Annexure-I
Application-cum-Undertaking for transfer of account under account portability.
The Branch Head,
Branch: …………………………
Dear Sir,
Please arrange to transfer my account from your business unit to business unit ………
Full particulars of the account are as under:
1. Full Name of account holder:
(In Block Letters) ……………………………………………….
2. Present address ……………………………………………….
3. A/c Type . ……………………………………………………
4. Account number (16 digit) ……………………………………………………
5. Name of the branch where the account ……………………………………………………
to be transferred.
6. Facilities/Add-ons available/ linked to the account:
(Please tick)
a) ATM/Debit card ……………………………
b) Credit Card ……………………………
c) E-banking ……………………………
d) Any other facility ……………………………
I / we hereby undertake that no ECS mandate/ any other mandate or commitment has been given to
any party and I / we shall be solely responsible for any disputes related to the account arising out of
any commitment/ liability, whatsoever, which is not known to the bank. The bank shall have
unequivocal right to link any legal claim, if made by any claimant , to the account of the customer at
the transferee branch.
I/we hereby declare that the information given above is true and correct.
Date:
Place:
Signature of Account holder/s
