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Page 1: TOP-UP Facility in existing Systematic Investment … TOP-UP...This facility will allow investor to opt for TOP-UP in their existing SIP, which are routed through Direct Debit and

TOP-UP Facility in existingSystematic Investment Plan (SIP)

UNITHOLDER’S DETAILS FOLIO No.

Sole/First Applicant (Mr./Ms.): FIRST NAME MIDDLE NAME LAST NAME

SIP Top-Up Amount: ` _________________________________ Top-Up Cap Amount: ` ____________________________ Top-Up Cap Year:OR

BA

NK

MA

ND

ATE

SEC

TIO

N (

Man

dat

ory)

Signature(s) of Bank Account Holder(s) as in Bank Records (Mandatory)

hereby authorise ICICI Prudential Mutual Fund and their authorised service providers to debit from my/our Bank Account No. mentioned below (hereinafter referred as “funding account”) by ECS (Debit Clearing)/Direct Debit for collection of SIP payments/authorise the bank to record a Standing Instruction for debit to my bank account as mentioned below, as instructed by ICICI Prudential Mutual Fund.

PARTICULARS OF BANK ACCOUNT

(NAME AS PER BANK RECORD) (NAME AS PER BANK RECORD)I/We, Mr. / Ms. / M/s.

Account Type Account NumberCurrent Savings NRO NRE FCNR

Name of Bank Branch

Branch City Maximum Amount `

9 Digit MICR code (Please enter the 9 digit number that appears next to the cheque number). In case of At Par accounts, kindly provide the correct MICR number of the bank branch. MICR code starting and/or ending with 000 are not valid for ECS.

Authorisation of the Bank Account Holder for Auto Debit (ECS)/Standing Instruction/Direct DebitI/We have read and understood the contents of the Scheme Information Document(s) and Statement of Additional Information and the terms & conditions of SIP enrolment and ECS (Debit Clearing) / Direct Debit/ Standing Instruction and agree to abide by the same. I /We hereby apply to the Trustee of ICICI Prudential Mutual Fund for enrolment under the SIP of the following Scheme(s)/ Plan(s) / Option(s) and agree to abide by the terms and conditions of the same. I/We hereby declare that the particulars given above are correct and express my willingness to make payments referred above through participation in ECS. This is to inform I/we have registered for the RBI's Electronic Clearing Service (Debit Clearing) and that my payment towards my investment in ICICI Prudential Mutual Fund shall be made from my/our below mentioned bank account with your bank. I/We authorise the representative carrying this ECS mandate Form to get it verified & executed. I/We authorise the bank to honour the instructions as mentioned in the application form. I/We also hereby authorise bank to debit charges towards verification of this mandate, if any. I/We agree that AMC/Mutual Fund (including its affiliates), and any of its officers directors, personnel and employees, shall not be held responsible for any delay/wrong debits on the part of the bank for executing the direct debit instructions of additional sum on a specified date from my account. If the transaction is delayed or not effected at all for reasons of incomplete or incorrect information, I/We would not hold the user institution responsible. I/We confirm to have understood that the introduction of this facility may also give rise to operational risks and hereby take full responsibility. I/We undertake to keep sufficient funds in the funding account on the date of execution of standing instruction. I/We have not received nor been induced by any rebate or gifts, directly or indirectly, in making this investment. The ARN holder has disclosed to me/us all the commissions (in the form of trail commission or any other mode), payable to him/them for the different competing Schemes of various Mutual Funds from amongst which the Scheme is being recommended to me/us. I/We hereby agree to avail the TOP UP facility for SIP and authorize my bank to execute the ECS/Standing Instruction/Direct Debit for a further increase in installment from my designated account. I/We agree that AMC/Mutual Fund (including its affiliates), and any of its officers directors, personnel and employees, shall not be held responsible for any delay / wrong debits on the part of the bank for executing the standing instructions of additional sum on a specified date from my account. I/We hereby understand and confirm that ICICI Prudential Asset Management Company would not be liable for any delay in crediting the scheme collection accounts by the Service Providers which may result in a delay in application of NAV.

Scheme Name, Plan & Option: __________________________________________________________________________________

Name of the Investor: _______________________________________________________________________________________FOLIO No.

Each SIP amount: ` ___________________________________________ Rupees in words: ___________________________________________________________________________

SIP Date ():

Scheme Name: ______________________________________________________________________________ Option/Sub-Option: ___________________________________________

DETAILS OF EXISTING SIP INVESTMENT WHERE IN TOP-UP HAS TO BE DONE

ICICI Prudential

Plan (): Direct

7th 10th 15th 25th SIP Start Month & Year:

Regular

SIP Frequency (): Monthly Quarterly

SIP End Month & Year:M M Y Y Y Y M M Y Y Y Y

Sole/

First

Appli

cant

Seco

ndAp

plica

nt

Third

Appli

cant

Signature(s) as per ICICI Prudential Mutual Fund Records (Mandatory)

ACKNOWLEDGEMENT - ICICI Prudential Mutual Fund - SIP TOP-UP FACILITY FOR EXISTING INVESTORS

M M Y Y Y Y

Sole

/Firs

tAp

plic

ant

Seco

ndAp

plic

ant

Third

Appl

ican

t

Top-Up Frequency (): Half Yearly Yearly

SIP TOP-UP DETAILS TOP-UP Frequency (): (In case of Quarterly SIP, only the Yearly option is available as SIP TOP-UP frequency)

SIP TOP-UP Amount: ` _____________________________________________ (TOP-UP Amount has to be in multiples of ` 500 only.)

Half Yearly Yearly(If TOP-UP frequency is not selected, then the default option will be Yearly.)

Cap Amount*: ` ____________________________________________ Cap Month-Year# : M M Y Y Y YORSIP TOP-UP CAP

(Investor has to choose only one option – either CAP Amount or CAP Month-Year)*TOP-UP CAP Amount: Investor has an option to freeze the SIP Top up amount once it reaches a fixed predefined amount. This amount should be same as the maximum amount mentioned in the bank mandate. In case of discrepancy between the CAP Amount & the maximum amount then whichever is lower shall be considered as the default amount of SIP till the end of SIP tenure.

#TOP-UP CAP Month-Year: It is the date from which SIP Top-Up amount will cease and last SIP installment including Top-Up amount will remain constant from Cap date till the end of SIP tenure.

Page 2: TOP-UP Facility in existing Systematic Investment … TOP-UP...This facility will allow investor to opt for TOP-UP in their existing SIP, which are routed through Direct Debit and

This facility will allow investor to opt for TOP-UP in their existing SIP, which are routed through Direct Debit and ECS mode only.

Incase, an investor has more than one existing SIP in a single folio in the same scheme with a single distributor, unless specifically instructed by the investor, the top-up request shall be considered for the first registered SIP.

Investors/unit holders subscribing for this facility are required to submit the request at least 30 days prior to the SIP date. TOP-UP will be applicable from next effective SIP installment.

(a) Investors can opt for SIP TOP UP facility, wherein the amount of the SIP can be increased at fixed intervals.

(b) The TOP UP amount has to be in multiples of Rs. 500 only.

(c) The frequency is fixed at Yearly and Half Yearly basis.

(d) In case of Quarterly SIP, only the Yearly frequency is available under SIP TOP UP.

Please see the illustration below to know how to calculate SIP Top-Up amount:

• SIP Tenure: 07Jan 2015 to 07 Dec 2016 • Monthly SIP Installment: Rs. 2000/- • TopUp Amount: Rs.1000/- • TopUp Frequency: 6 months

Installment No(s) From Date To Date Monthly SIP Installment SIP Top-Up Increased Monthly SIP Amount (`) Amount (`) Amount (`)

1 to 6 7-Jan-15 7-Jun-15 2,000 N.A. 2,000

7 to 12 7-Jul-15 7-Dec-15 2,000 1,000 3,000

13 to 18 7-Jan-16 7-Jun-16 3,000 1,000 4,000

19 to 24 7-Jul-16 7-Dec-16 4,000 1,000 5,000

(e) SIP TOP UP will be allowed in Micro SIP folio subject to condition that total investment including SIP TOP UP does not exceed Rs. 50000/- in a rolling 12 month period or financial year i.e. April to March, the limit on Micro SIP investments.

(f) Maximum amount: It is the upper most limit per transaction set by investor for his registered bank A/c to be debited.

(g) TOP-UP CAP

(i) Cap Amount: Investor has an option to freeze the SIP TOP UP amount once it reaches a fixed predefined amount.

(ii) Cap Month-Year: It is the date from which SIP Top-Up amount will cease and last SIP installment including Top-Up amount will remain constant from Cap date till the end of SIP tenure.

Investor has an option to choose either TOP-UP CAP Amount OR TOP-UP CAP Month-Year. In case of multiple selection TOP-UP CAP amount will be considered as default.

SIP Top-UP Cap Amount should be same as the maximum amount mentioned in the bank mandate. In case of discrepancy between the CAP amount and the maximum amount, then whichever is lower shall be considered as the default amount of SIP till the end of SIP tenure.

(h) Investor will have to furnish existing SIP details to avail Top-Up facility in that partifular SIP.

(i) Incomplete forms and the forms with incorrect details will be rejected. AMC reserves to call and rectify the SIP.

Separate form has to be used for each SIP.

SIP TOP UP FACILITY IN EXISTING SIP - TERMS AND CONDITIONS

Mutual Fund investments are subject to market risks, read all scheme related documents carefully.