Name Updation (Please Provide last DOB/DOI D D M M Y Y Y Y Aadhaar number 4 digits of Aadhaar) PAN number Nationality Passport No. (Please update Passport /VISA no. as per attached copy) VISA No. 8 LEI code (Applicable for Non Individual only)
9 LEI code expiry date LEI code - I/We authorize Axis Bank to update expiry date of LEI code, unless otherwise instructed in writing I wish to update below contact information in Individual Segment Non-Individual Segment Please select below if you wish to update in selective accounts only. All Linked Accounts Also update at Cust ID level for CA All Relationships Savings & FD Loan A/cs Current A/cs Credit Cards Only in A/c no
Contact Information (Applicable only for 10 Mobile No. & Alert Registration Country Code Mobile Number Transaction Alert EOD Alert Current Account) Joint account holders will receive One Time Password (OTP) and transaction SMS alerts for their transactions on ATM, Internet Banking and Mobile Banking. Monthly charge ` 5/- for Savings A/c except NRI customer. To unsubscribe from value added alerts please tick 11 Landline number Tel (R) I S D S T D N U M B E R
Tel (O) I S D S T D N U M B E R E X T N
12 E-mail ID (for e-mail statement registration. Physical statements will be discontinued once E-statements are activated) 13 Address (A) Communication i) Residence ii) Office (B) Permanent /Registered address (Note - Please leave space between two words. In case of joint Holders, each holder is required to fill separate form.)
ADD 1 ADD 2 ADD 3 Landmark
City State
Pin Code/Zip Code/PO Box Country
(For deemed OVD, OVD with updated address to be submitted within 3 months, Please attach address proof document not applicable for NRI, Current A/c, Credit cards and loan products) Terms & Conditions: I have read, and understood and agree to be bound by the Terms & conditions related to UIDAI guideline, sharing of Information with agencies/service provide on need to know basis, regarding various Products & Services / Fees & Charges including SMS Banking, E-Statement, & Internet Banking, including Terms & Conditions related to sharing of relevant information under foreign tax law like FATCA as displayed on www.axisbank.com. SMS alert charges are applicable (Only for Non Mandatory SMS) as mentioned on Bank website: www.axisbank.com under Fees and Charges section. Mobile No. may be updated in the bank records for sending any communication related to my above account, as well as transaction advice. I also authorise the bank to contact me on the above said number for doing verification, call backs or checks to confirm the veracity of any transaction, as deemed fit by the bank. I confirm that the mobile number is held by me and is not used by any third party and I undertake that I shall duly and promptly inform the bank, if and when my mobile number changes. Address Updation - Please note the communication address will be updated at account level and Registered address at Customer ID level (For Current Account) E-aadhaar Declaration -There is no change in the Aadhaar Detail after the date of download of e-Aadhaar submitted to the Bank.
Date D D M M Y Y Y Y Place For Individual accounts, in case of joint holder mobile number updation, signature of only joint holder is required. For non-individual accounts, signatures as per mode of operation are required for mobile number updation.
Signature Signature Signature Signature
For office use only
Certified that this Request Letter is complete in all aspect & all relevant documents are obtained & verified for mode of operations and signature of the A/c holder. The request may please be processed. The CRF has been personally submitted by the Customer. I have satisfied myself about the identity of the customer by verifying his / her Debit Card/ KYC document & also his / her signature in Bank’s record. I have done proper due dilligence for updating the records of the customer on his/her request at non-home branch. E-aadhaar Declaration : E-Aadhaar downloaded in my presence (applicable for cases where Aadhaar downloaded in front of the customer in the branch)
Bank induced request Request received date D D M M Y Y Y Y Request processed date D D M M Y Y Y Y
Request accepted by Request certified by Employee number (Employee number)
Signature Signature & S.S.No.
Acknowledgement to Customer
Customer Name Customer ID Date of request D D M M Y Y Y Y Name of the Branch Official Please Note: Your request will be processed within 2 working days. Delivery of kits /cheque books / statement etc. to your address will take Branch Official Signature between 5-11 working days if dispatched through courier and 15-18 working days if dispatched through speed post (depending on location) Branch Name SOL ID SR. No.
Account Number* This page is required to be filled only if there are requests numbered 14 to 24
Banking Requests
14 Duplicate Statement From Date D D M M Y Y Y Y To Date D D M M Y Y Y Y (Will be changed as applicable)
15 New Cheque book (Nominee name will get printed
No. of books 16 Passbook 17 Print Nominee Name on statement, passbook, etc) 18 Account activation Please activate my account. (For Individual A/c, kindly attach KYC document of all account holders. For Non-Individual A/c, attach KYC document of the entity) Name change if any to be requested on pg1 *Reason for not operating the Account i) *Please confirm if you would like to proceed with the REKYC along with the activation YES NO (*if none of the above mentioned is been selected bank shall not be proceeding with the REKYC of the account .) 19 Reversal of charges 1) ` debited on D D M M Y Y Y Y 2) ` debited on D D M M Y Y Y Y I agree to henceforth maintain Average Monthly/QuarterIy/Half Yearly Balance as per requirement (applicable (or cases where Average Balance Non-Maintenance is charged)
20 Scheme code conversion Existing scheme code New scheme code (Please attach necessary supporting document) I confirm that I have understood the Terms & Conditions, details of Features & Charges related to the requested scheme variant by visiting Axis Bank website and agreeable to all the Terms and Conditions including Average Minimum Balance (AMB) / Total Relationship Value (TRV) / Debit card / Any other conditions, as per relevant MID available on www.axisbank.com/download-forms/accounts. Also, the same was explained to me in detail by the Bank Official taking this request. I agree to convert my scheme to the variant as selected above and will maintain account balance as per requirement of new scheme code. I will not dispute or raise any legal action against Axis Bank if any benefits associated with the variant are withdrawn at the sole discretion of Axis Bank and / or charges (including applicable GST) levied if I am unable to fulfil the criteria associated with the product Label Code (Mention label code for conversion to salary account)
21 Account Transfer From Branch To Branch OR From Sol ID To Sol ID Reason for Transfer of Account 22 Stop Payment Request will be charged as applicable) Request received at (time) Payee Name : Date of Cheque (s): D D M M Y Y Y Y Cheque Number(s): Amount Reason for Stop Payment : 23 Debit Card Debit Card Number Deactivation 24 Any other (Please specify) Terms & Conditions Address Updation - Please note the communication address will be updated at account level and Registered address at Customer ID level (For Current Account). Please note address shall be captured as per OVD submitted in case of any discrepancy observed in the details submitted on CRF vis a vis OVD. Scheme code conversion - Please note that the new scheme code will be applicable from the next charge cycle. Account Transfer - Bank reserves the rights of recovery in case of any future debits accruing on this account as a result of any claims or transactions. All old cheques issued shall be honoured, if otherwise in order. The remaining channel facilities (debit card, internet banking & telebanking) shall remain the same. Also all the standing instructions and ECS mandates given would be honoured, if otherwise in order. The flexi linked FD's will continue to remain in the old branch, the new flexi linked FD's will be opened in the new branch and any cheques issued shall be honoured by withdrawal from the flexi linked deposits only. You can continue to use existing cheque book for transactions purpose ,however in case you wish to request for new cheque book , you can visit any of our banking channels. I have read and understood the above terms and certify that the details provided on the form are correct. Account Activation - As per customer eligibility decided by Axis Bank from time to time. E-aadhaar Declaration: There is no change in the Aadhaar Detail after the date of download of e-Aadhaar submitted to the Bank.
Date D D M M Y Y Y Y Place For Individual accounts, signatures of all account holders are required for Account Transfer, Account Activation & Scheme Code Conversion. For non-individual accounts, signatures as per mode of operation are required.
Signature Signature Signature Signature
For office use only
Certified that this Request Letter is complete in all aspect & all relevant documents are obtained & verified for mode of operations and signature of the A/c holder. The request may please be processed. The CRF has been personally submitted by the Customer. I have satisfied myself about the identity of the customer by verifying his / her Debit Card/ KYC document & also his / her signature in Bank's record. I have done proper due dilligence for updating the records of the customer on his/her request at non-home branch. For Scheme Code Conversion Only - I hereby confirm that I have explained the customer all the Terms & Conditions, details of Features & Charges, Average Minimum Balance (AMB)/ Total Relationship Value (TRV) requirement, Debit card and any other conditions as applicable to the product subscribed by the customer. The customer has agreed to abide by all the above-mentioned conditions which is also available at the Bank’s official website. E-aadhaar Declaration: E-Aadhaar downloaded in my presence (applicable for cases where Aadhaar downloaded in front of the customer in the branch) RL/CRF/Jul2020/VER.1
Bank induced request Request received date D D M M Y Y Y Y Request processed date D D M M Y Y Y Y
Request accepted by Request certified by Employee number (Employee number)
Signature Signature & S.S.No.
Acknowledgement to Customer
Customer Name Customer ID Date of request D D M M Y Y Y Y Name of the Branch Official Please Note: Your request will be processed within 2 working days. Delivery of kits /cheque books / statement etc. to your address will take Branch Official Signature between 5-11 working days if dispatched through courier and 15-18 working days if dispatched through speed post (depending on location)
