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    Account Related Common Request Form

    Uploaded by

    Jephias
    Kotak Mahindra Bank provides a common request form for customers to submit various requests related to their accounts. The form allows customers to request services such as cheque books, account statements, certificates, stop payments, and address changes. It collects details of the customer's account and the specific request including required dates, cheque or transaction numbers, and reasons for the request. The bank uses the form to process customer requests subject to fulfilling all requirements and charges applicable service fees according to its schedule of charges.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Account Related Common Request Form

    Uploaded by

    Jephias
    381 views2 pages
    Kotak Mahindra Bank provides a common request form for customers to submit various requests related to their accounts. The form allows customers to request services such as cheque books, account statements, certificates, stop payments, and address changes. It collects details of the customer's account and the specific request including required dates, cheque or transaction numbers, and reasons for the request. The bank uses the form to process customer requests subject to fulfilling all requirements and charges applicable service fees according to its schedule of charges.

    Original Description:

    Kotak account related common request form

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    Kotak Mahindra Bank provides a common request form for customers to submit various requests related to their accounts. The form allows customers to request services such as cheque books, account statements, certificates, stop payments, and address changes. It collects details of the customer's account and the specific request including required dates, cheque or transaction numbers, and reasons for the request. The bank uses the form to process customer requests subject to fulfilling all requirements and charges applicable service fees according to its schedule of charges.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    381 views2 pages

    Account Related Common Request Form

    Uploaded by

    Jephias
    Kotak Mahindra Bank provides a common request form for customers to submit various requests related to their accounts. The form allows customers to request services such as cheque books, account statements, certificates, stop payments, and address changes. It collects details of the customer's account and the specific request including required dates, cheque or transaction numbers, and reasons for the request. The bank uses the form to process customer requests subject to fulfilling all requirements and charges applicable service fees according to its schedule of charges.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Kotak Mahindra Bank

    Common Request Form


    (Kindly fill the form in Capital Letters only)

    Siebel Request No.

    For Bank Use:


    Customer Account Type:
    Wealth Privy Resident Individual Non Individual Non Resident Individual
    CRN Corporate CRN Date D D MM Y Y Y Y
    CASA Account Number

    I/We

    Mr./ Ms. FIRST NAME MIDDLE NAME LAST NAME

    Mr./ Ms. FIRST NAME MIDDLE NAME LAST NAME

    request you to process the requests as per the details provided below.

    1. Account Related
    Cheque Book Issuance At-Par Number of Cheque books

    Statement for the period D D M M Y Y Y Y to D D MM Y Y Y Y Physical statement E-mail statement


    Passbook Related Requests Register & Issue Passbook Duplicate Passbook Issuance Cancel the Passbook Issuance
    Cheque book not received request placed through requisition slip/Call Centre/Internet Banking/ATM Dropbox on ___ / ____ / ______

    Bankers Verification Signature Photo Address Purpose

    Cancellation/Revalidation of Demand Draft / Banker’s Cheque Drawn on DD/BC No

    (Please enclose original demand draft/banker’s cheque) Dated Amount Favouring

    2. Certificate/Report Related

    Interest Certificate TD CASA For the period

    Balance Certificate TD CASA Both For the period

    Confidential Report Paid Cheque Report Credit Confirmation For the period Purpose

    3. Stop Payment

    Stop Payment Stop Payment for Cheque No. from to


    Value of Cheque Date of Cheque Payee Name

    Reason for Stop Payment


    4. Account Transaction Related

    Erroneous credit / debit in account:

    Cheque No. Date Amount

    Drawn on

    Details of Debit / Credit:

    Date of Txn Amount

    Payee details required:

    Cheque No. Date Amount

    Returned cheque not received


    received:

    Cheque No. Date Amount

    Drawn on deposited at

    Any Other Request

    Signature(s)

    1st Account Holder 2nd Account Holder 3rd Account Holder 4th Account Holder
    In case of Non-Individuals, please affix In case of Non-Individuals, please affix In case of Non-Individuals, please affix In case of Non-Individuals, please affix
    Company Seal Company Seal Company Seal Company Seal

    (For Individuals - at Account level changes, all the account holders need to sign whereas at CRN level changes, respective CRN holder has to sign. For
    Non-Individual, signatures as per MOP required.)
    Important:
    ● Requests will be processed subject to fulfillment of all requirements and information being complete.

    ● Terms and conditions and rules for services apply

    ● Service charges, if any, will be as per bank’s schedule of charges

    ● Please place a separate request if there is a change in correspondence address along with new address proof.

    For Bank Use only

    Date of Acceptance D D M M Y Y Y Y Sol ID

    Signature verified by Sign & Emp Code Receiver’s stamp

    Documents sent to CPC / RPC on D D M M Y Y Y Y Authorized by

    KMBL/Apr-2015/V 1.0
    Kotak Mahindra Bank Ltd. CIN: L65110MH1985PLC03813 Registered Office: 27 BKC, C 27, G Block, Bandra Kurla Complex, Bandra (E), Mumbai - 400 051. www.kotak.com

    Acknowledgement Slip

    We acknowledge the receipt of Customer Request / Complaint instruction from Mr. /Mrs. / Ms.

    relating to customer relationship number under service request number

    Date: Bank Official (Sign and stamp)


    For Kotak Mahindra Bank Ltd.,

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