The document is a form for a UTI Mutual Fund unitholder to change their address and contact details in their folio. It requests the unitholder provide their folio number, old address, new address, and proofs of new address, old address, and identity. The unitholder must declare and sign the form, and submit copies of the address and identity proofs along with the original documents for verification.

1. To:
UTI Mutual Fund
A Unitholder’s information:
1. Folio Number :
2. Name of the sole / first holder
3. Scheme / Plan / Option
I/ We have changed the address from _______________________ (month and year) and wish to change the address/ contact details
in my / our folio as mentioned below :
Old Address recorded with UTI Mutual Fund in the above folio
City : Pin
State: Country:
New Address
City : Pin
State: Country:
I enclose herewith self attested copies of the following documents as listed at ‘B’, ‘C’ and ‘D’ below, the original documents for the same
are produced for verification at the time of submission.
B. PROOF OF NEW ADDRESS (any one) : (Please tick against the said box)
 Landline Telephone bill (MTNL/BSNL)  Electricity Bill  Aadhar Card  Ration Card  Voter Identification Card  Passport Bank Passbook or Statement
 Property Tax Receipt  Demat Account Statement  Quarter Allotment letter issued by Public Undertaking or Schedule Commercial Bank.
C. PROOF OF OLD ADDRESS (any one) : (Please tick against the said box)
 Landline Telephone bill (MTNL/BSNL)  Electricity Bill  Aadhar Card  Ration Card  Voter Identification Card  Passport Bank Passbook or Statement
 Property Tax Receipt  Demat Account Statement  Quarter Allotment letter issued by Public Undertaking or Schedule Commercial Bank.
D. PROOF OF IDENTITY : (any one) : (Please tick against the said box)
 PAN Card  Passport  Aadhar Card  Photo Ration Card  Voter Identity card  Driving License  Photo Debit Card
 Govt. or Defence identification card.
E. Please update my following details also:-
Mobile No PAN Please attach PAN Card Copy
Email ID
DECLARATION AND SIGNATURE OF UNITHOLDER/S (To be signed as per the mode of holding)
I/we have read and understood the guidelines printed on the reverse of this Form and agree to abide by the same.
Sole/First Unit holder Second Unit holder Third Unit holder
UTI Mutual Fund - Acknowledgement for form for change in address – (to be filled in by the investor)
Received, subject to verification, form for change in address
from Mr/ Mrs/ Ms : _______________________________________________________________
Folio No : _______________________________________________________________________
 
Receiving UFC/ Registrar’s official stamp
with date and signature
Form for change in address/ contact details
(Applicable to Non-KYC complied Individual Investors only)
Please fill in the information below legibly in English and in Capital Letters
Registrar: Karvy Computershare Pvt. Ltd., Unit: UTI Mutual Fund, Narayani Mansion, H.No.1-90-2/10/E, Vittalrao Nagar, Madhapur, Hyderabad - 500 081 • E-mail: uti@karvy.com
Date:
d d m m y y y y

2. Guidelines
1. This form is applicable for NON KYC complied Individual Investors.
2. However, all investors are encouraged to get KYC process completed in order to get them ready for invest in future.
3. Investors who are KYC complied and wish to change their address, are requested to fill up the “KYC Details Change
Form” and submit to any of our UTI Financial Centre. Post updation of address by the KYC Registration Agency (KRA),
the same will be reflected in our records.
4. In order to protect the interest of the investors, following documents are requested for Changing the address:
A] Proof of New address (Please refer to Para B of the Form on the reverse)
B] Proof of Old/currently registered address (Please refer to Para C of the Form on the reverse)
C] Proof of identity (Please refer to Para D of the Form on the reverse)
5. Please carry the original documents of the copies you wish to submit towards the proof. The original will be returned to
you after verification, across the counter.
6. Please fill in the Form in CAPITAL LETTERS.
7. Please inform us the change of address within 30 days from the date of change and in any case atleast 10 working days
prior to contemplated redemption request, if any.
8. If you are KYC complied, in order to change your address, please contact the Point of Service of SEBI registered KYC
Registration Agency.
9. The change of address will be processed subject to verification of signature and subject to receipt of all the required
documents.
10. In case of any assistance, please contact nearest UTI Financial centre.
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