Icici Pru Common Application Form

MAIN APPLICATION FORM (Please read the instructions before investing) Use this Form if you are making one time investment. For SIP investments use the separate blue coloured SIP form. Broker Code

Sub-broker Code

ARN - 4724

ARN - 4724

ARN-0155

54934

Date & Time of Receipt

Serial Number

APPLICATION NO.

1

FOR EXISTING UNITHOLDERS

If you are making a purchase in an existing folio, please mention the folio number in the space provided and proceeds to Step 3. Please note that the applicable details and mode of holding will be as per the existing folio.

2

Folio No. Date:

ABOUT YOU

Name of First Applicant

Date of Birth (Mandatory) D

Mr. Ms. M/s.

D M M

Y

Y

Y

Y

Status [Please tick (✓)]

Name of Guardian (in case of minor) / Contact Person (In case of Institutional Investors) Mr. Ms. Designation of the Contact Person (In case of Institutional Investors)

Mailing Address (Please provide full address)

Resident Individual

Bank/FI

HUF

AOP/BoI

Company

Club/Society

Trust

NRI/FII/PIO

Partnership

Minor

Sole Proprietorship PIN

City

Others (Please specify) _______

_______________________

Country

State Communication Tel. (Res.)

Tel. (Off.)

Mob

E-Mail Overseas Address (in case of NRIs/FIIs)

PIN

City Country

State Name of Second Applicant

Resident Individual

Non-Resident Individual

(Please tick (✓) the relevant box)

Resident Individual

Non-Resident Individual

(Please tick (✓) the relevant box)

Mr. Ms.

Single

Name of Third Applicant Mr. Ms.

Professional Housewife Business Service Retired Student Others (Please specify) _______ _______________________ _______________________

Guardian (In case of minor)

1st Applicant

MANDATORY DETAILS

Anyone or Survivor

Joint

Occupation [Please tick (✓)]

Permanent Account Number (PAN) [Please refer to instruction no.II(b)(4)]

2nd Applicant 3rd Applicant Folio No.

If you have already provided & validated PAN with an existing folio, please mention the Folio No.

3

Mode of holding [Please tick (✓)]

BANK ACCOUNT DETAILS OF FIRST APPLICANT

(Refer instruction No.III)

Bank Particulars (Name of the Bank) Branch Address City Account Number

Account Type Current

4

E-MAIL COMMUNICATION –

Savings

NRO

NRE

If “Mandatory Details” are not provided, your application is liable to be rejected.

I/We wish to receive the following via e-mail instead of physical document:

Account Statement

Quarterly Review & Annual Report

Communication on Change of Address, Bank, etc.

✄

Prudential ICICI AMC Ltd. - ACKNOWLEDGEMENT SLIP (To be filled in by the Investor)

✄

Application No.

Received from:

ress Add

Application for Units of Prudential ICICI____________________________________________ Option :_____________________________________________

Signature, Stamp & Date

23 1-Dec-2005

5

REDEMPTION / DIVIDEND REMITTANCE (Please refer to instruction no.VIII) DIRECT CREDIT OF DIVIDEND/REDEMPTION

Available in ABN Amro Bank, Bank of Punjab, Centurion Bank, Citibank N.A., Deutsche Bank, HDFC Bank, Hongkong Bank, ICICI Bank, IDBI Bank, Kotak Bank, Standard Chartered Bank, and UTI Bank. Unitholders having bank account with any of these bank will receive their Redemption/ Dividend Payments (if any) directly into their bank account automatically. In case Unitholders wish to receive a cheque please indicate the preference below. I want to receive the redemption and dividend proceeds (if any) by way of a cheque. (Please ✓ in this box)

6

ELECTRONIC CLEARING SERVICE (ECS) FOR DIVIDEND ONLY I authorise Prudential ICICI Mutual Fund to credit my dividend payments through ECS (Please ✓) Please quote 9 Digit Code No. of your Bank and Branch Corresponding to Bank Account Details given in Section - 3 above. (This number appears on every leaf of your chequebook after your cheque number)

IMPORTANT: Please attach a blank “cancelled” Cheque or a clear photocopy of a cheque issued by your bank veryfying of the Code No.

INVESTMENT DETAILS (Refer Instruction No.IV)

If you wish to use STP/SWP facility please tick the relevant box and fill in the STP/SWP Application Form on page 27

R

U

D

E

N

T

I

A

L

SWP

OPTIONS & SUB-OPTIONS (See the Key Features for Scheme specific options & sub-options) [Please tick (✓) the appropriate boxes, only if it is applicable to the scheme/plan in which you wish to invest]

NAME OF THE SCHEME (1) P

STP

I

C

I

C

Cumulative/Growth

I

(Please leave one box blank between words)

Rs.

Monthly

AEP-Appreciation

Quarterly

Half Yearly

Dividend Payout

Daily

Fortnighly

Quarterly

Dividend Reinvestment

Weekly

Monthly

Half Yearly

Amount Invested (C) = (A) + (B) (To be filled in if the column (B) is applicable to the Scheme/Plan)

DD Charges (B) (To be filled in, only if the Fund bears the DD Charges) $

Amount Paid (A)

AEP-Regular*

Rs.

Rs.

Bank Name & Branch

Cheque/DD No.

Account Type (For NRI Investors)

Cheque/DD Date

D

D

M

M

Y

NRO

Y

NRE

* Cumulative – AEP Regular Option : Encashment of Units is subject to declaration of dividend in the respective Scheme(s).

FCNR $ Read the Instruction Number VI(d).

7 NOMINATION DETAILS (Optional) I/We hereby nominate the undermentioned Nominee to receive the amounts to my/our credit in event of my/our death. I/We 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 the AMC / Mutual Fund / Trustees. Name of the Nominee Date of Birth (If nominee is minor) D D M M Y

Mr. Ms. M/s.

Y

Y

Y

Address of Nominee (Please provide full address)

PIN Code Relationship with minor

Name of the Guardian (If nominee is minor)

Signature of Guardian

Address of Guardian

PIN Code

YOUR CONFIRMATION

The Trustee DD MM YYYY Prudential ICICI Mutual Fund, I/We have read and understood the offer document(s) of Prudential ICICI Mutual Fund. I/We apply for the units of the scheme(s) and I/we agree to abide by the terms, conditions, rules and regulations of the scheme. I/We confirm to have understood the terms & conditions. Its investment objectives, investment pattern, fundamental objectives and risk factors applicable to the respective Fund(s). I/We agree to abide by the terms, conditions, rules and regulations of the Plan(s). I/We have understood the details of the scheme and I/we have not received nor been induced by any rebate or gifts, directly or indirectly, in making this investment.

SIGNATURE(S)

8

First Applicant

Second Applicant

Third Applicant

✄

✄ Prudential ICICI AMC Ltd. - ACKNOWLEDGEMENT SLIP (To be filled in by the Investor) Investment Plan

24

Cheque/DD No.

Dated

Amount (Rs.)

Drawn on (Name of Bank & Branch)

Note: All future communications in connection with this application should be addressed to the nearest Prudential ICICI Customer Service Centre, quoting full name of the first applicant, the application serial number, the name of the scheme, the amount invested, date and the place of the Customer Service Centre where application was lodged.

Prudential ICICI Mutual Fund

INSTRUCTIONS FOR FILLING UP THE APPLICATION FORM(S) I.

GENERAL INSTRUCTIONS

a) The application form is for Resident Investors/NRIs/FIIs and should be completed in English in BLOCK Letters. b) The signature(s) should be in English or in any of the Indian languages specified in the eighth schedule of the constitution of India. Thumb impressions must be attested by a Magistrate or a Notary Public or a Special Executive Magistrate under his/her official seal. Applications by minors should be signed by their guardians. In case of HUF, the Karta should sign on behalf of the HUF. Signature mismatch cases: While processing the redemption / switch out request in case the AMC / Registrar come across a signature mismatch, then the AMC/ Registrar reserves the right to process the redemption only on the basis of supporting documents confirming the identity of the investors. List of such documents would be notified by AMC from time to time on its website. c) There are two application forms. i)

Systematic Investment Plan (SIP) Form (Blue Colour) – To be used for SIP Investment. If you wish to apply for SIP through Auto Debit by way of Electronic Clearing Service (ECS) or Standing Instructions to your bank account you need to fill in the Instruction Form in addition to the SIP Form.

ii) Application Form (Red Colour) – To be used for one time investment. d) Investors opting for Systematic Transfer Plan (STP) should fill the details in the space provided on page 27. i)

The minimum amount that can be transferred from one scheme to another is Rs.1,000 for a minimum of 6 installments.

ii) STP will be available at weekly (every Monday), monthly (last day of the month) or quarterly (last day of the quarter) rests as per the standing instructions of the Unitholder. If any of these dates is a non-business day, the transaction would be processed on the immediate next business day. iii) For the target schemes, an entry load of 1% of the applicable NAV will be charged on the amount transferred under the STP facility. iv) Units so created in the target schemes will, in addition to any existing exit load for normal purchases, have an exit load of 1.25% of the applicable NAV, if the units are redeemed before completion of 2 years from the date of each STP transaction. v) To effect the STP transaction for a particular transaction date as mentioned above and as applicable for the respective frequency, the request for the same should be received on or before the last business day of the week preceding the week in which such effective transaction date falls. The unitholder can avail the STP facility for a maximum period of 10 years. e) The application form number, the scheme name and the name of the applicant should be mentioned on the reverse of the instrument that accompanies the application. f)

The Application completed in all respects along with the cheque/demand draft must be submitted to the nearest Customer Service Center. Applications incomplete in any respect or not accompanied by a cheque or demand draft for the amount payable are liable to be rejected and the money paid will be refunded without interest.

his specimen signature duly authenticated by his banker as well his new bank mandate, PAN details, UIN details (if applicable as per prevalent SEBI Guidelines) in order to facilitate the Fund to update its records and permit the erstwhile minor to operate the account in his own right. 3. In case of an application under Power of Attorney or by a limited company, body corporate, registered society, trust or partnership, etc. the relevant Power of Attorney or the relevant resolution or authority to make the application as the case may be, or duly certified copy thereof, along with the Memorandum and Articles of Association / bye-laws must be lodged along with the application form. Power of Attorney (POA): In case an investor has issued Power of Attorney (POA) for making investments, switches, redemptions etc. under his folio, both the signature of the investor and the POA holder have to be clearly captured in the POA document to be accepted as a valid document. At the time of making redemption / switches the fund would not be in a position to process the transaction unless, POA holder’s signature is available in the POA or proof of identity alongwith signature is produced along with the POA. 4. If the application is for Rs. 50,000 or more, then the PAN and IT Circle/ Ward/District (if available) of the applicant, parent/guardian in case of minor and all applicants in case of more than one applicant should be mentioned and a copy of the PAN card or Allotment Letter should be submitted. In case any of the applicants is not an assessee, the fact should be mentioned and Form 60/61 should be submitted along with the application. 5. Applicants should indicate their status by ticking the appropriate box. Applications without a tick in the ‘Status’ box will be considered as investment by “Others”. Those who select the status as “Others”, they should specify their status in the space provided.” 6. Applicants should specify the mode of holding. In case it is not mentioned, the default will be “either or survivor”. In the case of joint holders, the first named holder shall receive all the Account Statements, dividend/ redemption/refund warrants and any other correspondence sent from time to time. 7. Name of a contact person should be mentioned in case of the investment by a Company/Body Corporate/Partnership Firm/Trust/Foreign Institutional Investors (FIIs)/Society. III. BANK DETAILS The first Unitholder should provide the name of the bank branch, complete address of the branch, account type and account number, which is mandatory as per Securities Exchange Board of India circular IIAMRP/MF/CIR/07/826/98 dated April 15, 1998. Applications without this information will be deemed to be incomplete. IV. INVESTMENT DETAILS a) Investor has to fill a separate form for each scheme that he wishes to invest in. b) Investor should select only one option (growth/dividend) and corresponding sub-option (e.g. reinvest/payout in case of dividend option) under the scheme(s) wherever applicable by ticking the appropriate box.

g) No receipt will be issued for the application money. The Customer Service Centers will stamp and return the acknowledgement slip in the application form, to acknowledge receipt of the application.

c) Investor opting for AEP option (under Income Plan & Monthly Income Plan) should select the sub-option (regular/appreciation) and frequency (monthly/ quarterly/half-yearly). For details, please refer to the offer document of the respective schemes.

II. UNITHOLDERS INFORMATION

d) In case, the investor has not selected the option/sub-option for his investments, default option/sub-option as prescribed in the offer document of the relevant scheme will be applied.

a) Existing Unitholders Investors already having an account in any of the Prudential ICICI schemes, and making additional investments in the same schemes or any other schemes, should provide their Folio Number in Step 1. The names of the applicants, mode of holding etc. will be as per the folio number provided. Existing unitholders need not fill the details in Step 2 and directly proceed to Step 3. b) New Applicant 1. Name and address must be given in full (P.O. Box Address is not sufficient). In case of NRI/PIO/FII investors an overseas address must be provided. 2. Name of guardian must be mentioned if the investments are being made on behalf of a minor. Date of Birth is mandatory in case of minor. Investments of the existing minor investor on minor attaining majority: Upon attaining majority, a minor has to write to the fund, giving

e) For minimum application amount, please refer to table given on page 3 to 8. V. SYSTEMATIC INVESTMENT PLAN (SIP) a) SIP facility is available in the following schemes: Prudential ICICI Growth Plan, Prudential ICICI FMCG Fund, Prudential ICICI Technology Fund, Prudential ICICI Balanced Fund, Prudential ICICI Monthly Income Plan, Prudential ICICI Power, Prudential ICICI Dynamic Plan, Prudential ICICI Discovery Fund, Prudential ICICI Emerging S.T.A.R. (Stocks Targeted At Returns) Fund, Prudential ICICI Tax Plan, Prudential ICICI Index Fund, Prudential ICICI Income Plan, Prudential ICICI Flexible Income Plan, Prudential ICICI Income Multiplier Fund, Prudential ICICI Advisor Series, Prudential ICICI Child Care Plan, Prudential ICICI Long Term Plan and Prudential ICICI Infrastructure Fund.

15

Prudential ICICI Mutual Fund

INSTRUCTIONS FOR FILLING UP THE APPLICATION FORM(S) (Contd.) b) Investor opting for SIP need to fill the SIP Application Form (Blue Colour). If the payment option is Auto Debit through ECS or Standing Instruction to the Bank, investor also need to fill the respective forms on page 19 & 21. c) Investors opting for SIP investment can subscribe to this facility subject to the condition that each of the SIP installments including the initial purchase should be of the same amount. d) Entry load equivalent to 1% of the applicable NAV will be charged on the amount invested under the scheme(s) where SIP facility is available. e) Amount so invested into the schemes will, in addition to any existing exit load for normal purchases, have an exit load equivalent to 1.25% of the applicable NAV, if the units are redeemed before completion of 2 years from the date of allotment. f)

Issue post dated cheques dated either 1st or 7th or 10th or 15th or 25th of the month. A credit confirmation will be sent to the unitholder indicating the new balance to his or her credit in the account.

g) SIP Auto Debit via ECS (Debit Clearing) is available at the following 25 centres: Ahmedabad, Bangalore, Baroda, Bhopal, Bhubaneshwar, Chandigarh, Chennai, Coimbatore, Guwahati, Hyderabad, Indore, Jaipur, Kanpur, Kolkata, Lucknow, Ludhiana, Madurai, Mumbai, Nagpur, New Delhi, Panjim, Pune, Surat, Trivandrum and Vijaywada. h) Existing investors opting for SIP need to provide their Folio Number along with SIP details. VI. MODE OF PAYMENT a) The cheque/demand draft should be drawn in favor of “Prudential ICICI Income Plan” or “Prudential ICICI Flexible Income Plan” or “Prudential ICICI Gilt Fund – Treasury Plan” or “Prudential ICICI Gilt Fund – Investment Plan” or “Prudential ICICI Monthly Income Plan” or “Prudential ICICI Liquid Plan” or “Prudential ICICI Short Term Plan” or “Prudential ICICI Growth Plan” or “Prudential ICICI FMCG Fund” or “Prudential ICICI Balanced Fund” or “Prudential ICICI Tax Plan” or “Prudential ICICI Technology Fund” or “Prudential ICICI Power” or “Prudential ICICI Dynamic Plan” or “Prudential ICICI Floating Rate Plan” or “Prudential ICICI Income Multiplier Fund”or “Prudential ICICI Discovery Fund”or “Prudential ICICI Emerging S.T.A.R. Fund”or “Prudential ICICI Index Fund”or “Prudential ICICI Infrastructure Fund”, as the case may be and crossed “Account Payee Only”. The cheque / demand draft should be payable at the centre where the application is lodged. The cheque / demand draft should be drawn on any bank which is situated at and is a member / sub-member of the Bankers’ Clearing House. Cheques/ demand drafts drawn on a bank not participating in the Clearing House will not be accepted. b) Separate Cheque/Draft is required for each scheme invested. c) Payments by Stockinvests, cash, postal orders, money orders and outstation cheques will not be accepted. d) The Fund will reimburse demand draft charges subject to maximum of Rs. 10,000/- per transaction for purchase of units by investors residing at location where the AMC Customer Service Centers/Collection Centers are not located as per the table below: Amount of Investment

Rate of Charges of Demand Draft(s)

Upto Rs.10,000/-

At actuals subject to maximum of Rs.50/-

Above Rs.10,000/-

Rs. 2/- per Rs. 1000/-

However, the demand draft charges will not be reimbursed for Prudential ICICI Liquid Fund, Prudential ICICI Short Term Plan, Prudential ICIC Gilt Fund – Treasury Plan and Prudential ICICI Floating Rate Plan. AMC reserves the right to refuse the reimbursement of demand draft charges, in case of investments made by the same applicant(s) through multiple applications at its own discretion which will be final and binding on the investor. Investors residing at places other than where the AMC Customer Service Centers/ Collection Centers are located, are requested to make the payment by way of demand draft(s) after deducting bank charges as per the rates indicated in the above table. It may be noted that additional charges, if any, incurred by the investor over and above the levels indicated above will not be borne by the Fund. No demand draft charges will be reimbursed by the Fund for purchase of Units by investors residing at such locations where the Customer Service Centers/Collection Centers of the AMC are located.

16

e) NRI/FII/PIO Investors 1. Repatriation basis: Payments by NRIs / FIIs / Persons of Indian Origin residing abroad, may be made either by way of Indian Rupee drafts or cheques by means of (i) inward remittance through normal banking channels; or (ii) out of funds held in NRE/FCNR account payable at par and payable at the cities where the Customer Service Centres are located. In case of Indian Rupee drafts purchased through NRE/ FCNR Account, an account debit certificate from the bank issuing the draft confirming the debit should also be enclosed. In case the debit certificate is not provided, the AMC reserves the right to reject the application of the NRI investors. 2. Non Repatriation basis NRIs or people of Indian origin residing abroad investing on a non-repatriable basis may do so by issuing cheques/demand drafts drawn on Non-Resident Ordinary (NRO) account payable at the cities where the Customer Service Centres are located. VII. NOMINATION 1. 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 Hindu Undivided Family, holder of Power of Attorney cannot nominate. If the units are held jointly, all joint holders will sign the nomination form. Space is provided as a specimen, if there are more joint holders more sheets can be added for signatures of holders of units and witnesses. 2. 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. 3. 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 controls in force, from time to time. 4. Nomination in respect of the units stands rescinded upon the transfer of units. 5. Transfer of units in favour of a Nominee shall be valid discharge by the asset management company against the legal heir. 6. 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. 7. 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 Nominee.” VIII. DIRECT CREDIT OF DIVIDEND/REDEMPTION Prudential ICICI AMC had entered into an arrangement of a direct credit facility of redemptions/ dividends with certain banks. For the Investors who have an account with such banks, the AMC based on advice of the investor/ Unit holders have been crediting either redemption or dividend payments directly to the bank accounts of the Unit holders. Further, the default option for payment of redemption/dividend proceeds for all the prospective investments would be the Direct Credit into their bank account (in case the investor has provided his bank mandate as one of the banks participating in direct credit arrangement and if he fails to specify the mode of payment). The AMC may alter the list of the banks participating in direct credit arrangement from time to time/ withdraw direct credit facility from the banks, based on its experience of dealing with any of such banks or add / withdraw the name of the bank with whom direct credit facility arrangements can be introduced/ discontinued as the case may be. IX. E-MAIL COMMUNICATION Delivering service through web/e-mail helps the Fund to reduce expenses in the Fund and is a more efficient delivery channel. When an investor has communicated his/her e-mail address and has provided consent for sending communication only through email, the Mutual Fund / Registrars are not responsible for email not reaching the investor and for all consequences thereof. The Investor shall from time to time intimate the Mutual Fund / its transfer agents about any changes in the email address. In case of a large document, a suitable link would be provided and investor can download, save and print these documents. However, investor always has a right to demand a physical copy of any or all the service deliverable and Fund would arrange to send the same to the investor.

SYSTEMATIC INVESTMENT PLAN (SIP) APPLICATION FORM (Please read the instructions before investing) Use this Form for SIP investment. If you wish to make payment through Auto Debit ECS / Standing Instruction you also need to fill separate Instruction Form for the same. Broker Code

Sub-broker Code

ARN - 4724

ARN - 4724

ARN-0155 1

54934

Serial Number

Application No.

FOR EXISTING UNITHOLDERS

If you are making a purchase in an existing folio, please mention the folio number in the space provided and proceeds to Step 3. Please note that the applicable details and mode of holding will be as per the existing folio.

2

Date & Time of Receipt

Folio No. Date:

ABOUT YOU

Name of First Applicant

Date of Birth (Mandatory)

Mr. Ms. M/s.

D

D M M

Y

Y

Y

Y

Status [Please tick (✓)]

Name of Guardian (in case of minor) / Contact Person (In case of Institutional Investors) Mr. Ms. Designation of the Contact Person (In case of Institutional Investors)

Mailing Address (Please provide full address)

City

Resident Individual

Trust

HUF

Bank/FI

Company

AOP/BoI

Partnership

Club/Society

Sole Proprietorship

NRI/FII/PIO Minor

PIN

Others (Please specify) _______

State

Country

_______________________

Communication (Off.)

Tel. (Res.)

Mob

E-Mail Overseas Address (in case of NRIs/FIIs)

City

PIN

State

Country

Name of Second Applicant

Resident Individual

Non-Resident Individual

(Please tick (✓) the relevant box)

Resident Individual

Non-Resident Individual

(Please tick (✓) the relevant box)

Mr. Ms. Name of Third Applicant Mr. Ms.

Mode of holding [Please tick (✓)] Anyone or Single Survivor Joint Occupation [Please tick (✓)]

MANDATORY DETAILS

Permanent Account Number (PAN) [Please refer to instruction no.II(b)(4)]

Professional

Housewife

Business

Service

2nd Applicant

Retired

Student

3rd Applicant

Others (Please specify) _______ _______________________

Guardian

1st Applicant

If you have already provided & validated PAN with an existing folio, please mention the Folio No.:

3

BANK ACCOUNT DETAILS OF FIRST APPLICANT

Name of the Bank

If “Mandatory Details” are not provided, your application is liable to be rejected.

(Refer instruction No.III) Branch Address

Bank City

4

Folio No.

A/c. Type

A/c. No.

E-MAIL COMMUNICATION

Current

Savings

NRO

NRE

– I/We wish to receive the following via e-mail instead of physical document:

Account Statement

Quarterly Review & Annual Report

Communication on Change of Address, Bank, etc.

✄

Prudential ICICI AMC Ltd. - ACKNOWLEDGEMENT SLIP (To be filled in by the Investor)

✄

Application No.

Received from:

ress Add

Application for Units of Prudential ICICI____________________________________________ Option :_____________________________________________

Signature, Stamp & Date

Note: All future communications in connection with this application should be addressed to the nearest Prudential ICICI Customer Service Centre, quoting full name of the first applicant, the application serial number, the name of the scheme, the amount invested, date and the place of the Customer Service Centre where application was lodged.

1-Dec-2005

17

5

REDEMPTION / DIVIDEND REMITTANCE (Please refer to instruction no.VIII) DIRECT CREDIT OF DIVIDEND/REDEMPTION

ELECTRONIC CLEARING SERVICE (ECS) FOR DIVIDEND ONLY I authorise Prudential ICICI Mutual Fund to credit my dividend payments through ECS (Please ✓) Please quote 9 Digit Code No. of your Bank and Branch Corresponding to Bank Account Details given in Section - 3 above. (This number appears on every leaf of your chequebook after your cheque number)

Available in ABN Amro Bank, Bank of Punjab, Centurion Bank, Citibank N.A., Deutsche Bank, HDFC Bank, Hongkong Bank, ICICI Bank, IDBI Bank, Kotak Bank, Standard Chartered Bank, and UTI Bank. Unitholders having bank account with any of these bank will receive their Redemption/ Dividend Payments (if any) directly into their bank account automatically. In case Unitholders wish to receive a cheque please indicate the preference below. I want to receive the redemption and dividend proceeds (if any) by way of a cheque. (Please ✓ in this box)

6

IMPORTANT: Please attach a blank “cancelled” Cheque or a clear photocopy of a cheque issued by your bank veryfying of the Code No.

INVESTMENT DETAILS (Refer Instruction No.IV) OPTIONS & SUB-OPTIONS (See the Key Features for Scheme specific options & sub-options) [Please tick (✓) the appropriate boxes, only if it is applicable to the scheme/plan in which you wish to invest]

NAME OF THE SCHEME (1) P

R

U

D

E

N

T

I

A

L

I

C

I

C

I

Cumulative/Growth Dividend Payout

AEP-Regular*

Monthly

AEP-Appreciation

Quarterly

Monthly

Quarterly

Half Yearly

Half Yearly

Dividend Reinvestment (Please leave one box blank between words) * Cumulative – AEP Regular Option : Encashment of Units is subject to declaration of dividend in the respective Scheme(s). ✓ ) the appropriate box) SIP Payment Details (You can choose one of the 3 payment options below. Please tick (✓ OPTION - I : CHEQUE – First Installment Details (to be filled in in case of SIP through cheque) D

Cheque Date

Cheque No.

D

M

M

Drawn on Bank

Y

Y

Amount

Rs.

Branch

Subsequent Installment Details (to be filled in in case of SIP through cheque) Single Installment Amount

Cheque Number From

Cheque Dated 1st

Cheque Number To

Number of Cheques

Rs.

7th

10th

Start From 15th

25th

M

M

Y

Drawn on Bank

Y

End To Y

Y

M

M

Y

Y

Y

Y

Branch

OPTION - II : AUTO DEBIT THROUGH ECS (You only need to tick this box & fill SIP Auto Debit Instruction Form on page 19) OPTION - III : STANDING INSTRUCTION (You only need to tick this box & fill Standing Instruction Form on page 21)

7

NOMINATION DETAILS (Optional)

I/We hereby nominate the undermentioned Nominee to receive the amounts to my/our credit in event of my/our death. I/We 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 the AMC / Mutual Fund / Trustees. Name of the Nominee Date of Birth (If nominee is minor) D D

Mr. Ms. M/s. Address of Nominee (Please provide full address)

PIN Code Relationship with minor

Name of the Guardian (If nominee is minor)

Signature of Guardian

Address of Guardian

PIN Code

YOUR CONFIRMATION SIGNATURE(S)

8

The Trustee DD MM YYYY Prudential ICICI Mutual Fund, I/We have read and understood the offer document(s) of Prudential ICICI Mutual Fund. I/We apply for the units of the scheme(s) and I/we agree to abide by the terms, conditions, rules and regulations of the scheme. I/We confirm to have understood the terms & conditions. Its investment objectives, investment pattern, fundamental objectives and risk factors applicable to the respective Fund(s). I/We agree to abide by the terms, conditions, rules and regulations of the Plan(s). I/We have understood the details of the scheme and I/we have not received nor been induced by any rebate or gifts, directly or indirectly, in making this investment.

First Applicant

Second Applicant

Third Applicant

✄

✄

Prudential ICICI AMC Ltd. - ACKNOWLEDGEMENT SLIP (To be filled in by the Investor) First Installment Cheque No.

Cheque Dated

D

D

M

M

Y

Y

Rs.

Drawn on Bank, Branch & City Subsequent Installment Cheque Nos.

Cheque Number From

Drawn on Bank, Branch & City

18

Payment through

Auto Debit ECS

Bank Standing Instruction

Cheque Number To

Rs.

M M Y

Y

Y

Y

Systematic Investment Plan (SIP) Auto Debit Instruction Form Before filling this Instruction Form please ensure you have filled in the SIP Application Form ticking ECS Authorisation in SIP payment details (Section 6)

ARN - 4724

ARN-0155

Broker Code

First Investment with a Current Date Cheque

ARN - 4724

54934

Sub-Broker Code

Date & Time of Receipts

New Application Cancellation Change in Bank Account*

Application to be submitted at least 30 days before the commencement of SIP

I/We hereby apply to the Trustee of Prudential ICICI Mutual Fund for the Systematic Investment Plan (SIP) Enrolment under the following scheme and agree to abide by the terms and conditions of the plan.

[* Please provide a cancelled cheque]

APPLICANT AND SIP DETAILS Sole / First Applicant’s Name Application No.

Folio No.

Scheme Plan Option & Sub Option Each SIP Amount (Rs.) First SIP Transaction via Cheque No. (Note : Cheque should be drawn on bank, details provided below) Cheque Details SIP Date 1st 7th 10th 15th 25th Cheque No. Date SIP Period From To MM YYYY MM YYYY

Amount

We hereby, authorise Prudential ICICI Mutual Fund and their authorised service providers, to debit my/our following bank account by ECS (Debit Clearing) for collection of SIP payments. PARTICULARS OF BANK ACCOUNT (Mandatory) Bank Account Holders Name Bank Name Branch Name Account Number

Account Type

9 Digit MICR Code

Savings

Current

Cash Credit

(Please enter the 9 digit number that appears in your cheque next to the cheque number)

I/We hereby declare that the particulars given above are correct and express my willingness to make payments referred above through participation in ECS. 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 will also inform Prudential ICICI Mutual Fund, about any changes in my bank account. I/We have read and agreed to the terms and conditions mentioned overleaf.

3rd Holder

2nd Holder

1st Holder

Signatures as in Bank Records

✄

✄ Authorisation of the Bank Account Holder

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 Prudential ICICI 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.

Account Number

3rd Holder

2nd Holder

1st Holder

Signatures as in Bank Records

✄

✄ Acknowledgement Slip (Auto Debit) - Prudential ICICI Mutual Fund

Name of the Applicant ______________________________________________________________ Application/Folio No. ______________________ D D M M Y Y Y Y D D M M Y Y Y Y Each SIP Amount (Rs.) _________________________________________ SIP Period - From SIP Period - To Scheme ____________________________ Plan __________________________ Option & Sub-option ___________________________________

Signature, Date & Stamp

19 1-Dec-2005

Terms & Conditions SIP payment through Electronic Clearing Service (Debit Clearing) of the Reserve Bank of India (RBI)

List Cities for SIP Auto Debit via ECS (Debit Clearing) Ahmedabad, Bangalore, Baroda, Bhopal, Bhubaneshwar, Chandigarh, Chennai, Coimbatore, Guwahati, Hyderabad, Indore, Jaipur, Kanpur, Kolkata, Lucknow, Ludhiana, Madurai, Mumbai, Nagpur, New Delhi, Panjim, Pune, Surat, Trivandrum and Vijaywada. 1.

This facility is offered to the investors having bank accounts in select cities mentioned above. The cities in the list may be modified/ updated/changed/removed at any time in future entirely at the discretion of Prudential ICICI Mutual Fund without assigning any reasons or prior notice. If any city is removed, SIP instructions for investors in such cities via ECS (Debit) route will be discontinued without prior notice.

2.

New Investors who wish to enroll for SIP through Debit should fill this SIP Auto Debit Form in addition to the SIP Application Form.

3.

Existing investors need to provide their Folio No. and need not fill up the SIP Application Form.

4.

For new investors, please complete all sections of the SIP Application Form including Section 6. For minimum application amount to be invested in SIP, risk factors, features etc. please refer to page nos. 3 - 8 of the Key Information Memorandum. The cheques should be drawn in favour of "Prudential ICICI Growth Plan" or "Prudential ICICI FMCG Fund" or "Prudential ICICI Technology Fund" or "Prudential ICICI Balanced Fund" or "Prudential ICICI Monthly Income Plan" or "Prudential ICICI Power" or "Prudential ICICI Dynamic Plan" or "Prudential ICICI Discovery Fund" or "Prudential ICICI Emerging S.T.A.R. (Stocks Targeted At Returns) Fund" or "Prudential ICICI Tax Plan" or "Prudential ICICI Income Plan" or "Prudential ICICI Flexible Income Plan" or "Prudential ICICI Income Multiplier Fund" or "Prudential ICICI Index Fund" or "Prudential ICICI Infrastructure Fund"and crossed ‘‘Account Payee Only’’. The cheques should be payable locally at the centre where the Application is deposited at the Customer Service Centres of Prudential ICICI AMC. The cheques should be drawn on any bank which is situated at and is a member / sub-member of the Bankers’ Clearing House. Cheques drawn on a bank not participating in the Clearing House will not be accepted.

5.

Investors opting for SIP investment can subscribe to this facility subject to the condition that each of the SIP installments including the initial purchase should be of the same amount.

6.

a)

Completed Application Form, SIP Auto Debit Form and the first cheque can be submitted on any date of the month and the same would be processed subject to the condition that there would be a minimum of 30 days period between the submission of the application with the current date cheque and the first installment of SIP date.

b)

Completed Application Form for Cancellation/Change of Bank Mandate can be submitted on any date of the month and the same would be processed subject to the condition that there would be a minimum of 30 days period between the submission of the application and the SIP date.

7.

New investors should mandatorily give a cheque for the first transaction. The cheque should be drawn on the same bank account which is to be registered for ECS (Debit).

8.

The bank account provided for ECS (Debit) should participate in local MICR clearing.

9.

SIP auto debit is available only on specific dates of the month viz. 1st/7th/10th/15th/25th and in case 1st/7th/10th/15th/25th is a holiday, then next business day. In case the Auto Debit does not take effect for three consecutive times then the SIP would be liabile for cancellation.

10.

The applicant will have the right to discontinue SIP at any time he or she so desires by providing a written request at the office of the Prudential ICICI Mutual Fund Customer Service Centres. Notice of discontinuance should be received at least 30 days prior to the date that it is required to be effected in. The investor will cease to be a part of the SIP on receipt of the written request.

11.

SIP will be available only on monthly basis and an entry load equivalent to 1% of the applicable NAV will be charged on the amount invested under the scheme(s) where SIP facility is available. Amount so invested into the schemes will, in addition to any existing exit load for normal purchases, have an exit load equivalent to 1.25% of the applicable NAV, if the units are redeemed before completion of 2 years from the date of allotment.

20

12.

The investor agrees to abide by the terms and conditions of ECS facility of Reserve Bank of India (RBI).

13.

Investor will not hold Prudential ICICI Mutual Fund, its registrars and other service providers responsible if the transaction is delayed or not effected or the investor bank account is debited in advance or after the specific SIP date due to various clearing cycles or ECS.

14.

Prudential ICICI Mutual Fund, its registrars and other service providers shall not be responsible and liable for any damages/compensation for any loss, damage etc. incurred by the investor. The investor assumes the entire risk of using this facility and takes full responsibility.

15.

Prudential ICICI Mutual Fund reserves the right to reject any application without assigning any reason thereof.

Application for Standing Instruction Maintenance for Systematic Investment Plan (SIP) Before filling this Instruction Form please ensure you have filled in the SIP Application Form ticking Standing Instrcution in SIP payment details (Section 6) Application Form No. Existing Folio No. Date: D D M M Y Y

Y Y

To The Manager, Bank Name : _________________________________________________________________ Branch __________________________________________ Address: _______________________________________________________________________________________________________________________

Sub: Request for maintenance of a Standing Instruction (SI) for SIP with Prudential ICICI Mutual Fund I/We,____________________________________________________________________________________________, hereby authorise you to debit on a monthly basis (as a Standing Instruction) from my/our account number mentioned below (hereinafter referred as "funding account") for Rs.__________________________ (Rupees _____________________________________________________________ only) and remit the same on Account of Prudential ICICI Mutual Fund as per the details given below: Nature of Instruction

: Standing Instruction

Scheme Name

:

Option

:

Sub-option

:

Debit Account Number

:

(For new accounts, Bank will fill up the same)

Name of the Account Holder

:

Name of the Beneficiary

: Prudential ICICI Mutual Fund Account

Frequency

: Monthly

Start Month

:

SIP Date: 2

0 (Year)

2

0 (Year)

(Month)

End Month

: (Month)

Folio Number

1st

7th

10th

15th

25th

:

(To be filled by Prudential ICICI Mutual Fund) (For new investors)

I/We undertake to keep sufficient funds in the funding account on the date of execution of standing instruction. I/We hereby declare that the particulars given above are correct and complete. If the transaction is delayed or not effected at all for reasons of incomplete or incorrect information, I/we would not hold the Mutual Fund or the Bank responsible. If the date of debit to my/our account happens to be a non banking/business day as defined in the Offer Document of the said Scheme of Prudential ICICI Mutual Fund, execution of the SIP will happen on the previous business day and allotment of units will happen as per the Terms and Conditions listed in the Offer Document of the Mutual Fund. I/We have read and understood the offer document(s) of the Fund. I/We apply for the units of the scheme and I/we agree to abide by the terms, conditions, rules and regulations of the scheme. I/We confirm to have understood the terms & conditions. Its investment objectives, investment pattern, fundamental objectives and risk factors applicable to the respective Fund(s). I/We agree to abide by the terms, conditions, rules and regulations of the Plan(s). I/We have understood the details of the scheme and I/we have not received nor been induced by any rebate or gifts, directly or indirectly, in making this investment. Yours faithfully,

For Bank Branch use only:

3rd Holder

1st Holder

2nd Holder

Signatures as in Bank Records

Application Form No.

Existing Folio No.

Signature Verified by: ______________________________________________ Approved by BM: __________________________________________________ For CPU Use only: Maintained on:

D D M M Y Y

A/c. No.:

Y Y

Name of the A/c Holder: SI Start Date: D D M M Y Y

Y Y

SI End Date: D D M M Y Y

Y Y

Next SI Date: D D M M Y Y

Y Y Amount: _____________________

Maintained by: __________________________________________________

21 1-Dec-2005

Terms & Conditions SIP through Standing Instruction 1.

New Investors who wish to enroll for SIP through Debit should fill this Standing Instruction in addition to the SIP Application Form (Blue Colour).

2.

All SIP Standing Instruction request submitted on or before the 20th of the month will be processed in the immediately following month.

3.

Existing investors need to provide their Folio No. in this Standing Instruction and need not fill up the SIP Application Form.

4.

For new investors, please complete all sections of the Application Form including Section 6. For minimum application amount to be invested in SIP, risk factors, features etc. please refer to page nos. 3 - 8 of the Key Information Memorandum. The cheques should be drawn in favour of "Prudential ICICI Growth Plan" or "Prudential ICICI FMCG Fund" or "Prudential ICICI Technology Fund" or "Prudential ICICI Balanced Fund" or "Prudential ICICI Monthly Income Plan" or "Prudential ICICI Power" or "Prudential ICICI Dynamic Plan" or "Prudential ICICI Discovery Fund" or "Prudential ICICI Emerging S.T.A.R. (Stocks Targeted At Returns) Fund" or "Prudential ICICI Tax Plan" or "Prudential ICICI Income Plan" or "Prudential ICICI Flexible Income Plan" or "Prudential ICICI Income Multiplier Fund" or "Prudential ICICI Index Fund" or "Prudential ICICI Infrastructure Fund" and crossed ‘‘Account Payee Only’’. The cheques should be payable locally at the centre where the Application is deposited at the Customer Service Centres of Prudential ICICI AMC. The cheques should be drawn on any bank which is situated at and is a member / sub-member of the Bankers’ Clearing House. Cheques drawn on a bank not participating in the Clearing House will not be accepted.

5.

Investors opting for SIP investment can subscribe to this facility subject to the condition that each of the SIP installments including the initial purchase should be of the same amount.

6.

The applicant will have the right to discontinue SIP at any time he or she so desires by providing a written request at the office of the Prudential ICICI Mutual Fund Customer Service Centres. Notice of discontinuance should be received by 20th of the month. The investor will cease to be a part of the SIP on receipt of the written request.

7.

SIP will be available only on monthly basis and an entry load equivalent to 1% of the applicable NAV will be charged on the amount invested under the scheme(s) where SIP facility is available. Amount so invested into the schemes will, in addition to any existing exit load for normal purchases, have an exit load equivalent to 1.25% of the applicable NAV, if the units are redeemed before completion of 2 years from the date of allotment.

8.

Prudential ICICI Mutual Fund, its registrars and other service providers shall not be responsible and liable for any damages/compensation for any loss, damage etc. incurred by the investor. The investor assumes the entire risk of using this facility and takes full responsibility.

9.

Standing Instructions incomplete in any respect are liable to be rejected.

10.

SIP is liable for cancellation if direct debit fails for three consecutive times.

Statutory Details: Prudential ICICI Mutual Fund (the Fund) has been set up as a Trust sponsored by Prudential plc (through its wholly owned subsidiary Prudential Corporation Holdings Limited) and ICICI Bank Limited (erstwhile ICICI). Prudential ICICI Trust Limited is the Trustee to the Fund and the Prudential ICICI Asset Management Company Limited is the Investment Manager to the Fund. Risk Factors: Mutual Funds and securities investments are subject to market risks and there is no assurance or guarantee that the objectives of the schemes will be achieved. As with any securities investment, the NAV of the Units issued under the schemes can go up or down depending on the factors and forces affecting the capital markets. Past performance of the Sponsors, AMC/Fund does not indicate the future performance of the schemes. The Sponsors are not responsible or liable for any loss resulting from the operation of the schemes beyond the contribution of an amount of Rs 22.2 lacs collectively made by them towards setting up the Fund and such other accretions and additions to the corpus set up by the Sponsors. Please refer to the Addendum / Offer Document for scheme specific risk factors before investing.

22

Systematic Transfer Plan (STP) Application Form

(Please read the instructions before filling up the form) Use this Form if you wish to transfer your investment systematically from one scheme/plan to another

I/We hereby apply to the Trustee of Prudential ICICI Mutual Fund for the Systematic Transfer Plan (STP) Enrolment under the following scheme and agree to abide by the terms and conditions of the plan. Application Number

Folio Number (For existing Unitholders)

Broker Code

ARN - 4724

ARN-0155

Sub-broker Code

ARN - 4724

54934

Eligible Schemes from which you can Transfer: PruICICI Liquid Plan, PruICICI Income Plan, PruICICI Floating Rate Plan, PruICICI Long Term Floating Rate Plan, PruICICI Flexible Income Plan, PruICICI Short Term Plan, PruICICI Gilt Fund- Investment Plan and Treasury Plan, PruICICI Monthly Income Plan (An open ended fund. Monthly income is not assured and is subject to the availability of distributable surplus) and PruICICI Income Multiplier Fund.

Eligible Schemes into which you can Transfer: PruICICI Growth Plan, PruICICI Power, PruICICI Tax Plan, PruICICI Dynamic Plan, PruICICI Technology Fund, PruICICI FMCG Fund, PruICICI Balanced Fund, PruICICI Discovery Fund, PruICICI Emerging S.T.A.R. (Stocks Targeted At Returns) Fund and Prudential ICICI Infrastructure Fund.

Scheme Name (From where you wish to transfer amount): Plan

Scheme Name (To where you wish to transfer amount): Plan

Weekly

Frequency

Option Monthly

Quarterly

Option

Amount Rs. (Minimum of Rs.1,000)

No. of installments (Minimum of 6 installments)

Instructions for Systematic Transfer Plan (STP) i) ii) iii) iv) v)

The minimum amount that can be transferred from one scheme to another is Rs.1,000.00 for a minimum of 6 installments. STP will be available at weekly, monthly and quarterly rests as per the standing instructions of the Unitholder. Units so created in the target schemes will, in addition to any existing exit load for normal purchases, have an exit load equivalent to 1.25% of the applicable NAV, if the units are redeemed before completion of 2 years from the date of each STP transaction. The unitholder can avail the STP facility for a maximum period of 10 years. The request for STP should be received on or before the last business day of the week preceding the week in which the effective transaction date falls. SIGNATURE(S)

Name of the Sole/First Applicant Name of the Second Applicant Name of the Third Applicant

Sole/First Applicant Second Applicant Third Applicant

Systematic Withdrawal Plan (SWP) Application Form (Please read the instructions before filling up the form) Use this Form if you wish to withdraw your investment systematically.

Date (dd/mm/yyyy)

(Please use separate SWP enrolment form for each Scheme/Plan)

I/We hereby apply to the Trustee of Prudential ICICI Mutual Fund for the Systematic Withdrawal Plan (SWP) under the following scheme and agree to abide by the terms and conditions of the plan. I/We have read and understood the contents of the Offer Document and the instruction. Folio Number (For existing Unitholders)

Application Number

PAN/ GIR No. Scheme Name: Frequency:

Option Monthly; OR Quarterly

Number of Units to be withdrawn

Amount to be Rs. withdrawn

OR

Period of Enrolment from (dd/mm/yyyy)

To (dd/mm/yyyy)

Instructions for Systematic Withdrawal Plan (SWP)

4. 5.

New investors who wish to enrol for SWP should fill this enrolment form in addition to the Application Form. Existing investors need to provide the Folio No. and SWP details only. You can opt to withdraw on a Monthly/Quarterly basis. Withdrawal will be effected on the 1st Business Day of the month for monthly and quarterly basis and would be treated as a redemption. SWP will terminate automatically, if all the units are withdrawn from the folio or an expiry of the enrolment period whichever is earlier. The applicant will have the right to discontinue SWP at any time he or she so desires by providing a written request at the office of the Prudential ICICI Mutual Fund Customer Service Centres. Notice of discontinuance should be received 10 days prior to the month that it is required to be effected in.

Name of the Sole/First Applicant Name of the Second Applicant Name of the Third Applicant

SIGNATURE(S)

1. 2. 3.

Sole/First Applicant Second Applicant Third Applicant

27

Trigger Application/Cancellation Form (Please read the instructions carefully before filling up the form and use separate application form for each transaction) Use this form, if you wish to switch units from one scheme to another based on appreciation/stop-loss on your investment or on a specific date. Application Number

Folio Number (For existing Unitholders) D D

Date:

TRIGGER [Please tick (✓) the appropriate box]

Registration

M M

Y

Y

Y

Y

Cancellation

(In case of cancellation, the section ‘‘SWITCH TO’’ and ‘‘TRIGGER OPTIONS’’ need not be filled in) DETAILS OF TRANSACTION ON WHICH TRIGGER OPTIONS NEED TO BE EXERCISED/CANCELLED Mention the complete name of the scheme along with the plan. Please tick (✓) or fill the appropriate boxe(s) or column(s) SWITCH FROM (Name of the Scheme) P

R U D E

N

T

I

A

L

SWITCH TO (Name of the Scheme) I

C

I

C

I

P

R U D E

N T

I

A L

(Please leave one column blank between words)

(Please leave one column blank between words)

Options & sub-options

Options & sub-options

I

C

I

C

I

Cumulative/Growth

AEP-Regular* AEP-Appreciation

Monthly Quarterly

Half Yearly

Cumulative/Growth

AEP-Regular* AEP-Appreciation

Monthly Quarterly

Half Yearly

Dividend Payout

Daily

Fortnighly

Quarterly

Dividend Payout

Daily

Fortnighly

Quarterly

Dividend Reinvestment

Weekly

Monthly

Half Yearly

Dividend Reinvestment Weekly Monthly Half Yearly * Cumulative – AEP Regular Option : Encashment of Units is subject to declaration of dividend in the respective Scheme(s).

* Cumulative – AEP Regular Option : Encashment of Units is subject to declaration of dividend in the respective Scheme(s).

TRIGGER OPTIONS (In case of multiple triggers ticked, one whose condition is fulfilled first will be exercised and balance, if any, will be nullified) Switch the investment: Specific NAV Trigger: NAV Appreciation Trigger : On NAV (Switchout Scheme) reaching Rs. (Rupees in words ____________________________________________________ _______________________________________________________________________) per unit. NAV Stop-Loss Trigger : On NAV (Switchout Scheme) reaching Rs. ___ (Rupees in words ____________________________________________________ _______________________________________________________________________) per unit. (NAV per unit should be mention only in multiple of Re. 1)

Specific Date Trigger : On the day of

D D

M M

Y

Y

Y

Y

INSTRUCTIONS I / We have received, read and understood the offer document/key information memorandum. 1. Trigger will require folio number in case of existing investors or application form number in case of new investor. 2. Trigger facility will switch all the units in the above mentioned scheme within the respective Folio Number of the investor. 3. Entry and Exit loads for the scheme(s) shall be applicable as mentioned in the the relevant Offer Document(s)/Addendum(s). The same will also be applicable for SIP / STP / SWP. 4. Tigger facility is available in all the Schemes of Prudential ICICI Mutual Fund except SPIcE and Index Fund. 5. For the switch to happen the minimum purchase/redemption criteria should be met else the trigger will not be effected. 6. Trigger facility on each scheme will require a separate/independent Trigger request form to be filled. If an investor holds similar schemes in two folios, they will have to register separately for it mentioning the folio number.

7.

Target scheme, where units will be switched if option/sub-options are not selected, it will be switched to the default option (available under the Target Schemes). 8. Switch will be implemented on the day the trigger condition is satisfied. The Trigger is a one time operation and will cease once it is exercised. 9. Once switch is done exercising trigger option, the same will not be reversed whatsoever and it will be final and binding. 10. If trigger is not activated and/or implemented due to reasons, which are beyond the control of PruICICI AMC, the AMC would not be held responsible. Trigger facility is only a facility extended by the AMC for the convenience of the unit holders and does not form part of any scheme/fund objectives. 11. AMC reserves the right to amend/terminate this facility at any time, keeping in view business/ operational exigencies. I/We have read & understood and agree to abide by the terms and conditions and opt for the Trigger facility.

NAME(S) AND SIGNATURE(S) OF THE APPLICANT(S) SIGNATURE(S)

Name of the Sole/First Applicant Name of the Second Applicant Name of the Third Applicant

Sole/First Applicant Second Applicant Third Applicant

Prudential ICICI AMC Ltd. - ACKNOWLEDGEMENT SLIP (To be filled in by the investor) Folio / Application No. Received request for Trigger facility under Scheme

First Holder Name Plan

Option

switching into the Scheme ________________________________ Plan____________________ Option _________________________________________________________ In respect of Trigger Option (please ✓) NAV Appreciation Trigger : On NAV (Switchout Scheme) reaching Rs. _____________ NAV Stop-Loss Trigger : On NAV (Switchout Scheme) reaching Rs. _______________________ per unit switch the investment / Specific Date Trigger : On the day of D D M M Y Y Y Y

28

(Please retain this slip for all the future correspondence with Prudential ICICI MF in relevance to this Trigger.)

per unit switch the investment /

Signature, Stamp & Date