P
W Prakala Wealth Management Private Limited
M Wealth Managers To The World
Registered Office: First Floor • 2/102, Third Street • Karpagam Avenue • R.A. Puram • Chennai – 600 028 •
Tel: (044) 4202-0942/ 4207-3710 • E-mail: PrakalaWealth@[Link] Mobile /Whatsapp
-8939117522/9962605666
Dear Investor,
Please provide us the following details to enable us filling your mutual fund application:
1. Name of the Investor:
2. Date of Birth:
3. Address for Communication:
4. Mother Name:
5. Overseas Address in Case of NRIs:
6. Telephone No.: Indian Mobile No.:
Foreign Mobile No:
7. E-mail:
8. Name & Relationship of the Nominee:
9. DOB of Nominee:
10. Address of the Nominee (if different from that of the applicant):
11. Bank details: We will take it from the cheque (if it is your own cheque) provided by you. If not, please
give the following details separately: IFSC Code, MICR Code, Account Number, & Branch Contact
Details.
12. Preferred SIP Date (write the preferred week (1 st, 2nd, 3rd, 4th)/ date):
13. Name as in bank records:
[Link]
P
W Prakala Wealth Management Private Limited
M Wealth Managers To The World
Registered Office: First Floor • 2/102, Third Street • Karpagam Avenue • R.A. Puram • Chennai – 600 028 •
Tel: (044) 4202-0942/ 4207-3710 • E-mail: PrakalaWealth@[Link] Mobile /Whatsapp
-8939117522/9962605666
14. Annual Income:
15. PAN #:
16. Place of Birth:
17. Country of Birth:
18. Tax Identification Number ( If NRI):
19. In case of NRI please provide Indian Mobile Number:
[Link]