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Application For Closure of Demat Account (NSDL/CDSL) : Ddmmyyyy

This document is an application form for closing a dematerialized (demat) account with ICICI Bank Limited. It provides instructions for account holders to select an option for transferring any balances or holdings to another account or rematerializing mutual fund units. The form requires information such as the demat account number, holder names and signatures. It also asks the applicant to select a reason for closure from options like moving locations, unsatisfactory services or stopping trading.

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P Venu Gopala Rao
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© © All Rights Reserved
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Download as PDF, TXT or read online on Scribd
206 views

Application For Closure of Demat Account (NSDL/CDSL) : Ddmmyyyy

This document is an application form for closing a dematerialized (demat) account with ICICI Bank Limited. It provides instructions for account holders to select an option for transferring any balances or holdings to another account or rematerializing mutual fund units. The form requires information such as the demat account number, holder names and signatures. It also asks the applicant to select a reason for closure from options like moving locations, unsatisfactory services or stopping trading.

Uploaded by

P Venu Gopala Rao
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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ICICI Bank Limited, CPC-Demat Services, Ground Floor, B-Wing, Autumn Estate, Chandivali Farm Road, Opp.

Mhada Colony, Chandivali, Andheri (East), Mumbai - 400072.


(Important Note : Please do not send requests directly to this address. Kindly route all your requests through the nearest ICICI Bank Demat Servicing Branches)
Application for Closure of Demat Account (NSDL/CDSL)

Date D D M M Y Y Y Y DP ID Client ID (of account to be closed)

I / We hereby request you to close my / our Demat account with you as per following details:

Sole/First Holder

Second Holder

Third Holder

* Please tick the applicable option(s): (*Marked is a Mandatory field )

Option A (There are no balances / holdings in this account)

Option B Target Account Details


(Transfer the Transfer to my / our own account
balances / (Provide target account details and NSDL DP ID
holdings in enclose Client Master Report of Target
this account as Account)
per details given) CDSL
Transfer to any other account (Submit
duly filled Delivery Instruction Slip Client
signed by all holders) ID

Option C [Rematerialise / Reconvert (Submit duly filled Remat / Reconversion Request Form - For Mutual Fund units)]

* Please tick the reason for closing the Demat Account: (*Marked is a Mandatory field )
Moving to new area/abroad where ICICI Bank does not have a branch Unsatisfactory services
High demat charges Stopped trading forever
Consolidation of accounts Others (Please specify)

Recovery of dues

Direct Debit
Please debit my ICICI Bank Account(A/c No. for recovery of any pending dues against
my account

Cheque Payment
Cheque Number............................................................... drawn on Bank...........................................................................................................

Cash Payment

DECLARATION: In case of Account Closure due to Shifting of Account:


I/We declare and confirm that all the transactions in my/our Demat Account are true/authentic.
V - Dec 2017

SIGNATURE OF SOLE/FIRST HOLDER SIGNATURE OF SECOND HOLDER SIGNATURE OF THIRD HOLDER

Acknowledgement
We hereby acknowledge the receipt of the your request for closing the below mentioned Demat Account subject to verification:

DP ID Client ID

Demat Account Holder’s Name

Received by

Bank Official Signature Branch SR No

Date D D M M Y Y Y Y

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