Kotak Mahindra Bank

Closure of Savings / Current / Investment Account

I/We Account Number Credit to my/our other account number Send Demand Draft to my/our mailing address on record Collect Demand Draft at RTGS/NEFT Debit Card(s) No Unused Cheque(s) Sr. No. to Destroyed branch Enclosed located at hereby request you to close my/our branch and dispose the balance as follows:
(Kotak Bank Account only)

Please stop un-presented cheques as these will not be honoured after the account is closed. The Bank will not be liable / responsible for the return / dishonour of the same.

DEMAT ACCOUNTS linked to the above account for debit of service charges I/We are closing the account(s) separately Please link it to my/our other account number For maturity/interest payments on our TERM DEPOSITS, please Credit my/our other account number Pay by Demand Draft payable at ActivMoney (incorporate the details mentioned in RTGS Forms for Beneficiary details) Term Deposit All Term Deposit No.
(Kotak Bank Account only) (Kotak Bank Account only) (Kotak Bank Account only)

to my/our mailing address on record

and credit my/our Account No. Investment Account Close the following Accounts Account No.1 Signature should be as per the mode of operation Account No.2 Account No.3

Note: For closure of Investment Account, investments will continue with AMC and customer can approach AMC directly for future services Lockers (if applicable) Locker No Surrender Dr. charges to my/our new account OTHER INSTRUCTIONS GIVEN:
(Please furnish details e.g. Standing Instructions, etc.)

(Kotak Bank Account only)

The reason I wish to close my account (Please give a brief indication of the reason for closure)
(Please use the space on the backside of this form to furnish further details)

For any other Reason Signature(s)

Guardian in case of Minor

Account Holder

Account Holder

Account Holder

Date
Please Note: Phone Banking PIN, Net Banking PIN and Debit Cards issued to customers will be de-linked from the accounts closed above. In case the customer holds any other account in addition to the account being closed, he/she need not surrender/destroy the PINs, Debit Card as they will continue to be linked to any such accounts held by the customer as per original instructions.

RTGS / NEFT* Beneficiary A/c. Beneficiary Bank Name Beneficiary Branch Name Beneficiary Bank IFSC Code Beneficiary Bank A/c. Type

For Bank Use only (For all applicants) Cheque book collected/destroyed Debit card collected/destroyed Locker surrendered Debit card de-linked/Hotlisted Demat account closed If yes, holding in demat account nullified Memos checked and actioned Yes N.A. CD Limit zeroised Direct Debits/Standing Instructions Cancelled Net Banking Access Cancelled Mobile Banking Access Cancelled IVR Access Cancelled Account in TOD (CH001) (To Zeroise Account) BMs Signature Balance in the A/c Service Charges DD # Credit Account # UTR # Documents sent to CPC on Input Authoriser Net Amount Dated
(Enter closure code)

Yes

N.A.

Reasons for closure

For Bank Use only : Signature Verification Branch Stamp : Employee Code and Name :

Employee Signature :

Acknowledgement Slip We acknowledge the receipt of customer modification instruction type relating to customer relationship number Date: from Mr. /Mrs. / Ms under service request number Bank Official For Kotak Mahindra Bank Ltd., (Sign and stamp)