Sb- Closure Form - Axis Bank a433

CL OSURE FORM CLOSURE DATE :

SAVING NO:

I/WE

request you to close my/our savings /s at

branch.

Pay the proceeds by : Cash

Banker's Cheque /DD

Credit to

I/We confirm that all unused cheques issued to me /us have been enclosed/destroyed by me/us (No’s From I/we have enclosed /destroyed the following ATM/Debit Card/s issued to me/us:

To

)

Primary holder: Card Number t holder: Card Number It was our privilege to have you as our Customer. At AXIS Bank, it has been our constant endeavor to bring forth to the customer a range of products suiting his/her specific needs at a minimal cost with a strict adherence to quality standards. We sincerely appreciate if you could take a few moments of your precious time to fill up the following form. Reason for Closure of Reason Code

Reason

Please

01

Shifted to other location where there is no Axis Bank Branch

02

Opening the in some other Branch - Transfer of

03

Opening the in some different product scheme

04

Unhappy with service

05

Average Qaurterly Balance/Charges on the higher side

06

Dissatisfied with the present product offering

07

Other relationships with the Bank are closed

08

The holder is deceased

09

Forced/Centralized closure



Unhappy with service/product offering (please specify)

Others (please specify) Kindly provide us your address

Full Names & Signatures of All (in case of more applicants, please use an additional form) Primary Holder

Full Name

Signature

t Holder 1

Full Name

Signature

t Holder 2

Full Name

Signature

ACKNOWLEDGEMENT We acknowledge the receipt of request for closure of number on

in the name of

.

Name: Employee number:

(Signature of Branch Employee)

BANK USE ONLY Following have been destroyed: ATM/Debit Card No. Cheque Leaves from

to

Following have been delinked from the : Standing Instruction No. SIP No. OSC No. Demat No. Locker No. ECS transactions Credit card auto payment Branch Stamp with Date paid by:

The balance amount of Rs DD/PO No. Transferred to A/c No. Closure Charges, if any-Amount

Signature verified:

Approval (Branch Employee)

(Employee number)

(Branch Manager/Ops Head)