Scribd
Upload
2K views2 pages

ICICI MF Name-Change-Form

Uploaded by

kritikafinancialservices1
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
2K views2 pages

ICICI MF Name-Change-Form

Uploaded by

kritikafinancialservices1
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
You are on page 1/ 2

NAME CHANGE REQUEST FORM

Date:

To
The Trustee,
ICICI Prudential Asset Management Company Ltd.

Dear Sir/ Madam,


I/We, as stated hereunder, hereby submit the following request to change/correct the name(s) under the below given folio number(s) registered in your
records:

Folio No.: ________________________________________________________________________________________________________________________________

1ST /SOLE UNITHOLDER PAN

Current Name in Folio

Name to be
corrected/changed to NAME AS PER PAN

Reason for Name Minor Name Correction Major Name Correction Actual Name Correction
Change/Correction :
(Please ) Name change due to Marriage Name change due to Divorce Others (please, specify_______________________)

2ND UNITHOLDER PAN

Current Name in Folio


Name to be
NAME AS PER PAN
corrected/changed to

Reason for Name Minor Name Correction Major Name Correction Actual Name Correction
Change/Correction :
(Please ) Name change due to Marriage Name change due to Divorce Others (please, specify_______________________)

3RD UNITHOLDER PAN

Current Name in Folio


Name to be
NAME AS PER PAN
corrected/changed to

Reason for Name Minor Name Correction Major Name Correction Actual Name Correction
Change/Correction :
(Please ) Name change due to Marriage Name change due to Divorce Others (please, specify_______________________)

INVESTOR(S) DECLARATION & SIGNATURE (S)

I/we hereby declare and confirm that the information provided in this form is true and correct and is duly supported by the document proof enclosed alongwith the form. In
case of non submission of any of the documents or if the documents are not found to be in order, the AMC is reserves to right to not register the application submitted. The
AMC/Mutual Fund shall not be liable and/or responsible for any loss or damage that I/we may incur if the Form is rejected.

SIGNATURE OF SOLE / FIRST UNITHOLDER SIGNATURE OF SECOND UNITHOLDER SIGNATURE OF THIRD UNITHOLDER

ACKNOWLEDGEMENT - NAME CHANGE REQUEST FORM

Folio No.:

SIGN & STAMP


Name of 1st
Unitholder
1. Minor name correction - Documents to be submitted
Duly filled and signed form
Self-attested PAN card copy
Any Document with new /revised name having registered address e.g. KYC acknowledgement letter with address,
Passport copy, Election card copy, Aadhar card copy, Utility bills copy, Driving license copy, Registered bank state-
ment copy (All documents to be attested in original)

2. Major name correction - Documents to be submitted


Duly filled and signed form.
A self attested PAN card copy with new name and KYC verified with new name
Original cancelled cheque copy from the investor with his/her name and account number clearly printed on the
cheque. The name should match with the name change requested by the Investor.
In absence of such a Cheque, an attestation from the bank manager on the letter head of the Bank whose mandate
has been provided at the time of original investment, confirming the Investors Name, Bank branch, Account number
and Signature. Photo ID with Signature i.e. PAN Card (If not already available), MAPIN Card, Passport, etc.
Indemnity Bond duly signed by all the holders in that folio.
 For Amount (valuation) less than Rs. 10,000/ -
Plain paper (should be notarized)
 For Amount (valuation) more than Rs.10,000/-
Rs. 500 Stamp Paper (should be notarized)
If the investor has multiple folios in his name and the mode of holding is ‘Either or Survivor’, and the investor is not
the primary holder in all the folios, then the investor can submit a single indemnity bond for all the folios for
correction of name. The same applies to joint holders in the folio. However the investor will have to descriptively
mention his folio, his name and the order of holding (1st/2nd/3rd holder)

3. Actual Name change - Documents to be submitted


Duly filled and signed form.
Notarized copy of Notification in Official Gazette of India (Or) Affidavit for name change as per AMC
format(100Rs)Duly Notarised and the Copy of advertisement given for name change in 2 newspaper, 1 Regional
newspaper and one national, daily newspaper
A self attested PAN card copy with new name and KYC verified with new name
Attestation from the bank manager of the Bank whose mandate has been provided at time original investment,
confirming the Investors Name, Bank branch, Account number and Signature.
Any official/legal document reflecting the name change viz. Attested Bank statement from the same bank of which
bank mandate is on our record Passport.
For applications made by minor investors - Passport / School Certificate or Birth Certificate (relationship) duly
notarized / Official/ Gazette / Magistrate / Bank Manager, AMC.

4. Name change due to marriage - Documents to be submitted


Duly filled and signed form
Notarized copy of the marriage certificate OR
Certified true copy of the state Gazette OR the original copy of the state gazette in which a declaration has been
made to that effect.
A self attested PAN card copy with new name and KYC verified with new name

5. Name change due to divorce - Documents to be submitted


Duly filled and signed form
Notarized copy of the divorce certificate, OR
Family Court Order with Court seal duly notarized
A self attested PAN card copy with new name and KYC verified with new name

• In case of non submission of any of the documents or if the documents are not found to be in order, the AMC reserves
the right to not register the name correction application submitted.

You might also like