SBI Gold Fund NFO Application Form with KYC FORM

ANANDARAMAN .R, B.Com.INSURANCE & INV. ADVISOR

MOB:9843046519

$

Sponsor : State Bank of IndiaInvestment Manager : SBI Funds Management Pvt. Ltd.(A Joint Venture between SBI & AMUNDI)191, Maker Towers ‘E’, Cuffe Parade, Mumbai - 400 005. Tel.: 022-22180221-27, www.sbimf.com

APPLICATION NO.

APPLICATION FORM (Please fill in BLOCK Letters)

ARN & Name of Distributor Branch Code ( only for SBI and Associate Banks) Reference No. (To be filled by Registrar)

ACKNOWLEDGEMENT SLIP APPLICATION NO.

$ $TEAR HERE

(To be filled in by the First applicant/Authorized Signatory) :Received from :

StampSignature & Date

To be filled in by the Investor

Scheme Name Bank and Branch Cheque / DD No. & DateCheque/ DD Amount (Rs.)

Investors subscribing to the scheme through SIP must complete Registration cum Mandate form compulsorily alongwith application form

Sub-Broker Code

Sponsor : State Bank of IndiaInvestment Manager : SBI Funds Management Pvt. Ltd.(A Joint Venture between SBI & AMUNDI)

Attachments All purchases are subject to realisation of cheque / demand draft

Options (33333)

Growth Dividend Payout

Dividend Reinvestment

9 digit MICR Code

Note : AMC, reserves the right to use any mode of payment as deemed appropriate. AMC shall not be responsible if transaction through ECS / Direct Credit could not be carried out because of incomplete or incorrect information provided by investor.

(SEE NOTE 2)

1. PARTICULARS OF FIRST APPLICANT

NameMr./Ms./M/s.

2. PARTICULARS OF SECOND APPLICANT

3. PARTICULARS OF THIRD APPLICANT

NameMr./Ms./M/s.

PAN

PAN

5. CONTACT DETAILS

4. GENERAL INFORMATION – Please ( 33333 ) wherever applicable

Address for Correspondence for NRI Applicants only ( Please (33333) ) Indian by Default Foreign

Local

Address of

1st Applicant

State

Foreign Address(NRI / FII Applicants)

City

6. BANK PARTICULARS (As per SEBI Regulations it is mandatory for Investors to provide their bank account details)

Name of Bank

(This is 9 digit number next to the cheque number. Please provide acopy of CANCELLED cheque leaf)

Account Type (Please 3)

Savings

Current

NRO

NRE

IFS Code

Pin

Country

City

Zip

Branch Nameand Address

Account No.

City Pin

FCNR

Others

7. DIRECT CREDIT OF DIVIDEND/ REDEMPTIONUnit holders having core banking account with selected banks will receive their redemption/dividend proceeds (if any) directly into their bank account. Please attach a copy of aCANCELLED cheque leaf.

Upfront commission shall be paid directly by the investor to the AMFI registered Distributors based on the investors’ assessment of various factors including the service rendered by the distributor

Status (Please (33333)) Mode of Holding (Please (33333)) Occupation (Please (33333))

Professional Housewife

Business Retired

Student Service

Others

Single

Joint

Any one or Survivor

Individual PSU Partnership Firm Bank

Trust FII Minor through Guardian PIO

Society HUF Company/Body Corporate NRI

AOP/BOI Sole Proprietor Government Body Others

Mandatory Enclosures PAN Proof KYC Acknowledgement


EXISTING FOLIO NO. (For Exisiting unitholders: Please mention your Folio number, Name and PANdetails and then proceed to Investment and Payment details- 8)

Name

Date of Birth*

(Mr./Ms./M/s.)

*Mandatory in case of Minor and please provide photocopy of supporting documents

Name of

Name of Contact Person(in case of Institutional Investor)

Email ID

Guardian in case of Minor

D D M M Y Y Y Y

PAN

Telephone No. (R) Mobile No.

Telephone No. (O) Please (3) only in case you want paper based communication

Relationship of Guardian in case of Minor Father Mother Legal GuardianPlease mandatorily enclose the document evidencing the relationship of Minor with Guardian


SBI GOLD FUND

THIS BOOKLET CONSISTS OF 24 PAGES INCLUDING THE APPLICATION FORMS. PLEASE ENSURE THAT YOU HAVE ALL THE PAGES.

ARN - 30155


MOB:9843046519

Growth Dividend Payout Dividend Reinvestment

11. DECLARATION & SIGNATURE : "I/We have read and understood the contents of the Scheme Information Document and the details of the scheme and I/We have

not received or been induced by any rebate or gifts, directly or indirectly, in making this investment." "I/We hereby declare that the amount invested/to be invested by me/us in

the scheme(s) of SBI Mutual Fund is derived through legitimate sources and is not held or designed for the purpose of contravention of any act, rules, regulations or any statute

or legislation or any other applicable laws or any notifications, directions issued by any governmental or statutory authority from time to time." * I/We certify that as per the

Memorandum and Articles of Association of the Company, Bye laws, Trust Deed or Partnership Deed and resolutions passed by the Company / Firm / Trust. I/We are authorised

to enter into this transactions for and on behalf of the Company/Firm/Trust. ** I/We confirm that I am/we are Non Resident of Indian Nationality/Origin and I/We hereby confirm

that the funds for the subscriptions have been remitted from abroad through approved banking channels or from my/our Non Resident External/Ordinary account/FCNR Account

. * Applicable to other than Individuals / HUF; ** Applicable to NRI; I/We do not have any existing SIP/Micro SIPs which together with the current Micro SIP application will result

in aggregate investments exceeding Rs. 50,000 in a year (applicable to Micro SIP investors only). The ARN holder has disclosed to me/us all the commissions (in the form of trail

commission or any other mode), payable to him for the different competing Schemes of various Mutual Funds from amongst which the Scheme is being recommended to me/us

1st Applicant / Guardian / Authorised Signatory

SIGNATURE(S)

3rd Applicant / Authorised Signatory2nd Applicant / Authorised Signatory

⊗ ⊗ ⊗

Applicants mustsign as per modeof holding

PlaceDate

TEAR HERE

All future communication in connection with this application should be addressed to the Registrars to the scheme or SBIMF Corporate Office.

Investment Manager :SBI Funds Management Pvt. Ltd.(A Joint Venture between SBI & AMUNDI)191, Maker Towers ‘E’, Cuffe Parade,Mumbai - 400 005.Tel.: 022-22180244/22180221, Fax : 022 -22180244E-mail :[email protected],

Website : www.sbimf.com

Registrar:

Computer Age Management Services Pvt. Ltd.,

SEBI Registration No. : INR000002813)

148, Old Mahabalipuram Road, Okkiyam Thuraipakkan,

Adjacent to Hotel Fortune, Chennai 600097, Tamil Nadu

Tel: 044-30407000 & 24587000, Fax: 044-24580982

Email: [email protected], Website : www.camsonline.com

Scheme Name

Drawn on Bank and Branch Cheque / D.D. No. & DateCheque / DD Amount (Rs.)

8. INVESTMENT AND PAYMENT DETAILS : I/We would like to invest in the following Scheme of SBI Mutual Fund

Investment Amount (Rs. in Figures) Investment Amount (Rs. in Words)

One time Investment

( Please f i l l in your investment detai ls below)

Systematic Investment Plan (SIP)(Please complete enclosed SIP ECS/Direct Debit Faci l i ty Registrat ion cum Mandate Form)

Options (Please 3 )

For third party cheques, please see point 3 vii of Bank particulars mentioned in the guidelines.

SBI GOLD FUND

9. DEMAT ACCOUNT DETAILS –( Please ensure that the sequence of names as mentioned in the application form matches with that of the account held with the Depository Participant).

National Securities Depository Limited (NSDL) Central Depository Services (India) Limited (CDSL)

Depository

Participant Name

DP ID No.

Beneficiary Account No.

Depository

Participant Name

I N Target ID No.

Do you want Units in Demat Form (Please (3)) Yes No If Yes, please provide the below details

10A. NOMINATION : I wish to nominate the following person to receive the proceeds in the event of my death. (With effect from 01/04/2011, for individual investors applyingwith single holding, Nomination is mandatory. However, in case you do not wish to nominate please sign point 10 B.)

Name of the Nominee

Relationship

Address of Nominee/Guardian*

Name of the Guardian*

Signature of Guardian*(*Mandatory in case of Minor nominee)

⊗Date of Birth*

Percentage

D D M M Y Y Y Y

Name of the Nominee

Relationship




⊗Date of Birth*

Percentage

D D M M Y Y Y Y

Name of the Nominee

Relationship




⊗Date of Birth*

Percentage

D D M M Y Y Y Y

10B. NOMINATION : I do not wish to nominate any person at the time of making the investment.

Signature


MOB:9843046519

Sponsor : State Bank of IndiaInvestment Manager : SBI Funds Management Pvt. Ltd.(A Joint Venture between SBI & AMUNDI)191, Maker Towers ‘E’, Cuffe Parade, Mumbai - 400 005. Tel.: 022-22180221-27, www.sbimf.com

ARN & Name of Distributor Branch Code ( only for SBI and Associate Banks) Reference No. (To be filled by Registrar)Sub-Broker Code

SIP ECS/DIRECT DEBIT FACILITY : REGISTRATION CUM MANDATE FORMInvestors subscribing to the scheme through SIP ECS/Direct Debit Facility must complete this form compulsorily alongwith Application Form

SIP Registration - by Existing InvestorSIP Registration - by New Investor

Folio No./Application No. (For Existing Investor please mention Folio Number / For New Applicants please mention the

Name of 1st Applicant(Mr/Ms/M/s)Name of Father/Guardianin case of Minor

INVESTOR DETAILS

SIP DETAILS (ECS in select cities or Direct Debit in select banks only)

Scheme Name

Growth Dividend Payout Dividend ReinvestmentOptions (Please ✓ )

Each SIP Amount (Rs.)First SIP Cheque No.(Note : Cheque should be drawn on bank account mentioned below)

SIP Date Frequency5th 10th 15th No of SIPInstallments

Monthly SIP

DECLARATION : I / We hereby , authorize the AMC and their authorised service providers , to debit my / our following bank account directly or by ECS for collection of payments.BANK PARTICULARS (as per bank records)

Name of Bank

(This is 9 digit number next to the cheque number. Pleaseprovide a copy of CANCELLED cheque leaf)

Account Type (Please ✓)Savings

Current

NRO

NRE

Branch Nameand Address

Account No.

City Pin

FCNR

Others

Name of 1st Holder

Name of 2nd Holder

Name of 3rd Holder

9 digit MICR Code

IFS CodeDECLARATION & SIGNATURE : I/We hereby declare that the particulars given above are correct and express my willingness to make payments referred above to debit my/our account directly or through participation in ECS. If the transaction is delayedor not effected for reasons of incomplete or incorrect information, I / We would not hold the user institution responsible. I / We will also inform AMC, about any changes in my/our bank account. I/We do not have any existing SIP/Micro SIPs which togetherwith the current Micro SIP application will result in aggregate investments exceeding Rs. 50,000 in a year (applicable to Micro SIP investors only). The ARN holder has disclosed to me/us all the commissions (in the form of trail commission or any other mode),payable to him for the different competing Schemes of various Mutual Funds from amongst which the Scheme is being recommended to me/usI/We have read and agreed to the terms and conditions mentioned in SID/KIM.

1st Account Holder/ Guardian / Authorised Signatory

SIGNATURE(S)

3rd Account Holder2nd Account Holder Applicants must

sign as per modeof holding

BANKER’S ATTESTATIONCertified that the signature of account holder and the Details of Bank account are correct as per our records. Signature of authorised Official from Bank (Bank stamp and date)

The Branch Manager

Date

Bank

D D M M Y Y Y Y

Branch

Sub : Mandate verification for A/c. No.

This is to inform you that I/We have registered for making payment towards my investments in SBIMF by debit to my /our above account directly or through ECS. I/We hereby authorize youto honour such payments for which I/We have signed and endorsed the Mandate Form.Further, I authorize my representative (the bearer of this request) to get the above Mandate verified. Mandate verification charges, if any, may be charged to my/our account.Thanking you,Yours sincerely

1st Account Holder/ Guardian / Authorised Signatory 3rd Account Holder2nd Account Holder

A C K N O W L E D G E M E N T S L I P

(To be filled in by the First applicant/Authorized Signatory) :

Received from


an application for Purchase of Units alongwithAcknowledgement StampAll purchases are subject to realisation of cheques.

Folio No. /Application No.

Quarterly SIP


SIP MICRO SIPPlease( ✓)

Signature of authorised Official from Bank (Bank stamp and date)

Application Form Number)

DOCUMENT DETAILS (in case of Micro SIP)

Document DescriptionDocument Number (if any)

First Applicant / Guardian Second Applicant Third ApplicantPAN DETAILS (Furnishing of PAN together with an attested copy of PAN Card is mandatory)

For Rs.1st Cheque Number

20th 25th 30h (For February, last business day)

Mandatory EnclosuresPAN Proof KYC Acknowledgement



From* To (Please ✓ )SIP Period D D M M Y Y Y Y D D M M Y Y Y Y Till further notice## Please refer point no. xi overleaf

SIP with Cheque SIP without Cheque

S B I G O L D F U N D

* The earliest date for first SIP debit through ECS/Direct Debit is 15th October 2011 (for the applications submitted during NFO).

ARN - 30155


MOB:9843046519

Sponsor : State Bank of IndiaInvestment Manager : SBI Funds Management Pvt. Ltd.(A Joint Venture between SBI & AMUNDI)191, Maker Towers ‘E’, Cuffe Parade, Mumbai - 400 005.Tel.: 022-22180221-27, www.sbimf.com

APPLICATION SUPPORTED BY BLOCKED AMOUNT (ASBA) FORMBROKER/AGENT INFORMATION

Name and AMFI Regn. No. Sub Broker Name & Code SCSB SCSB IFSC Code Syndicate Member Code SL No.

ASBA Application No. Date D D M M Y Y Y Y

7. DETAILS OF BANK ACCOUNT FOR BLOCKING OF FUNDS

Bank Account Number

Bank Name

Branch Name

Total Amount to be blocked(Rs. In figures)

Rs. in words

ACKNOWLEDGEMENT SLIP$ $TEAR HERE


Sponsor : State Bank of IndiaInvestment Manager : SBI Funds Management Pvt. Ltd.(A Joint Venture between SBI & AMUNDI)

Note : AMC, reserves the right to use any mode of payment as deemed appropriate. AMC shall not be responsible if transaction through ECS / Direct Credit could not be carried out because of incomplete or incorrect information provided by investor.

SBI GOLD FUNDReceived from :

Address

ASBA Application Number Date : _____/_____/___________

SCSB Account details:

A/c No. _______________________________________ Bank Name ________________________________________________ Branch Name ___________________________________

Total Amount to be Blocked:SCSB Stamp, Signature

Rs. In figures ______________________Rs. In words _______________________________________________________________________

___________________________________________________________________________________________________________________

Date & time of receipt ________________________________________________________________________________________________

FOR OFFICE USE ONLY

IFS Code

INVESTORS MUST READ THE SCHEME INFORMATION DOCUMENT/KEY INFORMATION MEMORANDUM AND INSTRUCTIONS BEFORE COMPLETING THIS FORM.

ARN [Name & Code] [11 digit code] [Name & Code]


1. PARTICULARS OF FIRST APPLICANT (Name should be as available in Demat Account )

4. EXISTING FOLIO No. (If you have an existing folio number, please mention here)

Folio No.

5. DEMAT ACCOUNT DETAILS

Depository (Please 33333) National Securities Depository Limited Central Depository Services [India] Limited

Depository Participant Name

DP - ID

Beneficiary Account Number

6. INVESTMENT DETAILS

Scheme Name SBI GOLD FUND

2. PARTICULARS OF SECOND APPLICANT

3. PARTICULARS OF THIRD APPLICANT

NameMr./Ms./M/s.

PAN

NameMr./Ms./M/s.

PAN

NameMr./Ms./M/s.

PAN

Growth Dividend Payout Dividend ReinvestmentOptions (Please 3 )

ARN - 30155


MOB:9843046519

INSTRUCTIONS FOR FILLING ASBA APPLICATION FORM

1. An Application Supported by Blocked Amount (ASBA) investor shall submit a duly filled up ASBA Application form, physically or

electronically, to the Self Certified Syndicate Bank (SCSB) with whom the bank account to be blocked, is maintained.

l In case of ASBA application form in physical mode, the investor shall submit the ASBA Application Form at the Bank branch of

SCSB, which is designated for the purpose and the investor must be holding a bank account with such SCSB.

l In case of ASBA application form in electronic form, the investor shall submit the ASBA Application Form either through the

internet banking facility available with the SCSB, or such other electronically enabled mechanism for subscribing to units of Mutual

Fund scheme authorising SCSB to block the subscription money in a bank account.

2. Investors shall correctly mention the Bank Account number in the ASBA Application Form and ensure that funds equal to the subscription

amount are available in the bank account maintained with the SCSB before submitting the same to the designated branch.

3. Upon submission of an ASBA Application Form with the SCSB, whether in physical or electronic mode, investor shall be deemed to

have agreed to block the entire subscription amount specified and authorized the Designated Branch to block such amount in the Bank

Account.

4. On the basis of an authorisation given by the account holder in the ASBA Application Form, the SCSB shall block the subscription

money in the Bank Account specified in the ASBA Application Form. The subscription money shall remain blocked in the Bank Account

till allotment of units under the scheme or till rejection of the application, as the case may be.

5. If the Bank Account specified in the ASBA Application Form does not have sufficient credit balance to meet the subscription money, the

ASBA application shall be rejected by the SCSB.

6. The ASBA Application Form should not be accompanied by cheque, demand draft or any mode of payment other than authorisation to

block subscription amount in the Bank Account.

7. All grievances relating to the ASBA facility may be addressed to the BANK/AMC / RTA to the Issue, with a copy to the SCSB, giving full

details such as name, address of the applicant, subscription amount blocked on application, bank account number and the Designated

Branch or the collection centre of the SCSB where the ASBA Application Form was submitted by the Investor.

8. ASBA facility extended to investors shall operate in accordance with the SEBI guidelines in force from time to time.

8. DECLARATION & SIGNATURE1) l/We hereby undertake that l/We am/are an ASBA lnvestor as per the applicable provisions of the SEBl (lssue of Capital and Disclosure Requirements), Regulations 2009 (‘SEBl Regulations’) as amended from time totime. 2) ln accordance with ASBA process provided in the SEBl Regulations and as disclosed in this application, l/We authorize (a) the SCSB to do all necessary acts including blocking of application money towards theSubscription of Units of the Scheme, to the extent mentioned above in the “SCSB / ASBA Account details” or unblocking of funds in the bank account maintained with the SCSB specified in this application form, transfer offunds to the Bank account of the Scheme/SBI Mutual Fund on receipt of instructions from the Registrar and Transfer Agent after the allotment of the Units entitling me/us to receive Units on such transfer of funds, etc. (b)Registrar and Transfer Agent to issue instructions to the SCSB to remove the block on the funds in the bank account specified in the application, upon allotment of Units and to transfer the requisite money to the Scheme’saccount / Bank account of SBI Mutual Fund. 3) ln case the amount available in the bank account specified in the application is insufficient for blocking the amount equivalent to the application money towards the Subscriptionof Units, the SCSB shall reject the application 4) lf the DP lD, Beneficiary Account No. or PAN furnished by me/us in the application is incorrect or incomplete or not matching with the depository records, the applicationshall be rejected and the SBI Mutual Fund or SCSBs shall not be liable for losses, if any. All future communication in connection with NFO should be addressed to the SCSB/RTA/AMC quoting the full name of the Sole/First Applicant, NFO Application Number, ASBA Application Number, Despository Account details [if it has been provided], Amount applied for and the accpunt number from where NFO amount was blocked.

"I/We have read and understood the contents of the Scheme Information Document and the details of the scheme and I/We have not received or been induced by any rebate or gifts, directly or indirectly, in making this investment.""I/We hereby declare that the amount invested/to be invested by me/us in the scheme(s) of SBI Mutual Fund is derived through legitimate sources and is not held or designed for the purpose of contravention of any act, rules,regulations or any statute or legislation or any other applicable laws or any notifications, directions issued by any governmental or statutory authority from time to time." * I/We certify that as per the Memorandum and Articlesof Association of the Company, Bye laws, Trust Deed or Partnership Deed and resolutions passed by the Company / Firm / Trust. I/We are authorised to enter into this transactions for and on behalf of the Company/Firm/Trust.** I/We confirm that I am/we are Non Resident of Indian Nationality/Origin and I/We hereby confirm that the funds for the subscriptions have been remitted from abroad through approved banking channels or from my/our NonResident External/Ordinary account/FCNR Account . * Applicable to other than Individuals / HUF; ** Applicable to NRI; The ARN holder has disclosed to me/us all the commissions (in the form of trail commission or any othermode), payable to him for the different competing Schemes of various Mutual Funds from amongst which the Scheme is being recommended to me/us

1st Applicant / Guardian / Authorised Signatory

SIGNATURE(S)

3rd Applicant / Authorised Signatory2nd Applicant / Authorised Signatory

⊗ ⊗ ⊗All applicantsmust sign here

PlaceDate

Economy & Finance

SBI Gold Fund NFO Application Form with KYC FORM