Mutual Fund Coversion Form
Mutual Fund Coversion Form
Mutual Fund Coversion Form
(To be filled by the BO. Please fill all the details in BLOCK LETTERS in English. Fill up a separate DRF for different combination of Names and for different
RTAs).
I/We request you to convert (Destatementize) the enclosed Mutual Fund Statement of Account [SoA] registered in my/our name into my/our demat
account:
DP ID 1 2 0 9 3 9 0 0 Client ID
►Attach an annexure (duly signed by account holder(s)) in the above format if the space is not sufficient.
► If all holdings in the Statement of Account are to be destatementized, then “ALL” should be mentioned in the Quantity column.
Declaration by BO(s): I/We hereby declare that the abovementioned MF units are registered in my/our name(s) and are not already
destatementized and no certificates issued against these MF units. I/We also hereby declare that the units requested by me/us for
conversion into destatementized form are free from any lien or charge or encumberance and represent the bonafide units of the Issuer to
the best of my/our knowledge and belief.
Signature with
DP
Signature with
RTA
Depository Participant Authorization (From DP to RTA) We have received the above-mentioned Statement of Account [SoA] for
conversion into Destatementized form. It is also certified that the holder(s) of the SoA have a beneficial account with us in the same
name(s) and order of name(s) as mentioned above.
______________________________________
Depository Participant Seal and Signature