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Account Closure Form

This document is an account closure form for DBS Bank India Limited. It requests the bank to close listed account(s) and cancel any standing instructions or linked accounts. It provides details of the account number, customer name, and reason for closure. The customer confirms destroying their debit card and unused cheques. They select an option for repayment of the account balance, such as NEFT/RTGS transfer or issue of a pay order/demand draft. The customer agrees to terms including indemnifying the bank against dishonored cheques or instructions after closure. Signatures of all account holders are required.

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Dineshya G
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© © All Rights Reserved
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Download as PDF, TXT or read online on Scribd
482 views

Account Closure Form

This document is an account closure form for DBS Bank India Limited. It requests the bank to close listed account(s) and cancel any standing instructions or linked accounts. It provides details of the account number, customer name, and reason for closure. The customer confirms destroying their debit card and unused cheques. They select an option for repayment of the account balance, such as NEFT/RTGS transfer or issue of a pay order/demand draft. The customer agrees to terms including indemnifying the bank against dishonored cheques or instructions after closure. Signatures of all account holders are required.

Uploaded by

Dineshya G
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Account Closure Form

Date: D D M M Y Y Y Y
To,
DBS Bank India Limited
______________________ Branch
I/We authorise you to close the account(s) and cancel standing instructions /ECS/NECS (if any)/FD repayment/Investments POA linked to my/our account(s) listed
below. The balance in the account, after the recovery of any interest, tax or charges as applicable, is to be repaid to me/us as indicated below :

ACCOUNT DETAILS
Saving Account Number 1) 2) 3)

CIF ID

I / We confirm having destroyed my/our Debit Card & unused cheque. No cheques have been issued by me.
SECTION A
i) Reason for account closure :
Moved to non-DBS bank location/inconvenient bank location Inactive account / account not being used

Dissatisfied with account features Resigned from corporate (salary account)

Consolidating bank accounts within DBS Bank India Limited Customer Deceased

Unable to maintain minimum balance Service Charges / AQB related

Specific product facility no longer required Dissatisfied with Service (Branch / RM / Call Centre)

Location / convenience of branch / ATM not suitable Others __________________ (Please mention reason for closure)

SECTION B # : (Select anyone of the below)


The Balance in the account is to be repaid as follows :
1) Transfer vide NEFT / RTGS:
Customer(s) Name :
Account Number : Account Type : Resident NRE NRO
IFSC Code :
Bank & Branch Name :
2) Issue payorder / demand draft in favour of
3) Transfer to my DBS Account No.
4) Remittance : Kindly submit additional relevant forms / documents
TERMS AND CONDITIONS
I/We agree and understand that any cheques which have not been presented, ECS and Standing Instructions in the account received by the Bank after the date of account closure will stand dishonored by the
Bank and I/We agree to indemnify the Bank against any actions, proceedings, claims and/or demands that may arise due to reason of such dishonor.
I/We agree and confirm that I/We shall provide suitable amendment instructions to concerned asset management company, in case the account being closed above is a settlement account for wealth
management services availed of from the Bank.
I/We agree and understand that the Bank shall have a right of set off and general lien over the amount payable to me/us after closure of the aforesaid account and the Bank shall be entitled to recover any
outstanding amount including interest, charges, TDS and/or any other related charges.
IWe agree and accept that in case of my/our savings bank account/s mentioned above is/are dormant/inactive, the same will be activated to process the Account closure .
My existing savings account/s with the auto-saver facility will be closed and the relevant penal charges if any will be recovered from linked fixed deposit. (if applicable)

Signature Signature Signature


(as per bank records) (as per bank records) (as per bank records)

Name of 1st Account Holder Name of 2nd Account Holder Name of 3rd Account Holder

NOTE
1. All accountholders are required to sign this form and authenticate all corrections or amendments (If any) 2. A mandate holder cannot request for an account closure. 3. Account closed within six months of
opening will be charged as per the charges mentioned in the tariff schedule displayed in the branches and on the website. 4. For outward remittance on NRO / NRE accounts please submit the additional
remittances form. 5. For RTGS / NEFT please provide cancelled cheque. 6. Pay order / Demand Draft will be issued in all account holder name / or as per customer instruction. 7. # Third party transfer is not
allowed within DBS / NEFT / RTGS / DD / PO.

FOR BANK USE

Instruction received on D D MM Y Y Walk In Person/Representative Courier/Post RM/CSM others

Account closure only Account closure & Cif Suspension (*Check for Nil holdings) Cheque Book / Debit card destroyed

Signed by all A/c holder(s): Yes No Signature(s) Verified: Yes No A/c Balance Negative: Yes# No

A/c Lien @ Yes No Reason# @

A/c Closure Charges: less than 6 months recover charges less than 7 days no N.A

ATM / Debit cards: All linked if any, hotlisted : Yes *No Reason* ___________________________

NEFT / RTGS / PO All existing SI delinked Account closed CIF Suspended

Charges recovered (INR) : _______________Balance while closure (INR) __________________Interest credited after closure (INR) : ________________________

Total Amt Payable (INR) :_____________________________________________________________________ TRAN ID:_____________________ D.D. No.: _________________________

A/c closure Letter Despatched : Yes No DD/PO : Yes No (If no please specify reason)

RM CSM City Head /Branch Head Branch OPS CBO MAKER CBO CHECKER
Name

Sign

AC/001/MARCH 19

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