Account Closure and Term Deposit Premature Withdrawal Form

ACCOUNT CLOSURE/ FIXED DEPOSIT
PREMATURE WITHDRAWAL FORM

A/c No: Date: D D M M Y Y Y Y
1. Please ll the details in CAPITAL LETTERS 2. Please strike-oﬀ as NA for details which are not applicable
I/We request you to close my / our Savings / Current Account:

N A M E O F F I R S T H O L D E R
N A M E O F S E C O N D H O L D E R
N A M E O F T H I R D H O L D E R
*If there are more than 3 holders then please ll up the additional form
CURRENT ACCOUNT / SAVINGS ACCOUNT CLOSURE

I understand that at the time of Account Closure:
• Access to all channels linked to this Account will be disabled. • I/We shall be responsible for amending all the ECS/Auto debit mandates
• All the Standing Instructions in this Account will be cancelled. linked to this Account.
• I/We have surrendered/destroyed ATM/Debit Card associated with this Account. • I have surrendered unused cheque leaves. All the used/unused/not paid/
All ATM/Debit Card(s) linked to this Account will be cancelled. post-dated cheques which are surrendered/not surrendered will be treated
• Closure proceeds shall be the amount that is left over after deduction of as cancelled/destroyed.
Account Closure charges as applicable. • For lockers linked to this Account, I con rm that I have surrendered my locker/s
• My existing Sweep In Accounts along with the Savings/ Current Account linked to this Account.
will be closed and the relevant penal charges will be applicable on the • For Dormant/Inactive Accounts: In case my Savings Bank Account/ mentioned
Sweep In Deposits on closure of Account. above is/are dormant/inactive, the same will be activated to process the
Account Closure request.
Pay the proceeds by

(As per current Income Tax rules, if the Account Balance at the time of account closure exceeds ` 20,000/- the payment
By Cash will not be made through cash)
By Demand Draft
Credit to another Bank Account Credit to Induslnd Bank Account

Bene ciary Account No.: Bene ciary Account No.:
Bene ciary Bank Name & Branch:
Bene ciary IFSC Code:

Bene ciary Bank Address:
Reason for Account Closure:

1. Branch / ATM of other Bank is suitably located 8. Consolidating Bank Account within IndusInd Bank
2. Product features not suitable 9. Consolidating Bank Account - other Bank
3. Service Issues 10. Account wrongly opened (Incorrect Name, product, branch etc.)
4. Corporate Salary Account - Employer changed 11. Change of residential status

5. Service Charges / AMB related 12. Legal / Regulatory reasons
6. Transferred to other city 13. New Account: KYC / IP Funding reasons
7. Business shut down / closed (please specify)
14. Others________________________________________________
Page 1
FIXED DEPOSIT PREMATURE CLOSURE
Fixed Deposit No.: Full Closure Partial Closure#
#
Please specify amount
Maturity Proceeds: Credit to Induslnd Bank Account Other
Name of the Bank:
Account No.: IFSC Code:
I hereby authorise IndusInd Bank Ltd., to execute the

above mentioned requests and update all records (In case of (In case of
Current Account, Current Account,
linked to my IndusInd Bank Account. I have read all rubber stamp Signature of 1st holder rubber stamp Signature of 2nd holder
Terms and Conditions applicable and understood the required) required)
Schedule of Charges (SOC) at www.indusind.com
FOR BANK USE ONLY

Branch Employee Name :
Customer Segment : Pioneer Exclusive Other
AMB for last 3 months : Month 1______________________
Month 2______________________
Month 3______________________
Account Closure Approved by

ECN & Name :
Balance in Account : ___________________________
Account Cosure proceeds paid : ____________________________________________________________

(after deduction of closure charges (if applicable)
Mode of Payment : Cash / DD / IFT / NEFT

DD / UTR No. : ___________________________
ECN Stamp & Signature Branch Seal
CUSTOMER ACKNOWLEDGEMENT
Date: D D M M Y Y Y Y
ECN Stamp & Signature
Branch Employee Name:
Closure Request A/c:

Branch Seal
FD:
For charges and fees, please refer to our schedule of charges (SoC). Terms and Conditions apply.
Page 2

Account Closure and Term Deposit Premature Withdrawal Form

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Account Closure and Term Deposit Premature Withdrawal Form

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ACCOUNT CLOSURE/ FIXED DEPOSIT

PREMATURE WITHDRAWAL FORM

I/We request you to close my / our Savings / Current Account:

CURRENT ACCOUNT / SAVINGS ACCOUNT CLOSURE

Pay the proceeds by

Credit to another Bank Account Credit to Induslnd Bank Account

Bene ciary IFSC Code:

Reason for Account Closure:

4. Corporate Salary Account - Employer changed 11. Change of residential status

Account No.: IFSC Code:

I hereby authorise IndusInd Bank Ltd., to execute the

Schedule of Charges (SOC) at www.indusind.com

FOR BANK USE ONLY

Account Closure Approved by

Balance in Account : ___________________________

Account Cosure proceeds paid : ____________________________________________________________

Mode of Payment : Cash / DD / IFT / NEFT

ECN Stamp & Signature Branch Seal

Closure Request A/c:

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