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DISTRIBUTOR EMPANELMENT FORM

1 KEY CONTACT DETAILS (Please fill in Block Letters)

   
Reg.No:
Passed On Valid Upto
Name (Mr / Mrs / Ms / M/s) Email:
Address For Communication Address2
Address3 State
City Pin
Telephone No. Telephone No.(2)
Mobile No Fax
Status

2.KYD DETAILS

Date of KYD Letter  

3.BANK ACCOUNT DETAILS FOR BROKERAGE / OTHER PAYMENTS*

Bank Name Branch
City MICR Code
A/c. No. NEFT/IFSC Code
Account Type:    

4.ADDITIONAL INFORMATION

Individual PAN Corporate PAN
Date of Birth Date of Incorporation
Educational Qualification    

5.BUSINESS DETAILS (Change in Authorised Person shall be communicated to Principal Mutual Fund)

No.of Investors    
Funds Mobilised In MF
Cumulative to Date(in Rupees) Last one year(in Rupees)
Breakup of amount procured: Equity(%) Debt(%)
Expected Business in Current FY for Principal MF (in Rupees):    
Experience in Selling :
Insurance(in Rupees): Fixed Deposits(in Rupees):
IPOs(in Rupees): Bonds(in Rupees):
Others(in Rupees):    

6.DISTRIBUTOR DUE DILIGENCE

       
a.Whether the Distributor has raised AUM over Rs. 100 crore across the Mutual Fund industry in the non institutional category (retail) including high net worth individuals (HNIs).   
b.Whether the Distributor has received Commission of over Rs.1 crore p.a across the Mutual Fund industry. (To check if this condition was satisfied during the last financial year).   
c. Whether the IFA or Distributor has received over Rs. 50 lacs towards Commission from a single Mutual Fund. (To check if this condition was satisfied during the last financial year)   

7.ANY AWARDS / ACHIEVEMENTS

8.DECLARATION

I/We hereby declare that the information furnished herein is complete and correct in all respects. I/We undertake to abide by (a) such guidelines, code of conduct and other circulars etc. issued by SEBI and/or AMFI that may be applicable to me/us, and (b) the terms and conditions stated overleaf as amended from time to time. I/We further confirm that I/We (including our directors/employees/officers/partners) am/are not an employee of Principal Pnb Asset Management Company Pvt. Ltd. [AMC] nor a relative of any Director/Employee of the AMC/Sponsor or any of its associates [hereinafter referred as Related Person], apart from the ones mentioned below:

9.NOMINATION DETAILS FOR BROKERAGE / COMMISSION (Incase of Individual Agents Only):

I hereby nominate the person named below to receive the amounts of brokerage to my credit in the event of my death.
Nominee Name Date of Birth(If Minor):
Guardian's Name(Incase of Minor): Relationship:
*Address of Nominee/Guardian State
City Pin

10.TERMS AND CONDITIONS:

I Accept the Terms&Condition.   Click here for terms&conditions