ANNEXURE Q
APPLICATION FOR CLOSING AN ACCOUNT
(For Beneficiary Account only)
To, DP Name: DP Address: DP ID :
Date
D
D
M
M
Y
Y
Y
Y
1. I / We hereby request you to close my/our account with you as per following details:
Name of the holder(s)
Sole/ First Holder
Second Holder
Third Holder
2. Reason/s for Closure of depository account: ___________________________________________________
3. Client ID (of account to be closed)
4. Please tick the applicable option(s)
Option A [There are no balances / holdings in this account ]
Option B
[Transfer the balances / holdings in this account as per details given]
Transfer to my / our own account
(Provide target account details and enclose Client Master Report of Target Account)
Transfer to any other account
(Submit duly filled Delivery
Instruction Slip signed by all
holders)
Target Account Details
NSDL
CDSL
DP ID
Client ID
Option C [Rematerialise / Reconvert (Submit duly filled Remat / Reconversion Request Form-for mutual fund units)]
5. Signature(s)
Sole / First Holder
Second Holder
Third Holder
= = = = = = = = == = = = = = = = == = = = = = = = == = = = = = = = == = = = = = = = == = = = = = = = == = = = = = = = Acknowledgement
We hereby acknowledge the receipt of the your request for closing the following Account subject to verification:
DP ID
Client ID
Name of Sole / First Holder
Name of Second Holder
Name of Third Holder
Signature of the Authorised Signatory
Date
Seal/ Stamp of Participant