Account Closure Form
Date: D D M M Y Y Y Y
To,
DBS Bank India Limited
______________________ Branch
I/We authorise you to close the account(s) and cancel standing instructions /ECS/NECS (if any)/FD repayment/Investments POA linked to my/our account(s) listed
below. The balance in the account, after the recovery of any interest, tax or charges as applicable, is to be repaid to me/us as indicated below :
ACCOUNT DETAILS
Saving Account Number 1) 2) 3)
CIF ID
I / We confirm having destroyed my/our Debit Card & unused cheque. No cheques have been issued by me.
SECTION A
i) Reason for account closure :
Moved to non-DBS bank location/inconvenient bank location Inactive account / account not being used
Dissatisfied with account features Resigned from corporate (salary account)
Consolidating bank accounts within DBS Bank India Limited Customer Deceased
Unable to maintain minimum balance Service Charges / AQB related
Specific product facility no longer required Dissatisfied with Service (Branch / RM / Call Centre)
Location / convenience of branch / ATM not suitable Others __________________ (Please mention reason for closure)
SECTION B # : (Select anyone of the below)
The Balance in the account is to be repaid as follows :
1) Transfer vide NEFT / RTGS:
Customer(s) Name :
Account Number : Account Type : Resident NRE NRO
IFSC Code :
Bank & Branch Name :
2) Issue payorder / demand draft in favour of
3) Transfer to my DBS Account No.
4) Remittance : Kindly submit additional relevant forms / documents
TERMS AND CONDITIONS
I/We agree and understand that any cheques which have not been presented, ECS and Standing Instructions in the account received by the Bank after the date of account closure will stand dishonored by the
Bank and I/We agree to indemnify the Bank against any actions, proceedings, claims and/or demands that may arise due to reason of such dishonor.
I/We agree and confirm that I/We shall provide suitable amendment instructions to concerned asset management company, in case the account being closed above is a settlement account for wealth
management services availed of from the Bank.
I/We agree and understand that the Bank shall have a right of set off and general lien over the amount payable to me/us after closure of the aforesaid account and the Bank shall be entitled to recover any
outstanding amount including interest, charges, TDS and/or any other related charges.
IWe agree and accept that in case of my/our savings bank account/s mentioned above is/are dormant/inactive, the same will be activated to process the Account closure .
My existing savings account/s with the auto-saver facility will be closed and the relevant penal charges if any will be recovered from linked fixed deposit. (if applicable)
Signature Signature Signature
(as per bank records) (as per bank records) (as per bank records)
Name of 1st Account Holder Name of 2nd Account Holder Name of 3rd Account Holder
NOTE
1. All accountholders are required to sign this form and authenticate all corrections or amendments (If any) 2. A mandate holder cannot request for an account closure. 3. Account closed within six months of
opening will be charged as per the charges mentioned in the tariff schedule displayed in the branches and on the website. 4. For outward remittance on NRO / NRE accounts please submit the additional
remittances form. 5. For RTGS / NEFT please provide cancelled cheque. 6. Pay order / Demand Draft will be issued in all account holder name / or as per customer instruction. 7. # Third party transfer is not
allowed within DBS / NEFT / RTGS / DD / PO.
FOR BANK USE
Instruction received on D D MM Y Y Walk In Person/Representative Courier/Post RM/CSM others
Account closure only Account closure & Cif Suspension (*Check for Nil holdings) Cheque Book / Debit card destroyed
Signed by all A/c holder(s): Yes No Signature(s) Verified: Yes No A/c Balance Negative: Yes# No
A/c Lien @ Yes No Reason# @
A/c Closure Charges: less than 6 months recover charges less than 7 days no N.A
ATM / Debit cards: All linked if any, hotlisted : Yes *No Reason* ___________________________
NEFT / RTGS / PO All existing SI delinked Account closed CIF Suspended
Charges recovered (INR) : _______________Balance while closure (INR) __________________Interest credited after closure (INR) : ________________________
Total Amt Payable (INR) :_____________________________________________________________________ TRAN ID:_____________________ D.D. No.: _________________________
A/c closure Letter Despatched : Yes No DD/PO : Yes No (If no please specify reason)
RM CSM City Head /Branch Head Branch OPS CBO MAKER CBO CHECKER
Name
Sign
AC/001/MARCH 19
