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APPLICATION FOR CLOSING DEMAT ACCOUNT
(For Beneficiary Account only)
Date:
I/We hereby request you to close my/our account with you as per following details:
DP ID: Client ID:I N 3 0 0 44 8
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)]
1)
Reasons for closure of depository account (Please tick the reasons for closing the Demat Account)
Unsatisfactory services
Shifting to a new location where Axis Bank is not present
High Charges Others (Please specify)
Consolidation of Accounts
2)
I/We confirm to have surrendered all unutilized delivery instruction slips
I/We confirm to have exhausted / misplaced all delivery instruction slips
Confirmation for delivery instruction slips3)
Mode of payment for outstanding dues (if any)
Please debit my Axis Bank SB A/c No.
for recovery of my pending dues against my demat account.
Signatures(s) (as per the Bank A/c)
(Second Holder) (Third Holder)(First/Sole Holder)
Signature
(with seal of the branch)
4)
Instructions: 1. Relevant portions to be filled in. 2. Please strike off as N.A. whatever is not applicable. To be submitted in duplicate.
Cash Payment
Name(s) (as per the Demat A/c) Signatures(s) (as per the Demat A/c)
(Sole/First Holder)
(Second Holder)
(Third Holder)
Name of the beneficiary owner(s) match with the DP system.
Signature(s) of the beneficiary owner(s) match with the DP system.
Copy of PAN Card / Proof of Identity / Proof of Address collected for suspended Demat Account
(if applicable).
No holding exists in the Demat Account / in case of holding target Demat Account Details mentioned
on the Demat Account closure request.
All pending dues have been recovered by:-
Checklist
(To be filled in by Axis Bank Officials)
Direct debit
Bank a/c no debited
Transaction ID Date:
Cash Payment
Transaction ID Date:
Bank a/c no credited
I confirm having checked all the below mentioned points for the
Signature
(with seal of the branch)
Date:
Name of the official
Employee Number
Sol ID
Client ID:

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Demat closure-form-16

  • 1. APPLICATION FOR CLOSING DEMAT ACCOUNT (For Beneficiary Account only) Date: I/We hereby request you to close my/our account with you as per following details: DP ID: Client ID:I N 3 0 0 44 8 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)] 1) Reasons for closure of depository account (Please tick the reasons for closing the Demat Account) Unsatisfactory services Shifting to a new location where Axis Bank is not present High Charges Others (Please specify) Consolidation of Accounts 2) I/We confirm to have surrendered all unutilized delivery instruction slips I/We confirm to have exhausted / misplaced all delivery instruction slips Confirmation for delivery instruction slips3) Mode of payment for outstanding dues (if any) Please debit my Axis Bank SB A/c No. for recovery of my pending dues against my demat account. Signatures(s) (as per the Bank A/c) (Second Holder) (Third Holder)(First/Sole Holder) Signature (with seal of the branch) 4) Instructions: 1. Relevant portions to be filled in. 2. Please strike off as N.A. whatever is not applicable. To be submitted in duplicate. Cash Payment Name(s) (as per the Demat A/c) Signatures(s) (as per the Demat A/c) (Sole/First Holder) (Second Holder) (Third Holder)
  • 2. Name of the beneficiary owner(s) match with the DP system. Signature(s) of the beneficiary owner(s) match with the DP system. Copy of PAN Card / Proof of Identity / Proof of Address collected for suspended Demat Account (if applicable). No holding exists in the Demat Account / in case of holding target Demat Account Details mentioned on the Demat Account closure request. All pending dues have been recovered by:- Checklist (To be filled in by Axis Bank Officials) Direct debit Bank a/c no debited Transaction ID Date: Cash Payment Transaction ID Date: Bank a/c no credited I confirm having checked all the below mentioned points for the Signature (with seal of the branch) Date: Name of the official Employee Number Sol ID Client ID: