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Dormant Form

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Anonymous Ub9nEDl
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76 views1 page

Dormant Form

Uploaded by

Anonymous Ub9nEDl
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Date :

INACTIVE AND DORMANT ACCOUNT ACTIVATION FORM


Account Number :

Customer ID:

Name : ___________________________________________________________________________________________________________
First Name Middle Name Last Name
(Primary Applicant):

(Details to be filled in CAPITAL LETTERS)

To,
The Branch Manager
ICICI Bank Ltd._________________ Branch

Dear Sir/Madam,

I/We _______________________________________________________________________________________________________ confirm


that I/we have not operated my/our above Account for the following reason ________________________________________________
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
I/We request you to activate my/our above account and update my/our communication address* as per the address proof
provided.(*Only applicable in case of change in communication address)

House No. : Premise Name :

Building Level : Street No

Landmark :

Street Name : Locality :

Zip Code : Postal Code :

Telephone No : Mobile No :

ID proof provided : _______________________________ Address proof provided : __________________________________

Issue a new Cheque Book new Debit Card

Please send the Cheque Book Debit Card at Registered communication address Branch.
Sincerely,

Signature Signature Signature Signature

Name Name Name Name

(Primary Holder) (Joint Holder1) (Joint Holder 2) (Joint Holder 3)

For Bank Use Only

Service Request No. _____________________________________ Created On


For Debit Card
Employee ID : Approved for activation Yes No

Employee Signature _________________________ Signature of Branch Manager ______________________________

Verifier's employee ID and Signature _________________________________

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