account closure form citi bank
DESCRIPTION
Account Closure Form citi bankTRANSCRIPT
Name :
ACCOUNT CLOSURE REQUEST FORM
Date: D D M M Y Y Y Y
Please Note: (i) All accounts linked to the above account such as EEFC/FCY accounts for Current Accounts; Employee Reimbursement Account(ERA), Deposits and Junior a ccounts for Savings Accounts lso be closed., DEMAT and DMF Accounts will a
(ii) If the above account has a linked DEMAT/DMF account, please ensure that all holdings in the DEMAT/DMF account are zeroised before applying for account closure.
(iii) For NR accounts: In case of closure of a Term Deposits, the indicated deposit will be pre-liquidated.
I/We understand, agree and acknowledge that Citibank shall act solely on the basis of my/our instructions without any responsibility and liability upon the Bank. I/We further declare that I/We have already destroyed all cheque leaves and related card pertaining to above account.
CUSTOMER SIGNATURE (To be signed by all account-holders):
stSignature (1 Account Holder) ndSignature (2 Account Holder) rdSignature (3 Account Holder)
*Cannot be made to third-party accounts
Line 1 :
Line 2 :
City :
State : Country :
c By Demand Draft
Purpose of closure :
Branch :Account Number :
ACCOUNT DETAILS
DESIRED MODE OF RECEIPT* OF THE BALANCE AMOUNT (Please fill in the details for any of the options given below, as applicable, and strike out the rest)
c To another bank account by electronic transfer/Foreign Currency Telegraphic Transfer
Branch/City :Bank Name :
Name of account holder :
City :Citibank Account :
c To another Citibank account in India
Name of account holder :
Other bank account no.Reconfirm Account No.
: :
Account Type : # c Current Account c Savings Account (Resident) c NRE c NRO c FCNR
#Company accounts should be accompanied by a Board Resolution.
IFSC/SWIFT Code :
RECIPIENT ADDRESS DETAILS(Required only for Foreign Currency Telegraphic Transfers or Demand Drafts to be dispatched to “Other Address”. Please strike out this section if not applicable)
Currency : USD EURO GBP SGD CAD AUD c� c� �c� c� c� c� (This is applicable only for NRE accounts and FCNR deposits for Foreign currency telegraphic transfers or demand drafts. All other transfers will be in INR.)
c Mailing c Non-Mailing c Other AddressAddress for dispatch :
PIN/ZIP : Contact Number :Country Code Area Code
Signature verified by : Emp. ID: _____________Signature: __________________Name:________________________
ID Number: _________________ID Type:__________________________
Instruction received by : c In Personc Mail/Representative
c Yes c NoComplete set of originals received :
FOR BANK USE ONLY
Signature: __________________ Emp. ID: _____________Name:________________________(2)
Customer met in person by : Signature: __________________ Emp. ID: _____________Name:________________________(1)
Account Type : c Savings Account c Current AccountAccount Category
c NRE c NRO c Resident:
CV
/BA
N/A
CF/
Ver
1.0/0
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