BLOCK CAPITALS.

1. APPLICANTS PERSONAL DETAILS

Applicants Name

(See Note 1)
Date of Birth Nationality (please 3 ) Indian a

MR. ADITYA ANMOL

18/11/2008
Others

Fathers Name Mr.

ROHIT SINGH

Guardian (if Applicant is Minor)

Mr. ROHIT SINGH

Non-Resident Individual
PAN

Tax status (please 3 )

Resident a Individual

BSCPS1478M

Address for Correspondence (P.O. Box Address is not sufficient)

Permanent Address or Overseas Address (Mandatory for NRI/FII Applicants)

ASHABARI HOUSING COMPLEX BB 103 BLOCK O

VILL ALAMPUR SURO PO BACHHAWARA

DIST BEGUSARAI
BACHHAWAR

NEAR BAISNABGHATA FIRE STATION

KOLKATA
West Bengal
PIN 700094 Tel. (Res.) (ISD) (STD)

City/Town

State

City/Town

State

Bihar
851111

Country India Tel. (Office) (ISD) (STD) Email ID SHEKHAR.SPRIHA@GMAIL.COM

Country India

Postal Code

Mobile (ISD) (9339662008)-9331827661

Your Communication Preference (please 3 ) Are you KYC compliant

E-Mail a

SMS a

Fax (ISD) (STD)

a
Account No. 627801516906 Bank Name
ICICI BANK

Yes Enclose copy of KYC Acknowledgement Letter No Please enclose filled KYC Form
Account Type (Please 3) Savings a

KYC Application No. 0000039192

2. BANK ACCOUNT DETAILS (MANDATORY - if left blank, Application will be rejected)

Current NRE NRO FCNR

(See Note 2)
Others (please specify)

Branch Address GARIAHAT BRANCH,2/3,HINDUSTAN ROAD,KOL City MICR Code

KOLKATA

700229008

(This is a 9 Digit Number next to your Cheque Number)

3. NOMINATION DETAILS (Please strike out this Section if you do not wish to nominate)

(See Note 3)

I do hereby nominate the undermentioned Nominee to receive the Units allotted to my credit in my folio in the event of my death. I also understand that all payments and settlements made to such Nominee and Signature of the Nominee acknowledging receipt thereof, shall be a valid discharge by Fidelity/Fidelity Mutual Fund/Trustees.

Name and Address of Nominee Name Address

To be furnished in case Nominee is a Minor (strike out if not applicable) Name of Guardian Address of Guardian Signature of Guardian (Mandatory)

SPRIHA SINGH
ASHABARI HOUSING COMPLEX BB 103 BLOCK O KOLKATA-94

Date of Birth (in case Nominee is a Minor) 28/12/1979

4. FOLIOS TO BE ACCESSED ONLINE

Please list below the folios that you would like to access online. Please note that you would be able to access only those folios in which you are either a unit holder or a joint holder or a guardian.

5. DECLARATION AND SIGNATURES

I/We do hereby apply for the facility to access our present and/or future investments and effect transactions over various Fidelity service channels with respect to my/our unit holder account(s) with you. I/We have read and understood the terms and conditions subject to which this facility is offered by Fidelity and confirm that I/We shall be bound by them. I/We have no objection to Fidelity/Fidelity Mutual Fund/Trustee checking my/our identity before effecting any transaction over various Fidelity service channels. I/We acknowledge and confirm that this facility is made available to me/us subject to I/We fulfilling the Know Your Customer (KYC) requirement stipulated overleaf and enclose herewith relevant documents.

SIGNATURE (Applicant must sign here) Please refer the guidance notes/checklist and ensure that all relevant sections are completed.

Applicant

FOR OFFICE USE ONLY

Remarks Initial & Date

X
(See Note 4)

(See Note 5)

Date

DD / MM / YYYY

Page 1

Terms and Conditions with FIL Fund Management Private Limited and FIL FundsNetwork Private Limited
These Terms, together with the application form(s), are binding on you with respect to your dealings with Fidelity through various Channels. These Terms are issued to you by FIL Fund Management Private Limited (FFMPL) and FIL FundsNetwork Private Limited (FFPL) which are companies within the FIL Limited group of companies. You will deal with FFMPL in regard to the schemes launched by Fidelity Mutual Fund ("Fidelity MF"), a mutual fund registered with the Securities and Exchange Board of India ("SEBI"). FFMPL is the investment manager to the schemes launched by Fidelity MF. You will deal with FFPL in regard to schemes launched by various mutual funds registered with SEBI including Fidelity MF. FFPL has been established to act as a distributor and financial consultants or advisors in relation to, investments in all types of securities including but not limited to schemes launched by various Mutual Funds. FFPL also provides an online platform to deal in the units of the schemes of the Mutual Funds. You agree to execute all the necessary documents which may be needed from time to time to permit FFPL to send the necessary dealing details to Mutual Funds to give effect to the dealings through various Channels. 1. DEFINITIONS The definitions below apply throughout these Terms. i. "Authorised Representative" shall in respect of non individual investor mean such person or persons authorized by the investor to act on the investor's behalf for dealing with Fidelity and whose specimen signature has been lodged with Fidelity/its authorised representative. ii. "Channels" shall mean various electronic channels including but not limited to internet, telephone, etc provided by Fidelity through which you can deal with Fidelity. In case of FFMPL, these shall be the official points of acceptance of transactions in the schemes of Fidelity MF. iii. "Customer Relationship Number/User ID"("CRN/User ID) shall mean the unique identifying number assigned to you by Fidelity. iv. "Fidelity" shall mean FIL Fund Management Private Limited or FIL FundsNetwork Company, as relevant. The relevant company will be the one which manages or offers the particular product in which you propose to deal with References to "Fidelity" in the Terms will also include any company to which we may transfer our rights and obligations under the Terms in accordance with clause 8 (A). v. "Mutual Funds" shall mean various mutual funds registered with SEBI including Fidelity MF. vi. "PIN" shall mean the Personal Identification Number issued by Fidelity/its authorised representatives for the purpose of dealing with Fidelity. This PIN can also be used to avail of certain other services/facilities to be provided by Fidelity from time to time. vii."SEBI" means the Securities and Exchange Board of India. viii."Terms" means these terms for dealing with Fidelity through the Channel(s) and shall include all modifications and supplements thereto from time to time. ix. "Trustees" shall mean FIL Trustee Company Private Limited, the Trustee to Fidelity MF. x. "Unit" shall mean an interest of an investor(s) in the schemes of Mutual Funds consisting of each unit representing one undivided share in the net assets of that scheme as evidenced by the account statement. xi. "You" shall mean any person who does business with Fidelity under these Terms. The term "You" in case of individual investor includes your personal representatives. References to the singular shall include the plural and vice versa. References to clauses are to clauses of these Terms. References to statutes, rules or regulations shall be taken to include any amendments made to them from time to time. 2. GENERAL TERMS i. You agree that the transactions carried out through the Channels in Units of various schemes offered by the Mutual Funds shall be subject to the provisions contained in the respective offer documents and/or key information memoranda (as updated by issue of relevant addenda). ii. You agree and accept that pending receipt of all the relevant documents (including the registration form, the Terms, Know Your Customer Form (if applicable) and the necessary supporting documents) duly completed and signed by you ("Completed Documents") by Fidelity/its authorised representatives, a. you will be permitted to carry out only purchase transactions through the Channels; b. you will be permitted to invest as a sole investor only (i.e. you won't be able to invest jointly); and c. you authorise Fidelity / its authorised representative to block for further dealings, the folio(s) in which you have made investments through Channels. iii. You agree that the data provided by you pursuant to dealing with Fidelity could be shared by Fidelity with its authorised agents, representatives, affiliates, group companies and subsidiaries. iv. You agree and accept that you shall abide by these Terms (including the instructions relating to dealing with Fidelity) as may be specified by Fidelity with respect to dealing through the Channels from time to time. v. You agree and accept that Fidelity has the discretion to restrict a particular set/class of investors from dealing with Fidelity. vi. You accept the sole responsibility to maintain the secrecy of all information of confidential nature and shall ensure that the same is not disclosed to any person voluntarily, accidentally or by mistake. vii.You agree and confirm that Fidelity and/or its authorised representatives is not in a position to verify that the dealings are indeed undertaken by you/Authorised Representative(s) at the time of dealing through the Channels and they are not or shall be not held responsible for any transactions arising out of the misuse of the password and/or PIN by any person other than you/Authorised Representative(s). viii. You agree and consent to the transmission of data (personal, account/CRN/User ID related, etc) by electronic means through the Channels with respect to dealing with Fidelity. ix.You agree that Fidelity may suspend any or all the services provided for the purpose of dealing, without liability, in whole or in part, at any time without prior notice if you do not comply with any of these Terms or any modifications thereof. x. You shall not assign any right or interest or delegate any obligation arising herein. xi. You shall be responsible for the systems used by you with respect to dealings with Fidelity and for various security measures which you have to take to prevent unauthorised access to details relating to the dealing with Fidelity through the Channels, and Fidelity shall not be liable for any such unauthorised access. xii.You agree that Fidelity is currently permitting the dealing with Fidelity without any charge (however applicable entry/exit load/any other charge levied by the Mutual Funds will be chargeable in accordance with the offer documents), but Fidelity reserves the right to levy any charge it may deem fit. xiii. You agree that Fidelity is providing only a facility to you for the purpose of dealing in the Units of schemes of the Mutual Funds and hence there is no contractual obligation on Fidelity/Fidelity MF/the Trustees with respect to such facility. xiv.You acknowledge that dealing through the Channels will be at your own risks. You shall solely be responsible to evaluate all the risks arising out of the same. The risks would, inter alia include: " Internet frauds - The Channels may be susceptible to number of frauds, misuse, phishing, hacking and other actions, which could affect instructions sent to Fidelity/its authorised representatives. There cannot be any guarantee from such internet frauds, phishing, hacking and other actions. " The susceptibility of the Channels to virus(es) or other malicious, destructive or corrupting codes or programs. 3. TERMS APPLICABLE TO CRN/USER ID AND PIN ISSUED BY FIDELITY/ITS AUTHORISED REPRESENTATIVES i. You agree and unconditionally confirm that you shall be solely responsible to ensure protection and confidentiality of the password and/or the PIN and any disclosure thereof shall be entirely at your risk. ii. You grant express authority to Fidelity/its authorised representatives for giving effect to dealing requests made by you through the Channels authenticated by the password and/or the PIN. iii. You agree that Fidelity may, in its absolute discretion, issue a new password and/or PIN to you on the Terms stated herein or on such other Terms as Fidelity may deem fit. iv. You agree to notify Fidelity immediately if the password and/or PIN is lost or stolen or if you are aware or are of the belief that another unauthorized person is privy to or has used the PIN or it is suspected that the PIN has been tampered with. On receiving such notification, Fidelity/its authorised representative may issue a new CRN/User ID and/or password and/or PIN you. 4. TERMS APPLICABLE IF YOU ARE A NON - INDIVIDUAL INVESTOR/HOLD UNITS JOINTLY i. If any third party or unauthorized signatory (in case you are a non-individual investor) gains unauthorized access with respect to the dealings by using your password and/or PIN, you agree that Fidelity/its authorised representatives shall not be liable for any damage or loss arising out of such unauthorized use of the password and/or PIN. You agree to indemnify Fidelity/Fidelity MF/the Trustees and its directors, employees, agents and representatives against any liability, costs, or damages arising out of claims or suits by such other third parties or other person relating based upon or related to such access or use. ii. In case you are a non-individual investor, you undertake to submit to Fidelity/its authorised representatives a certified true copy of a resolution authorizing signatories (along with their specimen signatures) who shall have the full authority to act for and on behalf of you with respect to dealings through the Channels. Only these Authorised Representative(s) will be permitted to transact through the Channels. Additionally these Authorised Representative(s) will have the right (if permitted by the resolution) to specify the names of certain authorised personnel who could have the right only of online viewing of accounts and initiation of a transaction through the Channels. iii. In case you are a non-individual investor, you undertake that any changes to the list of the Authorised Representative(s) as mentioned above shall be communicated to Fidelity/its authorised representatives forthwith in writing and you agree that the same shall be effective only upon its registration by Fidelity/its authorised representatives. Fidelity/its authorised representatives shall not be held responsible for any transactions that are initiated/authorised by a person who has ceased to be an Authorised Representative(s), pending receipt of a written confirmation to this effect you and registration of the same by Fidelity/its authorised representatives. iv. In case you are a non-individual investor or have a joint account with the Mutual Funds (i.e. Units of the schemes of the Mutual Funds are held jointly by you), you agree that in case a transaction request through the Channel is not authorised by all the Authorised Representatives/joint holders in line with the mode of operation selected, within the applicable cut - off time as may be specified by Fidelity, then such transaction will expire and shall not be carried forward and a fresh transaction request will be required to be initiated. v. You agree that if the bank account through which you propose to make payments towards your dealing in the Units of the schemes of Mutual Funds is held jointly, you shall be solely responsible for getting the authorization of the other joint holder(s) for making the payment in favour of the respective Mutual Fund(s) and the dealing will be completed only on receipt of funds by the Mutual Fund concerned. 5. TERMS RELATING TO PROCESSING OF TRANSACTIONS SUBMITTED THROUGH CHANNELS i. You agree and confirm that all the authorised and complete transactions will be processed at the applicable NAV (as defined in the offer documents of respective schemes of Mutual Funds) subject to realization/utilization of the funds and acceptance of the transactions by the Mutual Funds/their authorised representatives. A transaction will be deemed to be complete only once it is authorised by all the joint holders/Authorised Representatives as the case may be and the funds are received by the Mutual Funds. In case of dealing with FFMPL, the electronic time stamping done on the transaction request received through a Channel after the transaction is complete shall be deemed to be time stamping done in accordance with guidelines issued by SEBI from time to time. In case of dealing with FFPL, the time stamping will be deemed to be done when the Mutual Funds accept the transaction file feed sent by FFPL. ii. You agree that you shall be responsible for all transactions conducted through the Channel(s) and records generated Fidelity/its authorised representatives shall be conclusive proof of the transaction being undertaken and shall be binding on you and may be used as an evidence in any proceedings, legal or otherwise. In case of any discrepancy with regard to a transaction, you agree to notify Fidelity/its authorised representatives within 7 days of receipt of the record of such transaction. iii. You agree that there may be a time lag between the time a transaction is completed and before the same is updated in the records of Fidelity/its authorised representatives. There may be a possibility of variances in values arising out of delayed data feeds, transmission losses in electronic data etc. for which Fidelity/its authorised representatives shall not be liable. iv. You agree that the payment for the transaction undertaken by the you over the Channel(s) will be facilitated through a payment gateway and Fidelity/its authorised representatives/Fidelity MF/Trustees will not be liable for any failures in the link or for any fraud (either payment gateway's and/or bank's end) that could take place at the time of at the time of making payment and you shall inform Fidelity/its authorised representatives immediately if the your bank account is debited and wherein corresponding Units have not been allotted. Fidelity/its authorised representatives shall re-confirm the receipt of the funds and following which it shall process the transaction based on the applicable NAV on the date of receipt of funds by the Mutual Funds.

Page 2

Terms and Conditions with FIL Fund Management Private Limited and FIL FundsNetwork Private Limited (Contd.)
v. You agree that submission of a transaction request through the Channel(s) shall not be deemed to be acceptance of the transaction by Fidelity/its authorised representatives/Mutual Funds and the transaction could be rejected if does not comply with the provisions of the respective offer document or for any other reason which Fidelity/its authorised representatives/Mutual Funds deems fit. 6. LIABILITY I. You agree to keep indemnified and hold Fidelity/Fidelity MF/Trustees and its officers and agents free and harmless at all times, against all monetary and other harm, injury, costs, losses, liabilities, damages, charges, actions, legal proceedings, claims and expenses and consequences including without limitation any costs between attorney and client, whether direct or indirect, by reason of dealing with Fidelity and/or doing and/or omitting to do anything in accordance with the Terms specified herein or any instructions relating to the dealing with Fidelity other than liabilities caused as a direct result of Fidelity's negligence, knowing default, fraud or breach of the relevant applicable rules or of these Terms. ii. You agree that Fidelity is not liable for any loss caused through a fall in value of investments (including, without limitation, those which may occur due to delays during the process of verifying an investor's identity in compliance with anti-money laundering regulations). iii. You agree that Fidelity shall not be held liable or responsible for any loss caused due to blocking by Fidelity/its authorized representatives of folios in which you have made investments through Channels pending receipt of Completed Documents. iv. You agree that Fidelity is also not liable for any indirect, special or consequential loss you might suffer (including direct or indirect loss of profit). v. You agree that you shall not hold Fidelity/its authorised representatives/Fidelity MF/Trustees responsible or liable if you incur any loss as a result of information being disclosed by you with respect to your dealing with Fidelity. vi. You agree and undertake not to hold Fidelity/its authorised representatives liable for the following: " any delay or failure in processing the transactions carried out by you due to any system failure at Fidelity/its authorised representatives' end or for any other reason whatsoever. " for any loss or damage incurred or suffered by you due to any error, defect, failure or interruption in the dealing arising from or caused by any reason whatsoever. " for any fraud, negligence/mistake or misconduct by you. " for any breach or non-compliance by you of these Terms. " for not permitting you to deal with Fidelity after such reasonable verification as Fidelity/its authorised representatives may deem fit. " for permitting any person who provides Fidelity/its authorised representatives with the password and/or PIN to deal with Fidelity. Fidelity/its authorised representatives shall be under no obligation to further ascertain your identification at the time of dealing with Fidelity. " for any loss or damage incurred or suffered by you due to withdrawal or termination or suspension of the dealing facility by Fidelity arising from or caused by any reason whatsoever. You agree that this undertaking shall be valid until such time you have not expressly informed Fidelity in writing that you do not wish to deal with Fidelity any longer and it shall be also valid in respect of any claims made on account of or relating to your dealing with Fidelity. 7. NO WAIVER No forbearance, delay or failure on Fidelity's part to exercise any power or right under these Terms shall operate as a waiver of such power or right, nor shall any single or partial exercise of such power or right preclude any further exercise of that or any other power or right. 8. ASSIGNMENT, TERMINATION AND AMENDMENTS A. Assignment You consent to Fidelity's assigning to any appropriate Fidelity group company or any third party which is appropriately regulated and authorised all or any of its benefits and obligations under these Terms. You will be notified of any such assignment. B. Termination Termination by you i. You may terminate dealing with Fidelity at any time by giving prior written notice to Fidelity/its authorised representatives or deactivation of your CRN/User ID. The CRN/User ID would continue to be active until such time such a request is received and registered by Fidelity/its authorised representatives. Termination by Fidelity i. Fidelity may, on its own accord and discretion, choose to treat a CRN as inactive/dormant where it is not used for a defined period of time in the interest of your security. ii. Fidelity may disallow the dealing facility, without liability, without prior notice on occurrence of any of the following events (i) non-compliance of the Terms stated herein; (ii) death, insolvency, bankruptcy or liquidation of the investor; (iii) any other cause arising out of the operation of law; or (iv) or such other reason as Fidelity deems proper. iii. Fidelity may, at its sole discretion, at any time suspend your right to deal with Fidelity for such reason and for such time period as it may deem fit. iv. Fidelity may terminate this agreement with you by giving you one month's notice in writing. In the event of termination for any reason whatsoever, Fidelity shall be entitled to recover all outstanding charges and dues from you, if any. C. Amendments Fidelity may amend these Terms to: a. comply with changes in law or regulation; b. correct inaccuracies, omissions, errors or ambiguities; c. take account of any corporate reorganisation inside the Fidelity group of companies and/or a transfer of our rights and obligations under these Terms to another company as contemplated by clause VIII (A); and d. reflect changes in the scope and nature of the services, products or investments we provide or wish to provide under these Terms, or changes to our computer or database systems, our administrative processes and procedures, market practice or customer requirements. 9. PROPERTY RIGHTS IN INFORMATION The intellectual property in all material provided on the website (including any ODs and addenda thereto, key information memoranda, other literature, manuals, reports, research papers, data, flow charts, drawings, designs, diagrams, tables, software, source code or object code or other information or materials in whatever form and on whatever media stored or held) is held by Fidelity/FFMPL unless otherwise stated. Except as expressly permitted herein or on the website, none of the material provided on the website may be copied, reproduced, distributed, republished, downloaded, displayed, posted, transferred or transmitted in any form or by any means, including, but not limited to, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of Fidelity/FFMPL. Further, you or an Authorised Representative (in case you are a non-individual investor) shall not transfer, reverse engineer, decompile, disassemble, modify or create derivate works based on the materials provided on the Website except as permitted herein or by law. The copyright, trademarks, service marks, registered designs, database rights, patents and all similar rights in and relating to the website arising or subsisting in any country in the world and the information contained in it are owned by Fidelity/FFMPL, its licensors or relevant third party content providers. Nothing on the website should be construed as granting, by implication, estoppel or otherwise, any license or right to use any trademark displayed on the website without the written permission of Fidelity or its relevant affiliate. You also agree not to use any information available on Fidelity website for any unlawful purpose, and you shall comply with any request of Fidelity or any of the third party providers to protect their respective rights in the information. 10. RULES, REGULATIONS AND BYE-LAWS You undertake to comply with all applicable laws and statutory requirements and agrees to be bound by and to diligently follow and ensure compliance with the Terms stated herein. 11. DISCLAIMER i. You are instructed that any information on the website of Fidelity should be used in conjunction with traditional investment techniques, which may include obtaining applicable legal, accounting, tax or other professional advice or services. Fidelity is not responsible for any omissions, errors or investment consequences arising from the use of this material available on the website of Fidelity by you. ii. The data and information provided on the website of Fidelity does not constitute advice and should not be relied upon while taking investment decisions. iii. Whilst every reasonable precaution has been taken to ensure the accuracy, security and confidentiality of data and information available through the Channel(s), Fidelity, Fidelity MF or the Trustees shall not be held responsible for any consequence of any action carried out by you or unauthorized person. iv. Fidelity may suspend or withdraw the Channel(s) at any time, and you acknowledge that the Channel(s) is also subject to interruption for reasons beyond Fidelity's control. v. Fidelity makes no express or implied warranty: a. that the dealing with Fidelity through the Channel(s) will be uninterrupted or free from errors or that any identified defect will be corrected; b. that the Channel(s) service is free from any virus or other malicious, destructive or corrupting code, program; c. with respect to the merchantability, satisfactory quality or fitness for a particular purpose of the Channel(s) or any of the products/services offered therein; or d. in relation to non-infringement of any third party rights. vi. Fidelity, the Fidelity MF or the Trustees to the Fund shall not be liable for any loss or damage or other consequences arising from any suspension, breakdown, withdrawal, interruption, technical flaw, the presence of virus or other malicious, destructive or corrupting code, programs over the Channel(s) or otherwise and any consequent delay or failure in completion of any payment or other instructions as a consequence thereof arising from the use or inability to use the Channel(s). 12. CONFIDENTIALITY Fidelity shall make reasonable efforts to keep all the information relating your dealing with Fidelity confidential. Provided however that Fidelity shall be entitled to disclose any information or particulars pertaining to you to any authority, statutory or otherwise as may be required by law or as required to effect the transactions requested by you. 13. PRIVACY Fidelity shall not sell or market any personal information or personalized data of its investors to unaffiliated organizations. Fidelity shall maintain your personal information and data according to strict standards of security and confidentiality. 14. MISCELLANEOUS a. In case of any dispute, either judicial or quasi-judicial the same will be subject to the exclusive jurisdiction of the courts in Mumbai. b. These Terms are subject to SEBI as amended from time to time and includes guidelines, circulars, press releases or notifications that may be issued by SEBI or the Government of India, to regulate the activities of mutual funds. I/We, accept the above Terms. On the basis of this acceptance I, request Fidelity/its authorised representatives to issue us a CRN/User ID, password and/or PIN.

SIGNATURE

Applicant

Date

DD / MM / YYYY

Page 3

INSTRUCTIONS
a. This Registration Form is meant for use by prospective as well as existing investor(s) who are eligible to invest in the schemes of the Fund for availing the various account access services across different channels hereinafter, for the sake of brevity referred to as 'covered services' offered by Fidelity from time to time. It is mandatory to comply with KYC requirements to be eligible to avail the covered services. If you are already KYC compliant, please furnish proof thereof along with your Online Registration Form, else, kindly fill in the KYC Form and submit the same with necessary documents indicated therein. c. Please submit this Registration Form along with associated enclosures to any Investor Service Centre of Fidelity nearest to you. In respect of Minor applicants, the Registration Form would need to be signed by the Guardian and the covered services would be made available to the Guardian. A guardian can access both his own investments and the investments of the minor unit holder using his Customer Relationship Number/User ID (CRN/User Id) and access credentials. The CRN/User ID and Access credentials are meant to be used by investors only for availing the covered services through designated channels and should not be used in any case for lodging offline transactions with any Official Acceptance Point of Fidelity or its Registrar. The covered services are not offered to Power of Attorney holders of unit holders. The facility of payments for investments in the covered services is offered through select banks through a third party integrator and is available only to investors who hold a bank account with these banks and avail the facility for online payments and/or other designated channels as may be offered from time to time.

d.

f. g.

b.

e.

GUIDANCE NOTES TO HELP YOU COMPLETE THE APPLICATION FORM

1. APPLICANTS PERSONAL DETAILS a. Please write your name exactly as it appears in your Bank Account (Sole Proprietorship concerns should apply in the name of the sole proprietor). Please mention your date of birth as this may be required to identify yourself while communicating with us. If the applicant is a minor, the name of the Guardian signing the form on behalf of the minor applicant and availing the facility for the benefit of the minor applicant should be filled in the space provided. If the Guardian already holds a CRN/User ID with Fidelity Online, please furnish the same in the space provided for the purpose. Please furnish your PAN in the space provided and enclose a self-attested copy of your PAN Card with your Online Registration Form for Online investments. Please furnish the full postal address of the Sole/First Applicant with PIN/Postal Code and complete contact details. P.O. Box is not sufficient. If you are already KYC compliant, please indicate the same in the form and enclose a copy of your KYC Compliance letter. If you are not yet KYC Compliant, your Online Registration Form needs to be accompanied by your KYC Application Form with relevant enclosures including identity and address proofs. d. We offer a Direct Credit Facility with the following banks for payout of Dividend entitlement/Redemption proceeds : ABNAMRO Bank ICICI Bank BNP Paribas IDBI Bank Citibank Kotak Mahindra Bank Deutsche Bank Standard Chartered Bank HDFC Bank UTI Bank HSBC If your Bank Details are of any of these Banks, we will directly credit your Dividend entitlement/Redemption proceeds into the same. If you have not furnished a copy of your cheque leaf, pending verification of your bank details, your redemption/dividend payouts would compulsorily be paid in the Cheque mode even if you hold an account with a bank through whom we offer direct credit facility. Nominee. If you wish to assign more than one nominee to the investment, please also fill the Multiple Nomination Form available on our website i.e. www.fidelity.co.in and send it with the Online Registration Form. 4. FOLIOS TO BE ACCESSED ONLINE a. Please indicate the folios that you wish to access under the covered services. Please note that the folios that you opt for accessing under the covered services would not be available for transacting offline till such time you choose to dissociate the folio from the covered services. b. Please indicate only those folios where you are one of the unit holders in the folio or are a guardian in respect of a unit holder in the folio. c. Upon receipt of your request, we would validate the same and subject to your application being in order, we would make all your folios accessible across the channels covered. d. Please note that where there are multiple unit holders in a folio, each unit holder would need to fill in the Registration Form. Thus, where you hold investments with another person, say your spouse, both you and your spouse would need to fill in the form, sign it and submit it for activation of the service for both unit holders. e. Please note that where the mode of holding in your folio is Joint, unless all joint holders apply for this service, transacting in such folio would not be possible. 5. DECLARATION & SIGNATURES Please ensure that the following are duly signed a. by the applicant: - Fidelity Online Registration Form on Page 1 - Terms and Conditions with FIL Fund Management Private Limited and FIL FundsNetwork Private Limited on Page 4 - KYC Form on Page 5 (if you are not KYC Compliant ) b. Signatures should be in English or any Indian language. Thumb impressions should be from the left hand for males and the right hand for females and in all cases be attested by a Magistrate, Notary Public or Special Executive Magistrate. c. In respect of Minor Applicants, the application needs to be signed by the guardian who would be availing the facility for the benefit of the minor.

b.

c.

d.

e.

f.

g.

2. BANK ACCOUNT DETAILS a. Please furnish Bank Account Details of the Applicant in this section. All dividend entitlements and redemption proceeds in respect of the investment would be paid to the Applicant favouring the Bank Account indicated in the Form. This is a mandatory requirement and applications not carrying bank account details would not be processed. To facilitate verification of your bank account details at our end, please furnish the following details/ documents :
l

b.

Clearing Circle in which your Bank / Branch participates ; MICR Code of your Bank/Branch. This is a 9 Digit number appearing next to the cheque number.

c.

A cancelled cheque leaf/copy of your cheque leaf, from the same bank account as is mentioned in the form.

3. NOMINATION As per SEBI regulations, you can assign a maximum of 3 nominees to the investment, to whom the amounts will be payable on death of the sole or all Unit Holders as the case may be. a. The nomination can be made only by individuals applying for/holding units on their own behalf singly or jointly. Non-individuals including society, trust, body corporate, partnership firm, Karta of HUF, holder of POAcannot nominate. b. A minor can be nominated and in that event, the name and address of the guardian of the minor nominee shall be provided by the Unit Holder. Nomination can also be in favour of the Central Government, State Government, a local authority, any person designated by virtue of his office or a religious or charitable trust. c. The Nominee shall not be a trust (other than a religious or charitable trust), society, body corporate, partnership firm, Karta of Hindu Undivided Family or a Power of Attorney holder. A non-resident Indian can be a Nominee subject to the exchange control regulations in force, from time to time. d. Nomination in respect of the units stands rescinded upon the transfer of units. e. Transfer of units in favour of a Nominee shall be valid discharge by theAMC against the legal heir. f. The cancellation of nomination can be made only by those individuals who hold units on their own behalf singly or jointly and who made the original nomination. On cancellation of the nomination, the nomination shall stand rescinded and the asset management company shall not be under any obligation to transfer the units in favour of the

CONTACT US Phone
E-Mail

1800 2000 500

online@fidelity.co.in

(toll-free) OR

0124 3915670

(at long distance rates)

Lines open from 9 a.m. to 6 p.m. on all Business Days.

Website

www.fidelity.co.in

Page 4

I
"Please note that the KYC 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."

Know Your Client (KYC) Application Form (For Individuals Only)

Application No.: 0000039192

Please fill this form in ENGLISH and in BLOCK LETTERS (All Information as applicable in Sections A, B and C below is mandatory) This information is sought under the Prevention of Money Laundering Act, 2002, the rules notified thereunder and SEBIs guidelines on Anti Money Laundering. For existing Mutual Fund investors, the address(es) furnished herein will be replaced in the records of the Mutual Fund/Authorised Agent. (Refer Notes/Guidelines overleaf) A. Identity Details (Please see guidelines A1 to A5 overleaf) 1. Name of Applicant (As appearing in supporting identification document) Title Name

a Mr.

Ms.

Others Please specify

Gender

Male

Female

ROHIT SINGH

Father's Name

2. Date of Birth 3. Nationality

Indian

Others Resident Individual

Please specify

Please affix most recent colour photograph 30mm x 40 mm

4. Status Please tick ( )

Non-Resident (Passport copy and overseas address proof is mandatory in case of NRIs)

Sign across the photograph

5. Permanent Account Number (PAN) (MANDATORY) Please tick ( ) Copy of PAN Card attached

B. Address Details (Please see guidelines B1 to B4 overleaf) 1. Address for Correspondence

City/Town/Village State 2. Contact Details (STD) Tel. (Off.) (ISD) Mobile E-Mail Id. (ISD) (STD) Tel. (Res.) Fax Country (ISD) (ISD) (STD) (STD)

Postal Code

3. 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 Any other proof of address document (as listed overleaf) 4. Permanent Address of Resident Applicant if different from B1 above OR Overseas Address (Mandatory) for Non-Resident Applicant

City/Town/Village State Country

Postal Code

5. 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. C. Other Details (Please see guidelines C1 and C2 overleaf) 1. Gross Annual Income Details Please tick ( ) Upto Rs. 5,00,000 Rs. 5,00,001 to Rs. 25,00,000 Rs. 25,00,001 to Rs. 1,00,00,000 Rs. 1,00,00,001 to Rs. 5,00,00,000 2. a. Occupation Details Please tick ( ) any one Private Sector Service Public Sector/Government Service Business Professional Agriculturist Retired Student Forex Dealer Others (Please specify) _______________________________________ b. If the following is additionally applicable to you Please tick ( ) one or more as applicable Civil Servant Bureaucrat Current or Former MP, MLA or MLC Politician Current or Former Head of State

Rs. 5,00,00,001 and above. Housewife

DECLARATION
I hereby confirm that I have read and understood the Instructions mentioned overleaf and apply to CDSL Ventures Limited ('CVL') or other agent of the mutual fund registered under the SEBI (Mutual Funds) Regulations, 1996 for compliance of Know Your Client (KYC) procedure for transacting in units issued by Mutual Funds and I agree to abide by the terms, conditions, rules, regulations and other statutory requirements applicable to the respective Mutual Funds. 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 and I am not making this application for the purpose of contravention of any Act, Rules, Regulations or any statute or legislation or any Notifications, Directions issued by any governmental or statutory authority from time to time. I hereby undertake to promptly inform CVL/the mutual fund agent of any changes to the information provided hereinabove and agree and accept that CVL, the respective Mutual Funds, their authorised agents and representatives ('the Authorised Parties') 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 CVL/the mutual fund agent to disclose, share, remit in any form, mode or manner, all/any of the information provided by me to the respective Mutual Funds in which I may transact/have transacted and/or to their authorised agents and representatives 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 by the Authorised Parties, in connection with this application. I hereby confirm that this is a unique KYC application and I have not applied for KYC in the past.

SIGNATURE OF APPLICANT

Place: Date:

For Office Use Only

Stamp of POS (Name & Location) & Receiver's Signature

Name and Employee Number of Receiver (Originals Verified) Self Certified Document copies received (Attested) True copies of documents received

KYC Ref.

IMPORTANT NOTES - PLEASE READ BEFORE FILLING UP THE FORM

1. This Application Form is meant to enable a person to comply with the client identification programme laid down by the Prevention of Money Laundering Act, 2002 (PMLA) hereinafter referred to as Know Your Client (KYC) requirements. It is for use by INDIVIDUALS only. A separate form is provided for non-individual entities such as Hindu Undivided Family (HUF), Corporates, Trusts, Societies, etc. This form is not an Investment Application Form, and is only meant for providing information and documents required for KYC compliance. Applicant must be KYC compliant while investing with any SEBI registered Mutual Fund which has subscribed to the services of CDSL Ventures Limited (CVL) for compliance of the KYC procedure. A list of Mutual Funds is available on the website of AMFI at www.amfiindia.com. Subscription to Mutual Fund Units may be made only after obtaining the KYC Acknowledgement at their respective designated Points of Acceptance/Investor Service Centres. Each Unitholders/Investors must attach their KYC Acknowledgement along with the Investment Application Form(s)/Transaction Slip(s) while investing for the first time in every folio. Applications Forms/Transaction Slips not accompanied by KYC Acknowledgement are liable to be rejected by the Mutual Funds. Joint Holders: Joint holders need to be individually KYC compliant before they can invest with any Mutual Fund. e.g. in case of three joint holders, all holders need to be KYC compliant and copies of each holders KYC Acknowledgement must be attached to the investment application form with any Mutual Fund. Minors: In case of investments in respect of a Minor, the Guardian should be KYC compliant and attach their KYC Acknowledgement while investing in the name of the minor. The Minor, upon attaining majority, should immediately apply for KYC compliance in his/her own capacity and intimate the concerned Mutual Fund(s), in order to be able to transact further in his/her own capacity. Power of Attorney (PoA) Holder: Investors desirous of investing through a PoA must note that the KYC compliance requirements are mandatory for both the PoA issuer (i.e. Investor) and the 8. 9. Attorney (i.e. the holder of PoA), both of whom should be KYC compliant in their independent capacity and attach their respective KYC Acknowledgements while investing. If an individual becomes a Mutual Fund Investor due to an operation of law, e.g., transmission of units upon death of an investor, the claimant/person(s) entering the Register of Unitholders of the Mutual Fund(s) will be required to be KYC compliant before such transfer can take place. The KYC process requires investors to provide their Proof of identity (PAN card copy only) and Proof of Address (any valid documents listed in section B of the KYC Application Form) to comply with KYC requirements. Mutual Funds reserve the right to seek any additional information/ documentation in terms of the PMLA at any point of time. Mutual Funds/CVL will not be liable for any errors or omissions on the part of the applicant/Unit holders in the KYC Application Form. Documents received in support of KYC requirements will be verified at the designated Points of Service (PoS), on a best effort basis. However acceptance and processing of the KYC Application Form is subject to independent verification by CVL. In the event of any KYC Application Form being rejected for lack of information/deficiency/ insufficiency of mandatory documentation, etc. CVL will inform the applicant of such rejection. The Mutual Fund, its Asset Management Company (AMC), Trustee Company and their Directors, employees and agents shall not be liable in any manner for any claims arising whatsoever on account of freezing the folios/rejection of any application/non-allotment of units or mandatory redemption of units/refund due to non-compliance with the provisions of the PMLA, SEBI guidelines or where the AMC/Mutual Fund believes that transaction(s) by an applicant/investors is/are suspicious in nature within the purview of the PMLA and SEBI guidelines and requires reporting the same to Financial Intelligence Unit - India (FIU-IND). Once the investor is KYC compliant, he will be required to intimate his/her KYC details to all the Mutual Funds with whom he/she has investments. The KYC Compliance will be deemed to have been completed for the investor in all folios held by him/her (identified by his/her PAN) in the records of the Mutual Fund. In case of NRIs, details of overseas address along with proper proof of the same and passport copy are mandatory documents.

2.

10.

3. 4.

11.

5.

6.

12.

7.

13.

GUIDELINES FOR FILLING UP THE KYC APPLICATION FORM

General 1. The Application Form should be completed in ENGLISH and in BLOCK LETTERS. 2. Please tick in the appropriate box wherever applicable. 3. Please fill the form in legible handwriting so as to avoid errors in your application processing. Please do not overwrite. Corrections should be made by canceling and re-writing, and such corrections should be counter-signed by the applicant. 4. Applications incomplete in any respect and/or not accompanied by required documents are liable to be rejected. 5. Applications complete in all respects and carrying necessary documentary attachments should be submitted at the designated PoS. A complete list of PoS is available on the website of AMFI at www.amfiindia.com, www.cdslindia.com and Mutual Fund websites. 6. You are required to submit a Proof-of-Identity document (PAN card is the only document which can be submitted) and a Proof-of-Address document for each address filled by you in this form. Documents submitted to support Identity and Address should be i. Proof of Identity Original PAN Card + Self-attested photocopies (Originals will be returned over-the-counter after verification) ii. Proof of Address Original Documents + Self-attested photocopies (Originals will be returned over-the-counter after verification) OR True Copies attested by a Notary Public/Gazetted Officer/Manager of a Scheduled Commercial Bank or Multinational Foreign Banks (Name, Designation and Seal should be affixed on the copy). Unattested photocopies of an original document are not acceptable If the above documents including attestation/certifications are in regional language or foreign language then the same has to must be translated into English for submission. A. Identity Details 1. Name: Please state your name as Title (Mr/Mrs/Ms/Dr/Commander/etc.), First, Middle and Last Name in the space provided. This should match with the name as mentioned in the PAN card failing which the application is liable to be rejected. If the PAN card has a name by which the applicant has been known differently in the past, than the one provided in this application form, then requisite proof should be provided e.g. marriage certificate, or gazetted copy of name change. 2. Date of Birth: Please ensure that this matches with the Date of Birth as indicated in the PAN card. 3. Nationality: Foreign Nationals are not allowed to apply, unless they are Non-Resident Indians (NRIs) or Persons of Indian Origin (PIO). 4. Status: Please tick your current residential status. 5. PAN: PAN is mandatory to be KYC compliant. Please read instruction given in 6(i) above carefully. 6. Please affix most recent colour photograph and sign across the photograph. B. Address Details 1. Address for Communication: Please provide here the address where you wish to receive all communications sent by the Mutual Funds with whom you invest. The address you give here will supercede existing information in the records of the Mutual Fund/Registrars and Transfer Agent to the Mutual Fund. This address should match with the address in the Proof-of-Address submitted as supporting document; otherwise the KYC Application Form is liable to be rejected. 2. Contact Details: Please provide your Telephone/Email contact details. The contact details given by you here will not supercede existing information in the records of the Mutual Fund/Registrars and Transfer Agent to the Mutual Fund. You will have to independently communicate the same to them in case of any change(s). 3. Proof of Address Documents: Please note that each of the two addresses mentioned by you will need to be supported by a Proof-of-Address bearing your or your spouses/parents (documents to establish relationship also to be submitted) name as supporting documents. Please tick the box as applicable, for the document provided by you. You may attach any one of the following documents (Any document having an expiry date should be valid on the date of submission): Latest* Telephone Bill Latest* Electricity Bill Passport Driving License Latest* Bank Passbook Latest* Bank Account Statement Voter Identity Card Ration Card Latest* Demat Account Statement Registered Lease/Sale Agreement of residence Proof of Address issued by Bank Managers of Scheduled Commercial Banks/Multinational Foreign Banks/Gazetted Officer/ Notary Public/Elected Representatives to the Legislative Assembly/Parliament/Document issued by any Government or Statutory Authority * These documents should not be more than three months old as on the date of submission of this form. Permanent Address/Overseas Address: If you are a Resident Indian, and your Permanent address is different from the one mentioned in the Address for Correspondence, please state it here. If you are a Non-Resident Indian or a Person of Indian Origin, it is mandatory for you to state your Overseas Address here. C. Other details 1. Gross Annual Income details: Please tick the applicable box indicating your Gross Annual Income (including both taxable and tax-free incomes). 2. Occupation details: Please indicate your current occupation by ticking the one most applicable to you. You are required to fill up the next section, if it additionally applies to you. After you have completed filling up the KYC Application Form, please submit the same along with the entire set of supporting documents to any designated PoS. Please also submit a photocopy of the Form for acknowledgement purpose, which you can retain for your records. Other important notes, after the KYC Acknowledgement is issued to you: 1. Please preserve the document from CVL which confirms your KYC compliance. You will need to attach photocopies of this document when you invest for the first time in every folio, in any Mutual Fund. 2. If you observe any error in the details captured by CVL, you are requested to approach your nearest designated PoS. 3. If you are already holding investments in any Mutual Funds, please provide a copy of your KYC acknowledgement, giving details of your folio/account numbers to such Funds or their Registrars. Please note that your signature on the KYC Application Form should match with that on the records of the Mutual Funds. 4. In respect of new investors, signature on the Application Form for investing/transacting in Mutual Fund should match with that on this KYC Application Form. 5. After allotment of KYC compliance, if there are any changes in an Applicants details such as Name, Address, Status, Income bracket, Occupation or Signature, the change should be registered with CVL through a designated PoS expeditiously, by using the KYC Details Change form. It should be noted that only after such registration will the change be reflected in the Mutual Funds records. Particularly with respect to change of address, investors should register such change giving 10 days time for the subsequent communications from Mutual Funds to reach them at their new address. Original/Attested copies of documents supporting the change will be required to be submitted together with the KYC Details Change Form. For any other investment related information or changes thereto, the applicant should approach the Mutual Funds or their Registrars. 4.

CHECKLIST (Before submitting this form, please go through the following checklist)
1. 2. 3. 4. 5. 6. Please ensure that the form is completed in all respects and signed by you. Please affix your recent photograph and sign across the photograph. Please attach a copy of your PAN card as proof of Identity Document. This should be a photocopy plus original for verification. Please attach a Proof of Address Document (one for each distinct address). These should be either original + photocopies or attested/notarised photocopies. If you are an NRI, you must mention your overseas address in B(4) and also submit your passport copy. Please submit a photocopy of the duly completed KYC Application Form.

For assistance or enquiries please approach the Point of Service where you had submitted your KYC Application Form.
graphics

alok

FIDELITY ONLINE and KYC DOCUMENTATION CHECKLIST

Know Your Customer (KYC) requirements are as per the regulatory provisions under the Prevention of Money Laundering Act 2002, rules issued there under and other related guidelines/circulars issued by the SEBI. For the convenience of those who have not completed their KYC, we provide the KYC application form along with the online registration form. This checklist would help complete the online and KYC application forms with required supporting documents.

S No Fidelity Online Application Form

1 2 3 4 5 6 PAN Details

Description

Requirements
Should match with PAN Card / KYC acknowledgement copy Mandatory Mandatory if investor is new to Fidelity Mandatory Mandatory Mandatory

Bank account Details Copy of cancelled cheque leaf Terms & Conditions should be signed by all the holders Folio link request form (if applicable) should be signed by all holders Address mentioned in Fidelity Online Application and KYC Acknowledgement to be same.

KYC Form only if KYC was marked as Yes in the Fidelity Online Application Form
1 Copy of KYC Letter / Acknowledgement from CVL Website Mandatory - should be self attested

KYC Form only if KYC was marked as No in the Fidelity Online Application Form
1 2 3 4 5 KYC Application form filled in English in BLOCK CAPITALS in black / dark ink Photograph should be affixed in the space provided and signed across Income/Occupation details are complete Signature of the applicant in the space provided Proof of Identity: Mandatory Colour and Passport size photo only Mandatory Mandatory Mandatory Require true copies self attested AND attested by a Notary Public / Gazetted Officer / Manager of Scheduled Commercial Banks or Multinational Foreign Banks / Fidelity or CAMS Service Centre Executives (Name, Designation and Seal should be affixed on the Copy). Mandatory Mandatory Mandatory Mandatory Mandatory - true copies self attested AND attested by a Notary Public / Gazetted Officer / Manager of Scheduled Commercial Banks or Multinational Foreign Banks / Fidelity or CAMS Service Centre Executives (Name, Designation and Seal should be affixed on the Copy).

Copy of PAN card is the only accepted proof of identity

Name, Date of Birth and PAN on the KYC application form should match with the details on the PAN Card 6 Proof of Address: Address details should be complete with PIN code If permanent and correspondence addresses are different, separate proofs for both addresses are required.

Any one of the following documents are valid as proof of address: Passport, Driving License, Voter's Identity Card, Registered Lease / Sale Agreement of residence, Proof of address issued by Bank Managers of Scheduled Commercial Banks / Multinational Foreign Banks / Gazetted Officer / Notary Public / Elected Representatives to the Legislative Assembly / Parliament / Document issued by any Government or Statutory Authority. Latest Telephone Bill (Landline), Electricity Bill, Demat Account Statement, Bank Account Statement if it bears address, else Bank Passbook bearing address AND latest bank statement Mobile phone and Credit Card statements and Gas Bills are NOT accepted as proof of address. 7 8 If applicant's tax status is NRI and overseas address is mentioned, original proof of address or photocopy should be furnished for the same. If applicant's tax status is NRI, Passport copy is required.

Documents having an expiry date should be valid on the date of submission.

Should not be more than three months old from the date of submission of the KYC application form. NOT accepted as proof of address Mandatory if NRI - Photocopy should be duly attested by relevant authority. Mandatory if NRI - should be self attested AND duly attested by relevant authority.