_

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Canara'Robeco Mutual Fund CANARA ROBcCO

In'llestment Manager: Canara RobecoAssetManagement Co.Ltd. (IN No: U65990MH1993PLC071003
Construction House, 4th Floor,S, Walchand Hirachand Marg, Ballard Estate,Mumbai 400 001.
Mutual Fund
Tel.: 66585000, Fax: 6658 5012/13, www.canararobeco.com Applicatio~ No.
2768601

"By mentioning RIACode, I/We authorise you to share with the

Upfront commission shall be paid directly by the investor to the AMFI
Declaration for "execution-only" transaction (only where .EUINbox is
left blank) (Refer Instruction 28): I/We hereby confirm that the EUINbox
has been intentionally left blank by me/us asthis transaction is executed
without anyinteraction or advicebythe employee/ retatlonshi pmanager/
sales person of the 'above distributor/sub broker or notwithstandinq
the advice of inappropriateness, if any, provided by the employee/
relationship manager/sales person' of the distributor/sub broker.

CKYCCompliance Status·· (ilyes, attach proal)

I Yes 0 I

I Yes 0 I

I Yes 0 I

Mr. I Ms. I M/s.

Father / Husband's Name

Occupation Please (v")

Status Please (v') Resident Individual NRI-NRE

Minor thru Guardian. Society
OTHERDETAIlSPleasetick (v') ~ Individual 0 Non-Individual (Mandatory)
1. GrossAnnuallncome Details Pleasetick (v') 0 Below1Lac _~5 Lacs Os -10 Lacs 010 - 25 Lacs 025 Lacs- 1Crore 0-1 Crore e above
[OR]
Net-worthin~--;- ason(date)I' I 0IIIM 1M Ii I vi y Iy Iy I

2. Pleasetick if applicable: o Politically ExposedPerson (PEP) o Relatedto a Politically ExposedPerson (PEP) ~Ot Applicable
3. Isthe entity involved in / providing any of the following services:
- Foreign Exchange/ Money Chanqer Services o YES JaNO
- Gaming / Gambling / Lottery Services(e.g. casinos, betting syndicates) o YES ~NO
- Money Lending / Pawning o YES ~
4. Any other information ~ --'-- ~ ~ _
I declare that the information is to the best of my knowledge and' belief, accurate and complete. I agree to notify Canara Robeco Mutual Fund / Canara Robeco Asset Management Company Limited
immediately in casethere is any change in the above information. .

ACKNOWLEDGEMENT SLIP (TO BE FILLED IN g( THE SOLE/FIRST APPLICANT)

_ Canara RobecoMutual Fund CANARA. ROBcCO

Application No.
Investment Manager: Canara RobecoAsset Management Co.Ltd.
Construction House, 4th Floor,S, Walchand Hirachand Marg, Ballard Estate,Mumbai 400 001. 2768601 ~."" 'Y'utu~1Fpnd
Date ------!)~ •~ ""
Receivedfrom Mr./Ms./M/s. _

,(

along with Cheque/DD as detailed overleaf. Cheques/Drafts are subject to realisation.

 -
NAME OF SECONDAPPLICANT
Mr. I Ms. I M/s. I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I
.,
Occupation Please (,() Private Sector Service 0 Government Service 0 Professional 0 Retired Student others 0
0 0
Public Sectqr.• \ .. , 0 Agriculturist 0 Business 0 Forex Dealer 0 Housewife 0 Please specify
Status Please (,f) Re~~tilndivi!iiJal 0 NRI-NRO 0 Trust 0 HUF 0 Bank / Fls 0 NRI-NRE 0
Minor thru Guardian 0 Company/Body Corporate 0 Flis/FIPs 0 Partnership Firm 0 Society 0
OTHERDETAILSPlease tick (,() o Individual o Non-Individual (Mandatory)
1. GrossAnnual Income Details Please tick (,() o Below 1 Lac 01-5 Lacs 05-10 lacs 010-25 Lacs o 25 lacs - 1 Crore 01Cro e above
[OR]
Net-worth in ~ 'as on (date) I I I I I J-.t-I
2. Please tick if applicable: o Politically Exposed Person (PEP) o Related to a Politically Exposed Person (PEP) o Not Applicable
3. Isthe entity involved in / providing any of the following services:
- Foreign Exchange / Money Changer Services o YES ONO
- Gaming / Gambling / lottery Services (e.g. casinos, betting syndicates) o YES 0
- Money lending / Pawning o YES NO
4. Any other information
I declare that the information is to the best of my knowledge and belief, acc~lete. I agree to notify canara Robeco Mutual Fund / Canara Robeco Asset Management Company Umited
immediately in case there is any change in the above information.
NAME OFTHIRD APPLICANT
Mr. I Ms. I M/s. I I I I I I .J,...1'1 I I I I I I I I I I I I I I I I I I I I I
Occupation Please (,() Private secto~ 0 Government Service 0 Professional 0 Retiretl 0 Student D others 0
Public Sector 0 Agricultufist 0 Business 0 Forex Dealer 0 H'ousewife 0 Please specify

Status Please (,f) ~dividual 0 NRI-NRO 0 Trust 0 HUF 0 Bank / Fls 0 NRI-NRE 0
Guardian 0 Company/Body Corporate 0 Flis/FIPs 0 Partnership Firm 0 Society 0
OTHERDETAILSPle~~ 0 Individual 0 Non-Individual (Mandatory)
1. GrossAnnualln meDetaiisPleasetick('() 0 Below Hac 01-5 Lacs 05-10lacs 010 - 25 lacs 025 lacs -1 Crore o 1 Crore & above
[OR]
as on (date) l [
I I I I I I ! I
o Related to a Politically Exposed PersonI (PEP)
Net-worth in ~
2. Please tick if applicable: o Politically Exposed Person (PEP) o Not Applicable
3. Isthe entity involved in / providing any of the following services:
- Foreign Exchange / Money Changer Services n YES ONO
- Gaming / Gambling / lottery Services (e.g. casinos, betting syndicates) o YES ONO
- Money lending / Pawning n YES ONO
4. Any other information
I declare that the information is to the best of my knowledge and belief, accurate and complete. I agree to notify Canara Robeco Mutual Fund / Canara Robeco Asset Management Company limited
immediately in case there is any change in the above information.
NAME OFTHEGUARDIAN(In case of first Applic~nt is a Minor) Relation with Minor Please (,()
Mr. I Ms. I M/s.
I I I I I I I I I I I I I I I I I I I I I j Mother 0 FatherD legal Guardian 0
Proof of DOB (Anyone Mandatory) o Birth Certificates o School Certificates / Mark Sheet o Passport o others
Occupation Please (,() Private Sector Service 0 Government Service 0 Professional 0 Retired 0 Student 0 others 0
Public Sector 0 Agriculturist 0 Business 0 ForexD~ 0 Housewife 0 Please specify

Status Please (,f) Resident Individual 0 NRI-NRO 0 Trust 0 Bank / Fls 0 NRI-NRE 0
Minor thru Guardian 0 Company/Body Corporate 0 ~ 0 Partnership Firm 0 Society 0

O1IHD"""PI.~ti.V) O"'M'" ~")

1. GrossAnnuallncome Details Please tick (,f) 0 Below Hac lacs 05 -10 Lacs 010-25 lacs 025 lacs -1 Crore o 1 Crore e above
[OR]
Net-worth in ~ as on (date) I
I I I I I I I I I I
2.
PI~tl.""~~ ,,"00 )PEP)
o Related to a Politically Exposed Person (PEP) o Not Applicable
3. Isthe entity involved in / providing a he following services:
- Foreign Exchange / Mon anger Services o YES. ONO
- Gaming / Gam' lottery Services (e.g. casinos, betting syndicates) o YES ONO
- Money lending / Pawning DYES ONO
4. Any other information
I declare that the information is to the best of my knowledge and belief, accurate and complete. I agree to notify Canara Robeco Mutual Fund / Canara Robeco Asset Management Company limited
immediately in case there is any change in the above information.
Mode of Holding Please (,() o Anyone or Survivor o Joint (Default option is Anyone or Survivor)

Payment Details
Sr. Amount
No.
Scheme Name Plan Option
Invested ro Cheque/DO No./UTR No.
(in case of NEFT/RTGS)
Bank and Brandl

1. ~N~~fi Rt)Bf 4 : ;j r , ...

Err, f RC-, we,
2.
f&U!TlfS t\JN{) R£C CRt>w m 1M.,D/ ... S-Lf r I '1 I"f~RANK "f'I1'1lA N~
KFin Technologies Private Limited
Selenium, Tower B, Plot Nos. 31 & 32, Gachibowli, Financial District, Nanakramguda, Serilingampally, Hyderabad 500 032
Tel No. : 04033215262/5269 Website: www.kfintech.com
PAN

occupation Please (v") Private Sector Service Student others 0

Housewife Pleasespecify
Public Sector
Resident Individual NRI-NRE
Status Please (.f)
Minor thru Guardian Society

OTHERDETAILSPlease tick {.f) ..Ja"!ndividual 0 Non-Individual (Mandatory)

1. GrossAnnual Income Details Please tick (.f) 0 Below 1 Lac ~ - 5Lacs 05 ·10 Lacs 010- 25 Lacs 025 Lacs·1 Crore o 1 Crore fJ above I

Net-worth in~ __ ----,- [_OR_)

__ as on (date) DI I f I I; I if: II I ' I
2. Please tick if applicable: 0 Politically Exposed Person (PEP) o Related to a Politically Exposed Person (PEP)
3. Isthe entity involved in / providing any of the following services:
- Foreign Exchange / Money Changer Services . 0 YES ~ NO
- Gaming / Gambling / Lottery Services (e.q, casinos, betting syndicates) 0 YES .Ja"NO
~ • -::'Mo~~y f-enqjngj, pa~ni~g. '. ,~ . '" ' 0 YES . ....0 NO
4. Any other information ", •
I declare that the information is to the best of my kriowl~dge and belief, accurate and complete. I agree to notify Canara Robeco Mutual Fund / Canara Robeco Asset M~nagement Comp,arlYlimited
immediately in case there is any change in the above information. ~
DEMAT ACCOUNT DETAilS (This section to be filled only if investor wish to hold units in dernat form) (Client Master List (CMl) to be enclosed) (Refer instruction no. 24)
.--------------
j
National Securities Depository limited (NSDL) Central Depository Services (India) limited (CDSL)

Depository Participant Name _-;==;:~~::;=::::;::=;~::;::::::;:::::;~::;::::;::=;~:;=::; Depository Participant Name LI__j_...L.....J_1'::.....JI_...L.....J___j_ _J_....J___j_ _J__L__j__J
DP ID No. INI Target ID No.

I I I I I
FATCA/CRS DETAilS For Individuals & HUF (Mandatory) (Refer instruction no. 30)
The below information is required for all applicant(s)/guardian: .
Address Type: ~esidential 0 Business 0 Re~istered Office (for address mentioned in Form/existing address appearing in Folio)
Do you have non-Indian Country[ies] of Birth / Citizenship / Nationality and Tax Residency? 0Ye~ Please tick as applicable and if yes, provide the below mentioned infor~ation (mandatory)

Country of Citizenship/
Nationality
Are you a US Specified Person? DYes ~ Are you a us Specified Person? DYes DNo Are you a USSpecified Person? Dyes DNo
please provide Tax Payer Id please provide Tax Payer Id please provide Tax Payer Id
Country of Jax Residency# Country ofTax Residency# Country of Tax Residency#
'Taxpayer Ide_ritification No. Taxpayer Identification No.
[other than India] [other than India) . [other than India]' ,. '-i

City

Tel Office

Account No.

Branch Address

'Bank Branch City

appears your
IFSCCODE(RTGS/NEFT) I (Mandatory for Credit via NEFT/RTGS)Please attach a cancelled cheque OR a clear photo copy of a cheque
(11Character code appearing on your cheque leaf. If you do not find this on your cheque leaf, please check for the same with your Bank)
 SIP ENROLLMENT DETAILS
SIPAmount Enrollment Period
(Rs.) REGUlARSIP: Start Month I IAI I\ I IEnd Month I,.;.I 11 I ' '1 Frequency Please ( ....) ~e '[J.MofifiiIv 0Quarterly
r o o (;:)/ ~ PERPETUAL
SIP: Start Month ~ Year 1.2.1 t> I 'b 1until further instruction (or) Endon Month GB Year I 2 I a I 91 9 I

SIPTop-up: Rs. (in multiplies of Rs. sao/-) Frequency Please ( ....) 0Half Yearly 0Yearly
PAYMENTMECHANISM: Debit through ECS/ Auto Debit facility (Fill up SIPRegistration cum Mandate Form for NACH/ECS/DirectDebit)
INVESTMENT DETAILSAND PAYMENT DETAILS (Payment through Cash/Outstation Cheques not accepted) I
Option.
Plan Option

@@@ Ownershippertentaqe of shares/cap~al/profits/propertylJf juridicalperson/interestinthe Trustasonthe dateotthe applicationshallbefurnished bythe investor.

$$$Inthe caseof Foreigninvestors,the beneficialownershipwill bedeterminedasperSEBIguidelines.Fordetailsreterto SAl/relevantAddendum.In caseof anychangeinthe beneficialownership,the investorwill beresponsibleto
intimateCRAMC / itsRegistrar/ KRAasmaybe·applicableimmediatelyaboutsuchchange.
Details of Beneficial Ownershi (Pleaseattach a se rate sheet with this format if the s ce rovided is.insufficient)
Sr.. Address Details of Identity sucihas % of ownership
PAN Pass art

[Pleaseattach selt-attestedcepy of PAN/Passport(proof af photo identity) along with application form]

NOMINATION DETAILSfor Individuals [Minor / HUF / POA Holder / Non lndividuals cannot Nominate - Refer Instruclion No 13)
o I/We do hereby nominate the undermentioned Nominee(s) to receivethe units to my / our credit in this folio no. in
the event of my / our death.I/We also understand that all payments and settlements made to such Nominee(s) and Signature of the Nominee(s) acknowieaging rec~ipt thereof, shall be a valid dischargeby the
AMC/ Mutual Fund/ Trustees.0I/We do not wish to nominate
No. Nominee(s) Name Date of Birth (in caseof Minor) Name ofthe Guardian @%ofShare
in caseof Minor)
() D M i-..1 Y y v y
[) D \t, [vi y y V
() D fvl 1\.4 v, y V Y

~ Third Applicant

Tothe trusteesCanaraRobecoMutual Fund.1/ Wehavereadand understoodthe contentsof the SAl,SIDand KeyInformationMemorandumof the Scheme.I/We herebyapplyto the Trusteesof CanaraRobecoMutual Fund
for allotment of unitsof the Scheme,asindicatedaboveandagreeto abidebythe terms, cqnditions,rulesand regulationsofthe Scheme.I/We herebydeclarethat 1/ Weareauthorisedto makethis investmentin the above
mentioned,Scheme(s)andthat the amountinvestedinthe Scheme(s)isthrq,ugh'legitimateisolir<es omyan~doesnot1involveand isnot designedfor the purposeof anycontraventionor evasionof,anyAct,Rules,Regulations,
Notificationsor Directionsof the provisionsof IncomeTaxAct,Anti MoneylaunderingAct,Anti CorruptionAct or anyother applicablelawsenactedbythe Governmentof Indiafrom time to time and we undertaketo provide
I / documentation,if any,requi(,"dto substantiatethe factsof this undertaking.I havenot receivednor beeninducedbyany rebateor gifts, directlyor indirectlyin makingthis investment.I / Weauthorise
. detailsof my/our accountand all my/our transactionsto the intermediarieswhosestamp appearson'the 'applicationform. I alsoauthorisethe Fundto disdosedetailsas necessary,to the Registrar&
call centres,banks,custodians,depositoriesand/or authorisedexternalthird partieswho are.involvedin transaction,processing,despatches,etc. for the purpose,ofeff~ctingpaymentsto me/us. TheARN
I L_;' .,--,-- _•• - me/us all the commissions(in the form of trail commissionor anyother mode),payable-to hitn for the dilterlnt competingSchemesof variousMutual Fund!from amongstwhichthe-Schemeisbeing
recommendedto me/us. ,- •
I/We herebydeclarethat currentlythere is no subsistingorder/ruling/judgement etc., in forcewhichhasbeenpassedbyof anycourt,tribunal, statutoryauthority or regulator,includingSEBIprohibitingor restrainingme/us
from dealingin securities.
Thatin the event,the aboveinformationand/or anypart of it is/arefound to befalse/untrue/misleading.I/We will beliablefor the consequencesarisingtherefrom. I/Wewill indemnifythe Fund,AMC,Trustee,RTAandother
intermediariesin caseof anydisputeregardingthe eligibility,validity,and authorisationof my/our transaction. .
1/ We herebyprovidemy ( our consentin accordancewith AadhaarAct, 2016and regulationsmadethereunder,for (i) collecting,storing and usage; (ii) validating / authenticatingand (iii) updating my/our Aadhaar
number(s)in accordancewith the AadhaarAct,2016 [and regulationsmadethereunder)and PMLA.1/ Weherebyprovidemy/ our consentfor sharing( discloseof the Aadhaarnumber(s)includingdemographicinformation
wtth the assetmanagementcompaniesof SEBIregisteredmutualfund and their RegistrarandTransferAgent (RTA)for the purposeof updatingthe samein my / ourfolioswith my / our PAN. <
Applicableto NRlsonly: I/We confirmthat I am/we are NonResidentof IndianNationality/Originand I/We herebyconfirmthat the fundsfor subscriptionhavebeenremittedfrom abroadthrough approvedbankingchannels
or from fundsin my/our NonResidentExternal/Ordinary Account/ FCNR/ NRSRAccount.Investmentin the Schemeismadebyme / uson: 0 RepatriationbasisO Non Repatriationbasis.
1/ We haveunderstoodthe information requirementsof this Form(readalongwtth the FATCA& (Rs Instructions)and herebyconfirmthat the informatio.nprovidedby me/us on this Formistrue, correct,and complete.
1/ We alsoconfirmthat I / Wehavereadand understoodthe FATCA& CRSTermsand Conditionsbelowand herebyacceptthe same,

To,The Trusteesof Canara Robecq ~utu~1 Fund,'su~ : Our Subscription to the Schemesof - I '1 ,
We, the undersigned" being the partner of M/s. . a Partnership firm fo'rmed under Indian Partnership Act, 1932 do hereby jointly and
severally authorise Mr. to subscribe an amount of~ '.l -for allotment of units of • • Scheme on
behalf of and in the name of our firm. He is / They are also authorised to encash / disinvest the above units. We undertake to intimate you in writing about any change in the constitution or composition
of our flrm-and upon suc~ change; alsd arrange to lodge the specimen sigflalUres of the partners authorised to geal iNitM"e a)lpve units. We enclose the copy of the Partnerfl,ip Deed along with this
application for subscription. .
Name of the Partners Signatures J i."
 CANARA ROBcCO
SIP REGISTRATION CUM MANDATE FORM For investment through NACH/Direct Debit
Mutual Fund
"Direct" in ARNcolumn.) All sections to be completed in ENGLISHin BLACK/BLUECOLOURED
INKand in BLOCKLmERS

Declarationfor "execution-only" transaction (only where EUINbox is left blank) - I/We herebyconfirm that the EUINbox has been intentionally left blank by me/us as this is an "execution-only"
any interactionor advicebythe employee/relationshipmanager/salespersonof the abovedistributor or notwithstandingthe adviceof in-appropriateness,if any,providedbythe employee/relationshipm.,n.".r/,.I,·s!
personof the distributor and the distributor hasnot chargedanyadvisoryfeeson this transaction.

In casethe subscription(Iumpsum) amount is Rs.10,000/- or more and our Distributor hasopted to receivetransactionscharges,Rs.150/- (for first time mutual fund investor)or Rs.100/- (for investor
other than first time mutual fund investor)we be deductedfrom the subscriptionamount and paid to the distributor. Unitswill be issuedagainstthe balanceamount invested.
Upfront commissionshall be paid directlybythe investorto the AMFIregisteredDistributorsbasedon the investors'assessmentof variousfactorsincludingthe servicerenderedbythe distributor.

(Default SIPfrequency is Monthly)

SIPDate: 0 1st 0 5th 0 15th (Default) 0 20th 0 25th

DEMATACCOUNTDETAILS(Optional) Please (,() 0 NSDLOR 0 COSL Fordates29th, 30th and 31st,the date consideredwill be 28th. In.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~MdMem~tioo~lliehfu~dMeco~h~wm~rn~
Depository Participant (DP) ID Beneficiary Account Number (NSDLonly)
Any Date SIP ~ / [ill]/ ""","--'-""...L..o""'_''''''""1

SIPStart Month/Year [iIi]/

Depository Participant (DP) ID (COSLonly) (The application form should mandatorily accompany the latest ~~~I
Client investor master/Demat account statement.) SIPEnd Month/Year

o SIPTOP-UP(Optional) (Tickto availthis facility)

o Yearly
Note: • Default Frequency is Annual
• It is mandatory to submit NACH(OlM)
OPTION: • NACHmandate should be provided for maximum
amount in line with your Top-Up mandate f1 SIP
tenure.
Cheque/DD No'/UTR No.(in case of NEFT/RTGS)~ Date ~------I

YOURCONFIRMATION/DEClARATION: i/we herebydeclarethat i/we do not haveanyexistingMicroSIPswhichtogetherwiththe currentapplicationwill resultin atotal investmentsexceedingRs.50,000 in a yearasdescribedin
Instructionofthe commonapplicationform.TheARNholderhasdisclosedto me/usallthe commissions(intheformoftrail commissionor anyothermode),payableto himfor the differentcompetingSchemesofvariousMutualFunds
from amongstwhichthe Schemeisbeingrecommendedto me/us.TheAMCwouldnot beliablefor anydelayin credrtingthe Schemecollectionaccountsbythe ServiceProviderswhichmayresultin a delayin applicationof NAV.

--------------------------
CANARA ROB'CCO DEBIT MANDATE FORM
c,
Ji Mutual Fund UMRN'
u::
i!!
~OJ
Sponsor Bank Code 3
.&>

] I/We hereby authorise s

~
c:: BankAccountNumber 8
o
~
~
With Bank ? OrMICR" I, fi2..I 32..t> t) r I
E
OJ
An amount
of Rupees12
Amount in Figures13 I fit) D \) I '+
~mumAmount
~ FREQUENCY"
::E
~ FolioNo.16
 VALID FOR THREE MONTHS FROM THE DATE OF ISSUE

YEs/ryr~
YES BANK Ltd., UNIT NO.6, CENTRAL BUSINESS PARK KAMLA NAGAR lol~loI5IRlol~l~
AGRA282004
----_ _ .._-
IFS CODE: YESBOOOO711
... Payable At Par At All Branches of YES BANK Ltd.
D D M M Y Y Y Y
or Bearer
_---- __ <:IT ~ crT

SAVINGS
fAk No·1 071151100005642 __
1~lctl~:~.~. ] New Account

MANISHA AGARWAL
Please sign above