Service Request No.

Date : No. 5

Signature Addition/Deletion/Modification
(For Current Account only)
Customer Details

I/We hold current account *

(Please fill in all the details in CAPITAL LETTERS and use BLACK INK only. Fields with * (asterisk) are mandatory)
A/c Title ..............................................................................................................................................................................
(As per bank records)
*Mobile No. :
(For Individual/Sole Proprietor , mobile no. of a/c holder to be given. For others mobile no. of person who is submitting the request)
Customer Declaration
Type of Constitution (Please applicable box)
Individual Bank Sole Proprietor Government Body Private Ltd. Co. HUF Public Ltd.
Co. Society Partnership Trust Other (please specify) .....................................................
Request Type

I/We want to (please √ applicable box)

Change Mode of Operation (MOP) Add a Signatory/(ies)
Change in Style of Signature Delete a Signatory/(ies)
New Mode of Operation
Change mode of operation (Please √ applicable box)
Any one Any two jointly As per board resolution Others (please specify):...........................................
Details of Signatories to be added :

Mr./Ms./Mrs./Dr.................................................................................

..........................................................................................................
Please affix most
Designation .....................................................................................
recent colour
photograph Ref. ICICI Bank Current a/c no.(If any) # .........................................

SPECIMEN SIGNATURE UNDER RUBBER STAMP

Valid ID proof (Please applicable box): PAN card Driving license Passport copy Voter ID
Bank pass book with photo Others, please specify: .......................................

Mr./Ms./Mrs./Dr.................................................................................

..........................................................................................................
Please affix most Designation .....................................................................................
recent colour
photograph Ref. ICICI Bank Current a/c no.(If any) # .........................................

SPECIMEN SIGNATURE UNDER RUBBER STAMP

Valid ID proof (Please applicable box): PAN card Driving license Passport copy Voter ID
Bank pass book with photo Others, please specify: .......................................

Mr./Ms./Mrs./Dr.................................................................................

Please affix most ..........................................................................................................

recent colour Designation .....................................................................................
photograph
Ref. ICICI Bank Current a/c no.(If any) # .........................................

Valid ID proof (Please applicable box): PAN card Driving license Passport copy Voter ID
Bank pass book with photo Others, please specify: .......................................
#If reference of the existing account is given (any reference account where the signatures of the authorized signatory is already updated), then ID proof and
photo can be waived.
Declaration for Signature Difference
To be used in case of difference of Signature in Identity Proof and Signature to be updated in Bank Record
DOCUMENT
With reference to my .................................................. bearing reference number
REFERENCENUMBER
............................................................ and the account opening form I have submitted herewith, I request you to record my new specimen
signature as below:
......................................................................................................
DOCUMENT
The signature in the .................................................................................. is different. This difference in signature is
because.........................................................................................................................................................................................
NAME OF THE CUSTOMER
For partnership and limited companies, the witness must be another partner/director.
Employee number/Signature: ..........................................................................................................
Name of the Bank official: .................................................................... Name of partner/director........................................................................
Signature of the Bank official: .............................................................. Signature of partner/director.................................................................
Change in style of signature

Mr./Ms./Mrs./Dr........................................................................................ Designation:.....................................................................................

OLD STYLE OF SIGNATURE UNDER RUBBER STAMP NEW STYLE OF SIGNATURE UNDER RUBBER STAMP

Signatory to be deleted

(I) Name: Mr./Ms./Mrs./Dr.....................................................................................................................................................................................

(II) Name: Mr./Ms./Mrs./Dr....................................................................................................................................................................................

(III) Name: Mr./Ms./Mrs./Dr...................................................................................................................................................................................

(IV) Name: Mr./Ms./Mrs./Dr...................................................................................................................................................................................

Mandatory Documents Required

Certified self-attested KYC documents to be submitted for addition/deletion/modification of operation of new authorised
signatories
Constitution Documents Required
I Individual/Sole proprietor Photo identity proof Power of attorney, if any
ii) Companies/Body Trust/Clubs/Societies/ Photo identity proof Board resolution
Associations/Banks
iii) Partnership Firms Photo identity proof Partnership letter
Deed
Power of attorney, if any
iv) Government bodies Photo identity proof Office Order

Customer Signatures under Firms rubber stamp :

I/We hereby declare that the particulars given herein are true, correct and complete to the best of my/our knowledge and belief. The
signatures of the authorized signatories as per the existing Mode of Operation under the firm's rubber-stamp are provided below.
(*In case of a Partnership, all continuing partners# signatures are required)
ATM/Debit card of the deleted signatory is surrendered at branch

Signature Signature Signature

Name Name Name

*(Authorised Signatory) *(Authorised Signatory) *(Authorised Signatory)

Annexure I Bridger information (Sheet To be used only for Signature edition required)

Information Sheet for Authorised Signatories/ Directors for Addition of Signatories.

Name of Entity:_____________________________________ Account Number:___________________________________
Customer ID _____________________

Constitiution - Partnership Private Ltd Company Public Ltd Company TASC Others

Name :- (Applicable for First Middle Last

Joint account Holders,
Authorised signatories,
Partners, Directors)

Date of Birth DD/MM/YYYY

Nationality
Address Line 1

Line 2
City

Pin Code State

PAN
Name :- (Applicable for First Middle Last
Joint account Holders,
Authorised signatories,
Partners, Directors)

Date of Birth DD/MM/YYYY

Nationality
Address Line 1

Line 2
City

Pin Code State

PAN

Name :- (Applicable for First Middle Last

Joint account Holders,
Authorised signatories,
Partners, Directors)

Date of Birth DD/MM/YYYY

Nationality
Address Line 1

Line 2
City

Pin Code State

PAN

Name :- (Applicable for First Middle Last

Joint account Holders,
Authorised signatories,
Partners, Directors)

Date of Birth DD/MM/YYYY

Nationality
Address Line 1

Line 2
City

Pin Code State

PAN
Branch use only

Documents submitted (Please applicable box)

1. General Checks
1A. Request letter (To be i) To be on letterhead with rubber stamp as per the title in our records.
used only if bank s **In case of proprietor and if letterhead is not available, the letter can be
suggested format is not used) signed under the rubber stamp
ii) Properly dated and should not be more than 3 months old
iii) In case of sole proprietorship: to be signed by the proprietor
In case of partnership: to be signed by all partners
In case of trust/ society/club/ association: to be signed by chairman/
president /trustee/secretary/treasurer/existing signatories
In case private and public limited companies: as per the mode
of operation
In case of Government entity : as per the mode of operation
iv) Note: In case of delegating board resolution, request letter must be
signed by the authorized individual with appropriate rubber stamp
1B. Photo & ID Proof i) Should be affixed with round stamp of ICICI Bank
The name and signature on the documents provided should tally with
the name and specimen signature and should be valid. In case, if the
signatures differs, declaration over leaf needs to be filled, i.e. Annexure 8.
In case ID proof is not legible Annexure 7 should be filled
ii) Photocopy should be self-attested by the customer
iii) The document should be verified with the original and must have
employee ID and must be signed by a Bank official.
iv) For Foreign Nationals - Valid passport and Visa is mandatory.
v) If the Co-operative Bank is the client, KYC confirmation can be taken
signed by General Manager or GM and above rank and if the same is not
authorised signatory than id proof of that person to be taken.
1C. Specimen signature i) Attested by the bank official
1D. Bridger Sheet i) Completely filled Bridger information sheet to be provided for incoming
signatories. (Circular 7425-Annexure -I)
2. In case of Individual/Sole Proprietor
2A. Power of attorney i) Notarized on all pages with notary adhesive stamp. (On stamp Paper)
ii) Mode of operation must be specified (per cheque/ transaction is
acceptable but mode of operation per day is not)
iii) Client must attest Power of Attorney (in case of sole proprietorship,
the proprietor must attest under rubber stamp on all the pages of POA)
iv) Names, addresses and signatures of 2 witnesses.
v) Original or photocopy (the photocopy must be affixed with stamp)
Verified with Original

3. In case of Private Limited/Public Limited/ Trust/Clubs/Societies/Associations/Banks

3A. Board resolution i) Should not be more than 6 months old

ii) Must be on a letterhead with rubber stamp as per the title in our
records
iii) Extracts to mention date, place and time
iv) Mode of operation must state clearly if it is a supersession/partial
modification
v) Board Resolution to be signed as defined:-
a) Private/Public Limited Two directors or Company secretary under
appropriate rubber stamp
b) Trust Two Trustees or members under appropriate rubber stamp
c)Clubs/ Society/ Association / - 2 members under appropriate rubber
stamp
d) Banks - To be attested by general manager/above OR secretary
under appropriate rubber stamp (bye-laws in case the authority of
board resolution is not clear).
vi) Note: If board resolution is more than 6 months old, it must be
signed and acknowledged with True and Updated by company
secretary or an individual authorized to certify the board resolution.
4. In case of partnership firms
4A. Deed i) One partner must attest all pages
ii) Name of the firm and partners should be mentioned in the deed
iii) All deeds made since account opening should be attested and
provided
4B. Partnership letter i) Must be dated and on letterhead with rubber stamp as per title in our
records
ii) Name of the firm should be mentioned and should tally with finacle
iii) Mode of operation ( revised mode of operation post the changes)
mentioned
iv) All partners names and signatures under the firm s rubber stamp
on the last page
4C. Power of attorney i) Notarized on all pages with notary adhesive stamp.
ii) Per cheque / per transaction mode of operation is acceptable, while
mode of operation per day is not.
iii) Power of attorney should be in the firm s capacity and not in an
individual capacity
iv) Any one partner can attest all except the last page which must be
attested by all the partners under the firm s rubber stamp
(Annexure to POA)
v) Names, addresses and signatures of 2 witnesses
vi) Original or photocopy (photocopy must be affixed with Verified
with Original stamp. It must have the employee ID and must be
signed by a bank official)
5. Government bodies
5A. Office order i) Signed by authorized government official
ii) Name of additional signatory should be mentioned
iii) Date / office order number should be mentioned on the office order
iv) Name of incoming and outgoing signatory
5B. Handover/Takeover i) Handover/ Takeover document to be signed by the incoming &
outgoing signatory.
6. Banks /Coop Banks /Regional Rural Banks/ Capital Local Area Banks
6. Banks /Coop Banks / i) Request letter on Companies letterhead signed by the authorised
Regional Rural Banks/ signatory(s) in the account as per existing MOP.
Capital Local Area
ii) BR should be signed by the Officer not below the Rank of General
Banks Manager or Secretory.
iii) Bye laws in case Authority of BR is not clear.

7. Change in style of signature

7A. Sole Proprietor / i) Proprietor and Individual should provide both old and new styles of
Individual signature. The old style must be attested by a Bank official with
Signature and employee number. (if the client is unable to sign his
old signature, the client must provide an affidavit)
ii) Under joint account (Individual) the request should be signed by all
the joint holders.
iii) If a sole proprietor wants to change the style of signature with a power
of attorney, the same should be attested by the sole proprietor on the
firm s letterhead
7B. Partnership i) Request signed as per mode of operation, in case where single
authorised signatory is updated a letter should be signed by all partners
and should be obtained along with a copy of all subsequent deed since
account opening.
7C. Companies i) In case of change of style of the signature of the authorised
signatory or director of a company, a request letter from the
MD&CEO / Chairman & CEO/ 2 Directors / 1 Director + Company
Secretary is required.
ii) In case of change of style of the signature of the MD &CEO/
Chairman & CEO of a company then letter from two directors with
company secretary is required.
7D. Trust / Clubs/ i) Members must sign the request letter
Societies /
Associations /
Constitution
7E. HUF i) In case of a karta s request for a new style of signature, the old
signature must be attested by a Bank official with signature and
employee number. (If the client is unable to sign his old signature,
the client must provide an affidavit attested in the presence of a
Bank official)
8. Deletion of signature

8A. Sole proprietors / i) There would be no deletion of signatures to a sole proprietors

Individual account. Account needs to be closed.
ii) If authorised signatory or POA holder operates the Sole Proprietors
account, for deletion of such signatory, letter, signed by sole
proprietor on firm s letterhead. If letter head is not available, then
the request letter should be signed under the authority of the
proprietor.
8B. Partnership i) Death of the partner dissolves the partnership firm. For dissolution
of the firm in case of death or retirement, a request letter signed by
all existing partners for deletion of the signatory on the firm s letter head.
ii) True and updated copy of reconstituted deed duly attested by all
the existing partners.
iii) If the account is operated by authorised signatory or POA holder,
then for deletion of such signatory, letter signed by all the partners
and should be obtained alongwith a copy of all subsequent deed
since account opening.
8C. Companies i) A request letter signed by authorised signatory/ies as per mode of
operation .
ii) Board Resolution duly signed by two directors or the company
secretary on company's letterhead under for Stamp/Rubber seal.
8D. Trust / Clubs/ i) A request letter signed by authorised signatory/ies.
Societies/
ii) Board Resolution duly dated and signed by two trustees or
Associations /
members or chairman or secretary or president.
Constitution
8E. HUF i) There would be no deletion of signatures to a HUF account.
Account needs to be closed.
8F. Banks /Coop I) Request letter on Companies letterhead signed by the authorised
Banks / Regional signatory(s) in the account as per existing MOP.
Rural Banks /
ii) BR should be signed by the Officer not below the Rank of
Capital Local Area
General Manager or Secretory.
Banks
9. Change in Mode of Operation
9A. Sole proprietors / i) There would be no change in MOP to a sole proprietors / individual
Individual account, if he issolely operating the account.
ii) If MOP needs to be changed for authorised signatory or POA holder
in the Sole Proprietor/ individual account, the letter should be
signed by individual in case of individual account or sole proprietor
on firm s letterhead. If letter head is not available, then the request
letter should be signed under the authority of the proprietor.
9B. Partnership i) Request letter signed by all the partners and should be obtained
alongwith a copy of all subsequent deed since account opening.
9C. Companies i) A request letter signed by authorised signatory/ies as per mode of
operation.
ii) Board Resolution duly signed by two directors or the company
secretary on company's letterhead under for Stamp/Rubber seal.
 9D. Trust / Clubs/ i) A request letter signed by authorised signatory/ies.
Societies /
ii) Board Resolution duly dated and signed by two trustees or
Associations /
members or chairman or secretary or president.
Constitution
9E. HUF i) There would be no change in mop to HUF account, if he is solely
operating the account.
9F. Banks /Coop i) Request letter on Companies letterhead signed by the authorised
Banks / Regional signatory(s) in the account as per existing MOP.
Rural Banks /
ii) BR should be signed by the Officer not below the Rank of
Capital Local Area
General Manager or Secretory.
Banks

Branch Use Only

Declaration by Branch Official I confirm

Documents submitted as per the constitution- Checked & verified

All documents verified with Original, stamped (black ink) and signed with I-view Signature Number

The applicant(s) signature is present as per MOP. Signature have been verified with bank records

All documents self attested/signed and stamped (black ink) by customer

The account is not Inactive / Dormant / Lien/ Frozen

Request is dated (Not more than 3 months)

The details match with the Bank's records

FCRM scan image is clear & legible

ATM / Debit card is physically destroyed in case of signatory deletion and hotlisted in the system

Customer ID *

I/We (Staff/DBM/BSCM) confirm that we have checked the request letter and the relevant documents

Staff DBM/BSCM

Name & Employee ID : ________________________________________ Name & Employee ID : ____________________________________

Signature: ___________________________________________________ Signature: ______________________________________________

Bank
Seal

ICICI/RSPPG/V1/1211/LIAB/SIGNADD/DEL/MOD

Acknowledgement Slip (To be filled in by the Bank staff)

Date

Received from ___________________________A/c No.___________________________________for Add signatory / Delete signatory / Modify

Mod of operation (MOP) / Change in style of signature

The necessary changes will be carried out in the Bank s records only for the account mentioned above

ICICI Bank (Branch Name): ______________________________ Bank

Seal
Signature of Bank Official ____________________________________