Request For Closure Of Savings Bank Account (For Non-Resident Individuals)

(To be submitted with Photo copy of self-attested valid passport)

Date: D D M M Y Y Y Y

To
ICICI Bank Limited,
RPC Mumbai,
Autumn Estate, 5th Floor, 'A' Wing,
Near Mhada, Chandivali, Andheri (E)
Mumbai - 400 072, INDIA.

Please close my/our NRE/NRO Savings Account/s. My account details are given below

Name of the Account Holder: .................................................................................................................................................................................................

Savings Account Number/s: ..................................................................................... Email address: ..................................................................................

Contact number/s: ..................................................................................................... Mobile No: ........................................................................................

COUNTRY CODE + AREA CODE + NUMBER COUNTRY CODE + NUMBER

Reason for Closure Returning to India Charges levied Account opened with another bank Any other:

Also, I request you to de-link my I-direct trading account linked to the above account (if applicable).

I understand that at the time of account closure

Access to all channels linked to this account will be disabled.

All the Standing Instructions in this account will be cancelled.
I/We have surrendered/destroyed ATM/Debit Card associated with this account. All ATM/Debit Card/s linked to this account will be cancelled.
The PO/DD issued for closure proceeds shall be the amount that is left over after deduction of account closure charges as applicable.
My existing Quantum Optima accounts along with the savings bank account will be closed and the relevant penal charges will be applicable on
the Quantum Optima deposits on closure of account.
I/We shall be responsible for amending all the ECS/Auto debit mandates linked to this account.
I have surrendered unused cheque leaves. All the used/un used/not paid/post dated cheques which are surrendered/not surrendered will be
treated as cancelled/destroyed.
For lockers linked to this account, I confirm that I have surrendered my locker/s linked to this account.
For Dormant/Inactive accounts: In case my savings bank account/smentioned above is/are dormant/inactive, the same will be activated to
process the Account Closure request.
To be submitted with Photo copy of self-attested valid passport

Instructions for Closure Proceeds

Please make payment of the balance amount by (please Many one of the following options)
Transfer to another ICICI Bank account, Alc Holder's Name:............................................................................................................................................
Alc No.: ................................................................................................ (*refer to point 4 in notes)
Pay Order(PO)/Demand Draft (DD) payable at...................................................................................................................................................................
a) Send PO/DD (in INR) to the address mentioned below
Receiver's Name ......................................................................................................................Tel No. ............................................................................
COUNTRY CODE + AREA CODE + NUMBER
DD to be mailed to (address) :............................................................................................................................................................................................
.............................................................................City ..............................................Country.................................PIN code.............................................
b) Send PO/DD (in Foreign Currency:............................................) to my correspondence address (OVERSEAS) as per bank records.

First Applicant First Applicant 1 First Applicant 2

SIGNATURES*
(as per Bank's records)

Notes
1. For account closure related charges.
2. A mandate holder cannot request for an account closure.
3. *Signatures of a II account holders are mandatory for account closure.
4. Closure proceeds of NRO Savings account cannot be transferred to an NRE or any third party account.
5. Applicable service tax will be levied on repatriation of closure proceeds.

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