ICICI Bank Limited, CPC-Demat Services, Ground Floor, B-Wing, Autumn Estate, Chandivali Farm Road, Opp.
Mhada Colony, Chandivali, Andheri (East), Mumbai - 400072.
(Important Note : Please do not send requests directly to this address. kindly route all requests through the nearest ICICI Bank Demat Servicing Branches.)
Application for Closure of Demat Account (NSDL/CDSL)
Date D D M M Y Y Y Y DP ID Client ID
*Please tick the applicable option(s): (*Marked is a Mandatory field)
Option A (There are no balances/holdings in this account)
Option B Transfer to my/our own account Target Account Details
(Transfer the (Provide target account details and
balances / enclose Client Master Report of
NSDL DP ID
holdings in Target Account)
this account as CDSL Client ID
per details given) Transfer to any other account (Submit
duly filled Delivery Instruction Slip
signed by all holders) PAN
Option C (Rematerialise/Reconvert (Submit duly filled Rematerialisation form for securities/Reconversion request form for Mutual fund units)]
"If option C is selected, kindly follow the rematerialisation/reconversion process. Demat account will be closed only after the rematerialisation/
reconversion process is completed (approximate TAT of rematerialisation is 30-45 days and for reconversion 7-10 days)
* Please tick the reason for closing the Demat Account: (*Marked is a Mandatory field)
Moving to new area/abroad where ICICI Bank does not have a branch Unsatisfactory services
High demat charges Stopped trading forever
Consolidation of accounts Others (Please specify)
Recovery of dues
Direct Debit
Please debit my ICICI Bank Account (A/c No. for recovery of any pending dues
against my account
Cheque Payment
Cheque Number............................................................... drawn on Bank........................................................................................
Cash Payment UPI Payment .....................................................................................................................................
Refund of charges
*Please provide operative Savings Bank account number for refund of pro rata AMC charges (if any). In case of Non ICICI Bank account, please provide a cancelled cheque copy.
ICICI Bank Account Non ICICI Bank Account
Bank Account No.
DECLARATION: In case of Account Closure due to Shifting of Account:
I/We declare and confirm that all the transactions in my/our Demat Account are true/authentic
Signature of Sole/First Holder Signature of Second Holder Signature of Third Holder
V - April 2022
For Branch Use Only
I confirm that the account is active, applicant(s) signed in my presence, all relevant details are matching in our Bank records and
verified by me.
Name & Employee ID:
Signature of the Branch Official: