CHANGE OF BANK FORM (COB)

(For existing Unit holders - Individual / HUF / Sole Proprietor only)

• Website: www.icicipruamc.com • Email: enquiry@icicipruamc.com
• Toll free numbers: 1800 222 999 (BSNL/MTNL), 1800 200 6666 (Other Service Providers)

FOLIO NO(s). (Mandatory): __________________________________________________________________________________________________________________________________________________________

1st Holder
(Mandatory) TAX STATUS: ________________________________
2nd Holder

3rd Holder MODE OF HOLDING: _________________________

Account No. DOCUMENT REQUIRED FOR BOTH OLD/EXISTING AND NEW BANK MANDATE:
Any One Document to be submitted for the respective mandate. All documents
Account Type Savings Current NRE NRO Others should have the First Unit Holder’s Name, Account Number, Account type, IFSC,
(Please )
MICR, Bank address details.
(Please specify here if others: ___________________________________)
New Bank Mandate :
Bank Name Original cancelled cheque
Bank passbook (with current entries not older than 3 months)
Bank Address
Self-attested Bank account statement issued by the concerned bank (not older
Bank City than 3 months) OR, Bank letter, on letterhead of the bank duly signed by branch
manager/authorized personnel stating the investor's bank details.
MICR Code IFSC Code AND
(9 digits) (11 digits)
Old/Existing Bank Mandate:
YOUR CONFIRMATION/DECLARATION Original cancelled cheque
I/We have read and understood the contents of the Scheme Information Document(s)/Key Infromation
Memorandum(s) & Statement of Additional Information(s) of the Scheme(s) and agree to abide by the terms, Bank passbook (with current entries not older than 3 months)
conditions, rules and regulations of the Scheme(s) as on the date of this transaction. I/We hereby declare that I In case of non-availability of old bank proof, In-Person verification (IPV) is mandatory.
am/we are not US Person(s). The ARN holder has disclosed to me/us all the commissions (in the form of trail For IPV - Original with self attested copies of PAN Card as per the applicable Mode of
commission or any other mode), payable to him for the different competing Schemes of various Mutual Funds Holding/ Photo Identity Proof for PAN Exempt Investors like Passport, Voter ID, Ration
from amongst which the Scheme is being recommended to me/us. I/We hereby confirm that I/we have not been Card, Driving License.
offered/communicated any indicative portfolio and/or any indicative yield for this investment.
NOTE :
1. In case of photocopies of above documents are submitted, unit holder must procure original
Signature(s)

for verification at any of the AMC branches or official point of acceptance of transactions.
2. The name printed on the documents should be same as per the folio.
3. The AMC reserves the right to accept the request, subject to additional verifications,
First Holder Second Holder Third Holder production of additional documents or In Person Verification of unit holder.
(To be signed as per Mode of Holding) 4. Core Banking account (CBS) is mandatory.

IN CASE OF NON-AVAILABILITY OF EXISTING BANK PROOF, IN-PERSON VERIFICATION (IPV) IS MANDATORY. THE INVESTOR IS REQUIRED TO VISIT THE NEAREST
AMC BRANCH SERVICE CENTRE FOR IPV. For IPV - Original with self attested copies of PAN Card as per the applicable Mode of Holding/ Photo Identity Proof for PAN Exempt Investors
like Passport, Voter ID, Ration Card, Driving License.

IN-PERSON VERIFICATION (IPV)

Dear Sir/ Madam,
This has the reference to my/our investments in the captioned folio(s).
I/we would like to add the Bank Mandate for which I/we confirm having submitted the required documents to the AMC/RTA on date________________. But I am unable to
provide the documents towards existing bank mandate whose details are provided below.
Existing Bank Account Details:

Bank Name :

Branch Name : Account No.:

Account Type: IFSC code :

Branch Name
Since, I/we do not have existing bank mandate proof, I/we have personally visited <____________________________> AMC branch on date___________________ for IPV and
I request you to process the bank mandate.

Thanking You,
Yours faithfully,

1st Holder 2nd Holder 3rd Holder

Signature

Name

Contact No.

Encl.: ID Proof and Proof of New bank (Original New bank details to be shown by Investors for verification)

For Office Use Only

______________________________________________ID Verified in Original vide no: _____________________________________
Name of Employee
Verified By <_______________________________________> Emp. Code _______________________________ Signature__________________________________

Designation __________________________________

Acknowledgement - Change of Bank Form (COB)

Acknowledgement
Seal & Stamp
Folio No. Change of Bank Details