Reliance Income Fund

Sale of Units at applicable NAV based price.

For Office Use Market Status An open-ended Income Scheme

Trade World, ‘B’ Wing, 7th floor, Kamala Mills Compound, S. B. Marg, Lower Parel (W), Mumbai - 400 013.

ARN - 4724

ARN - 4724

ARN-0155

54934

APPLICANT DETAILS

TO BE FILLED IN CAPITAL LETTERS. Pl. use one box for each letter, leaving one box blank between two words

UNIQUE IDENTIFICATION NO. (UIN) Under MAPIN Database (for Corporate Investors)

(For existing unitholders )

EXISTING FOLIO NO.

Name of Sole / 1st applicant/Minor/Karta of HUF/Non-individual Mr. / Mrs. / Miss / Mst / M/s.

Date of Birth D

Name of Parent/ Guardian In case of Minor Mr. / Mrs. / Miss

D

Name of 2nd applicant Mr. / Mrs. / Miss

M

M

Y

Y

PAN / GIR No. *

Ward /Circle/Dist

1st applicant

D

D

D

D

M

M

Y

Y

Y

Y

M

M

Y

Y

Y

Y

Date of Birth

* Compulsory for Investment amouting to Rs. 50,000 & above

2nd applicant 3rd applicant CONTACT DETAILS

City

Office

Residence

*NRI s are requested to furnish their Indian address in this section

District

PIN

State

Foreign Address in respect of NRI / FII applicants

City

Country

ZIP

Contact Person for Non-Individual applicants

Tel. No. STD Code

Office

Mobile No.

Residence

Fax

E-mail Id.

An open-ended Income Scheme Trade World, ‘B’ Wing, 7th floor, Kamala Mills Compound, S. B. Marg, Lower Parel (W), Mumbai - 400 013. SCHEME : PLAN :

Y

Date of Birth

Name of 3rd applicant Mr. / Mrs. / Miss

Indian Address* for Correspondence :

Y

OPTION : (Please mention the scheme Name, Plan & Option in Bold Capital Letters. Please refer to Scheme Details.) Amt. In Rs. Cheque / DD No. Date

Received from:

57 Amt. In Words Pin Code

Signature & Stamp

Bank Branch

BANK ACCOUNT DETAILS (Please Refer Instruction 6) Account Type

Bank Name Branch

SB

Current

NRO

NRE

Account No.

Branch Address

PIN

9 Digit MICR Code

SUBSCRIPTION DETAILS SCHEME : PLAN : #

OPTION : (Please mention the scheme Name, Plan & Option in Bold Capital Letters. Please refer to Scheme Details.) # Credited to my bank directly* / through ECS *Facility available with HDFC Bank & ICICI Bank Cheque to address Amount Invested Rs.

DD Commission (if any) Rs.

Net Cheque / DD Amount Rs.

Cheque / DD No.

Please attach Bank Advice / Documentary proof for DD Comm.

Cheque Date

Cheque/DD Amt. In Words Drawn on Bank

Account Type

Branch

Payable at

(Account Type to be furnished by NRI/FII Applicants) SB Current NRO NRE FCNR

E-MAIL & OTHER OPTIONS I / We wish to receive the following through e-mail instead of physical document : Account Statement

I/We would like to apply for : I-Pin for Internet based facilities through www.reliancemutual.com

Quarterly Newsletter / Fact-sheets

Recurring Investment Plan Recurring Withdrawal Plan Systematic Transfer Plan

T-Pin for Call center facilities

Annual Report

I would like to join :

Trigger Option Please

Dispatch

email

the relevant form to me/us

NOMINATION Nominee's Name : Mr. / Mrs. / Miss /Mst.

Date of Birth D

Guardian (In case of Minor Nominee)

D

M

M

Y

Y

Y

Y

Address of Nominee /Guardian

City

PIN

DECLARATION & SIGNATURE/S (refer instruction 11)

SIGNATURE/S

I/We would like to invest in Reliance .......................................................... subject to terms of the Offer Document and subsequent amendments thereto. I/We have read the instructions and the Offer Document before filling the Application Form. 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.

APPLICABLE TO NRIs ONLY: I/We confirm that I am/We are Non-Resident of Indian Nationality/Origin and I/We hereby confirm that the funds for subscription have been remitted from abroad through normal banking channels or from funds in my/our Non-Resident External / OrdinaryAccount/FCNR Account. Place :

Specimen Signature of Nominee/Minor Nominee's Guardian (OPTIONAL)

Sole/ 1st applicant/ Guardian Authorised Signatory

2nd applicant / Authorised Signatory

3rd applicant Authorised Signatory

Date:

CHECKLIST Have you filled up the application form in all respects? Have all the applicants / signatories signed the application form? Is the amount mentioned is matching with cheque/DD amount? Have you furnished the Bank details / direct credit information correctly? Have you filled up Scheme/Plan opted ? Have you furnished the PAN No./ Details (for investment of Rs. 50,000 & above)

Have you filled up Guardian's name & date of birth of minor (for Investment on behalf of minor) Have you furnished your E-Mail Id & contact tel. Nos.? Have you mentioned Scheme Name on the Cheque & signed the cheque ? Is the amount matching with application form? Have you put the current date on the cheque ?

58 Have you attached the supporting documents ? (For Power of Attorney Applicants & Non Individual investors)

INSTRUCTIONS 1.

Please read the Key Information Memorandum and the Offer Document carefully before investing. Applicants are deemed to have read, understood and accepted the terms subject to which this offer is being made and bind themselves to the terms upon signing the Application Form and tendering payment.

7.

As per SEBI guidelines, it is mandatory to provide the Applicant’s PAN/GIR No. and the I.T. Circle/Ward/District, if the amount invested is Rs.50,000/- or more. The application form will not be accepted in the absence of same . In case the PAN has been applied for and not yet allotted, please write “Applied for / Not allotted’’. In case of non assessees, please mention “Not an Assessee”.

2.

Please submit separate application & cheque for each Scheme.

8.

3.

The Applicants’ name and address must be given in full (P.O. Box No. alone is not sufficient).

As per the SEBI guidelines, it is mandatory for investors to mention their bank account details in the application form. In the absence of the bank details the application form will not be accepted.

4.

In case of non-individual applicants, i.e. HUF / Companies / AOP / BOI / Trusts / Societies / FIIs etc. the name and telephone number of the contact person to whom the correspondence should be addressed to is to be provided.

9.

Please mention the application serial no. on the reverse of the cheque/demand draft tendered with the application.

5.

In case of applications made under Power of Attorney, the original Power of Attorney or a duly certified copy thereof duly notarised should be submitted with the application.

6.

In case of applications made by a Limited Company or by a Body Corporate or a registered society or a trust, a copy of the relevant resolution or authority to make the application, as the case may be, alongwith a certified copy of the Memorandum and Articles of Association or Trust Deed / Bye Laws, whichever is applicable, must be lodged along with the application form or within 10 days of submission of the application form at any of the designated centres of Reliance Mutual Fund or Karvy Computershare Pvt. Ltd. In case, such documents are not received by the Registrars within the prescribed time, the AMC reserves the right to act as deemed fit on a case to case basis. Applications from NRI/PIO/FII must be accompanied with Foreign Inward Remittance Certificate (FIRC) / Bankers Certificate certifying that the funds towards payment have been drawn out of funds held in their NRE / NRSR / FCNR Accounts, if the payment is made by way of Pay Order / DD.

10. Cheques/DDs payable locally, crossed and marked “Account payee” should be drawn in favour of “Reliance Income Fund” as the case may be. Out station cheques or cash will not be accepted. 11. Individual applicant/s can avail of nomination facility by nominating a person to receive the proceeds upon the death of the unitholder(s). However persons applying on behalf of a minor or on Power of Attorney cannot nominate. 12. Signatures can be in English or in any other Indian language. Thumb impressions must be attested by a Judicial Magistrate/Notary Public under his/her official seal. In case of HUF, the Karta should sign on behalf of the HUF. 13. In case of NRI/FII investors the Account Statements/Redemption Cheques / Dividend warrants / Other correspondence will be sent to the Indian address. 14. Investors requiring documents to be sent to them through email need to indicate such option by ticking the relevant box. 15. Application along with cheque / DD / Pay order can be submited at the official collection centres of Reliance Mutual Fund or Karvy Computershare Pvt. Ltd.

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DESIGNATED INVESTOR SERVICE CENTRES Reliance Capital Asset Management Limited CORPORATE OFFICE: Kamala Mills Compound, Trade World, ‘B’ Wing, 7th Floor, Senapati Bapat Marg, Lower Parel (W), Mumbai - 400 013. AHMEDABAD: 107, 1st Floor, Abhijit-I, Mithakhali Six Roads, Navrangpura, Ahmedabad - 380 009. BARODA: 501, Arundeep Complex, Near Race Course Circle (South), Baroda - 390 007. BANGALORE: S 201, Manipal Centre, Dickenson Road, Bangalore - 560 042. CHANDIGARH: SCO-127/128, 1st Floor, Sector 9/C, Chandigarh - 160017.. CHENNAI: ACE Tower, 2nd Floor, No. 75, Dr. Radhakrishnan Salai, Mylapore, Chennai - 600 004 COIMBATORE: 575 C, Shylaja Complex, D.B. Road, R.S. Puram, Coimbatore - 641 002. GOA: Shop No.1, Ground Floor, Rayu Chambers, Dr. Atmaram Borkar Road, Panjim, Goa - 403 001.

HYDERABAD: Unit No.7, 6-3-1093, 6th Floor, V V Vintage Boulevard, Above Food World, Rajbhavan Road, Hyderabad - 500082 INDORE: 216, Starlit Tower, 29/1, Y. N. Road, Opp. State Bank of Indore - Head Office, Indore - 452 009. JAIPUR: Office No. 334, 3rd Floor, Ganapati Plaza, M I Road, Jaipur - 302 016, Rajasthan.

LUDHIANA: SCO-122, 1st Floor, Feroze Gandhi Market, (Behind Ludhiana Stock Exchange Building), Ludhiana 141001.. MUMBAI: Mittal Chambers, 228, Ground Floor, Nariman Point, Mumbai - 400 021. NEW DELHI: Office No. 405, 4th Floor, Ashoka Estate, 24 Barakhamba Road, New Delhi - 110 001.

JAMNAGAR: Shop No. 4-5, Ground Floor, “Shilp” Building, Indira Gandhi Marg, Jamnagar - 361 001.

NAGPUR: Office # 2, 3rd Floor, A Block,Poonam Chambers, Chhinchwara Road, Byramji Town, Nagpur - 440 013.

KANPUR: Unit No. 717, 7th Floor, Krishna Tower, 15/63, Civil Lines, Kanpur - 208 002.

NASIK: G-18, Ground Floor, Suyojit Sankul, Sharanpur Road, Nasik-422 002.

KOLKATA: Reliance House, 5th Floor, 34 Jawaharlal Nehru Road, Kolkata - 700 071.

PUNE: 105 & 106, First Floor, ‘Winners Window’, F.C. Road, 1218/2A, Behind Vaishali Restaurant Shivaji Nagar, Pune - 411 004.

KOCHI : 2nd Floor, Thekkekkara Mansion, Opp. Kavitha Theatre, M. G. Road, Kochi - 682 035. LUCKNOW: 11-A, Ground Floor, Saran Chambers II, No.5, Park Road, Lucknow - 226001.

SURAT: 414, 4th Floor, Vishvakarma Arcade, Majura Gate, Ring Road, Surat - 395001.

Karvy Computershare Private Limited Agra l Ahmedabad l Ajmer l Allahabad l Amritsar l Bangalore l Baroda l Bharuch l Bhavnagar l Bhubaneswar l Chandigarh l Chennai l Cochin l Coimbatore l Dehradun l Dharwad l Durgapur l Erode l Goa l Guntur l Guwahati l Hubli l Hyderabad l Indore l Jaipur l Jalandhar l Jalgaon l Jamshedpur l Kanpur l Karaikudi l Kolkata l Kota l Lucknow l Ludhiana l Mangalore l Meerut l Moradabad l Mumbai l Mysore l Nagpur l Nasik l New Delhi l Patna l Pondicherry l Pune l Raipur l Rajahmundry l Rajkot l Ranchi l Salem l Siliguri l Surat l Tirunelveli l Tirupur Trichy l Varanasi l Vijayawada

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Call : 30301111 www.reliancemutual.com