CHANGE OF SIGNATURE / NAME Date D D M M Y Y Y Y UNIT HOLDER INFORMATION Folio No. APPLICANTS DETAILS Title Mr. M/s. Ms. 1st Name Status Resident Individual Trust Company Proprietor HUF Minor Society FII NRI PIO Partnership Firm Trust HUF Minor Society FII NRI PIO Partnership Firm Trust HUF Minor Society FII NRI PIO Partnership Firm Trust Other 2nd Name Status Resident Individual Trust Company Proprietor Other 3rd Name Status Resident Individual Trust Company Proprietor Other BANK ACCOUNT DETAILS FOR VERIFICATION Name A/c No A/c Type Current Savings NRO NRE FCNR Other Address City Pin MICR Code (9 digit)* IFSC Code (11 digit)* *Mentioned on your cheque leaf BANKER'S ATTESTATION OF CUSTOMER'S SIGNATURE & BANK ACCOUNT DETAILS Name Name of the Banker: Signature with Bank’s seal: Designation: Employee Code: OLD & NEW NAMES OF THE UNIT HOLDER / NEW SPECIMEN SIGNATURE I/We request Axis Mutual Fund to update new name/s and/or signature/s and various records in the folio/s as per the details mentioned above and below. I/We hereby agree that new name/sand/or signature/s will be valid and effective only after the changes are updated and a confirmation is received by me/us. After the new name/signature audition, any requests with old name/signature will not be honored by the fund. Sole / First Unit Holder Second Unit Holder Third Unit Holder Old Name’s New Name’s New Signatures ACKNOWLEDGEMENT Received, subject to verification request to Change of Name Change of Signature ISC Stamp & Signature Form Folio No. INSTRUCTIONS 1. Separate forms needs to be filled for separate folios of the investor 2. Following documents need to be submitted for the change of signature 3. • Duly signed request letter from Investor. • Self-attested Govt. issued Photo ID proof - e.g.: PAN Card, Passport etc., where the signature tallies with the new signature of the investor. • Signature attestation letter from Bank. Following documents need to be submitted for the change of signature Post Marriage • Duly signed request by the investor (Request letter should be accompanied with both the maiden name signature and new signature). General Name corrections • Duly signed request by the investor • Duly signed request by the investor • 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. OR Affidavit on a `100 non judicial stamp paper duly notarised in original • PAN, KYC along with any of the following: • Ration card / Election Card / Passport / Aadhar / School transfer certificate / standard • 10th or 12th certificate • Certified copy of Marriage certificate duly attested • New signature (post change in name) certified by the banker • • Complete bank details (if any) along with personalized cancelled chq leaf New signature (if any, post change in name) certified by the banker • • Copy of the pan card and KYC in new name Copy of the pan card and KYC in new name 4. The above documents shall be in Original. If copies are furnished, the same must be submitted at the ISCs where they will be verified with the original documents to the satisfaction of the Fund. The original documents will be returned across the counter to the Unit Holder after due verification. In case the original of any document is not provided for verification, then the copies should be attested by the bank manager with his/her full signature, name employee code, bank seal and contact number. 5. In the event of a request for change in bank account information being invalid/incomplete/ not satisfactory in respect of signature mismatch/document insufficient/not meeting any requirement more specifically as indicated in clauses, the request will be liable for rejection.
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