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Change of Bank Details - Declaration Form: D M M Y Y D

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CHANGE OF BANK DETAILS - DECLARATION FORM

Date D D M M Y Y

To,
Axis Asset Management Limited
Axis House, First Floor, C-2, Wadia International Centre,
Pandurang Budhkar Marg, Worli, Mumbai - 400025, India.
Subject: Change of Bank Account Details

Reference: Folio Number


Dear Sir,

This has reference to the captioned subject. In this regard, I,

Amount in ` Vide cheque no.


Dated D D M M Y Y Y Y

Drawn on Bank in the


Scheme of Axis Mutual Fund and was allotted folio number
I now wish to update my bank account details as mentioned in the aforesaid folio due to – Bank Account Closed / Bank Account Number erroneously mentioned/Not mentioned.
In this regard, I would like to state that I have closed my bank account / inadvertently erroneously mentioned the bank account details, as mentioned herein below and presently
registered in your records / mentioned in the application form, and confirm that I am not holding any documents pertaining to the said bank account. (Leave the bank details blank
in case account number was not mentioned in the original application form).
Bank Account No. as per folio
Bank Name
Branch Address

In view of the aforesaid facts, I would like to hereby request you to update my bank account details, as mentioned herein below, in respect of my folio no.

New Bank Account No. Bank Name


Branch Address

I agree to furnish such other documents for effecting the aforesaid change of my bank account details, as may be required by you from time to time.
I hereby further agree to indemnify you and keep you fully indemnified, at all times, against any lossed, costs, charges, expenses, levies, penalties, etc. as may be imposed upon /
incurred by you on account of your acting on the aforesaid request for change in bank account details.

Thanking You,
Yours faithfully,

Name of the investor


Address of the investor
Phone number of the investor
Encl.: Original letter from the new banker of the investor, confirming his bank account, ID Proof and Proof of new bank as specified in the Addendum.
Signature

Sole/First Holder Second Holder Third Holder

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