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Annexure-A

REQUEST LETTER FOR ACTIVATING/CLAIMING AMOUNT IN UNCLAIMED


DEPOSIT/INOPERATIVE ACCOUNT FOR 10 YEARS OR MORE
Date:

From: To:

(Name/s and address* of the Account holder/s) The Branch Manager

The Hindu co-operative Bank Ltd.

Sir,

Ref: My/Our SB/CA/FD Account Number:_________________________

Sub: Activating / Claiming of the amount held under unclaimed despot/


Inoperative Account (DEAF Transferred Account)
I/We were holding a Saving/ Current/Term Deposit........................................Account bearing
number.............................which was not operated/ claimed on the due date, in view of the
following reason for more than ten years:

..........................................................................................................................................

a) To evidence of having account with your Bank branch we submit the following:

(Any one of the following should be submitted, which should have the account number and
account holder’s name)

1) Pass book/ account statement 2) Cheque book (Un-used and / or counter foil of the used
Cheque leaves 3) Counter foil for cash /Cheque remittance made to the account 4) Deposit
receipt- in respect of claim towards Term Deposit accounts

b) The old address at the time of account last operation and *present address is as under:

OLD ADDRSS NEW ADDRESS AND MOBILE/PHON NO:


c) I am / We are submitting the following documentary evidences for proof of identity and
proof of present address.

For proof of Identity :(In addition to Aadhaar card submit any one document copy along with
original for verification)

1) PAN Card 2) Voter ID 3) Passport 4) Driving License 5) Ration Card 6) UIDIs must

For proof of address : (Submit any one document copy along with original for verification 1) EB
bill 2) Telephone Bill 3) Bank Account statement 4) Letter from employer

d) I/ We request you to activate the account/ pay the amount held under unclaimed deposit to
me/ us.

e) I/ We are aware that if the claim amount is above Rs.20,000/- only account payee banker's
Cheque/Demand draft will be issued in favour of the account holder/s.

(Signature /LTI of account holder/s**)

**Witness(i)

**Witness(ii)

Note: (i) In respect of the accounts held under joint names all the account holders' should sign
and ID proof and address proof should be submitted for all of them.

(ii)** If account holder/s is /are illiterate and LTI is affixed, that should be witnessed by two
persons known to the bank.
(FOR OFFICE USE)

Date of Activation/Disbursement..............................

• Verified the required evidences submitted by the claimant and found correct.

• Amount available to credit of unclaimed deposit account :Rs.

• Amount paid to the account holder/s Rs.

• If the amount is above 20000/- DD No.: .................. Dated ................... for ....................
issued in favor of ............................................................................

CLERK OFFICER BRANCH HEAD

Place:

Date:

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