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Close Account Request Form - Personal

Please complete the form in BLOCK CAPITALS. Please tick where applicable and ensure that no blank or partially completed forms / documents are signed and handed over to the Bank staff.

Date

Customer Name (s) Address to be used for future correspondence City Country Tel (Off) Tel (Res) State PIN Code Email Mobile #

I / We authorise you to close the account listed below. The balance in the account, after the recovery of any interest, tax or charges payable by me/us, is to be repaid to me as indicated on page 2. Customer Number Savings / Current Account Number Fixed Deposit Number (s) Other Accounts * * Please provide separate requests for closure of Demat / Wealth Management / Retail Loans / Credit cards / Lockers

Please tick the reason for closure of the account

Code 1 2 3 4 5 Reason for Closure Account moved within HSBC Unable to maintain the minimum balance / Charges too high Inactive Account not being used Moved to non HSBC Bank location / Inconvenient Bank location Interest Rate not competitive Code 6 7 8 9 Reason for Closure Account holder deceased Dissatisfied with the service / product features Resigned from Corporate (Salary Account) Others - Please specify __________________________________

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Close Account Request Form - Personal

The Balance in the account is to be repaid as follows : (choose any one option only) Transfer vide NEFT / RTGS or Telegraphic Transfer (less applicable charges) as per the application enclosed. (Kindly complete separate NEFT / RTGS / TT application form as applicable) (NEFT - mandatory for all amounts below INR 1,000)

Bank draft (less applicable charges) to be mailed to the future correspondence address

Transfer to my HSBC Account _____________________________

I/We hereby declare that all the unused cheque leaves, Debit/ATM cards have been destroyed by me/us. I/We agree and understand that any unpresented cheques, ECS and Standing Instructions in the account received by the Bank after the date of account closure will stand dishonoured by the Bank and I/We agree to indemnify the Bank against any actions, proceedings, claims and /or demands that may arise due to reason of such dishonour. I/We agree and confirm that I/we shall provide separate instructions to the Bank for closure of the Safe Deposit Lockers / Demat accounts / Credit cards / Wealth Management Accounts / Retail Loans, if held by me/us. I/We agree and confirm that I/we shall provide suitable amendment instructions to concerned Asset Management Company in case the account being closed above is a settlement account for Wealth Management Services availed from the Bank. I/We agree and understand that the Bank shall have a right of set off and general lien over the amount payable to me/us after closure of the aforesaid account and the Bank shall be entitled to recover any outstanding amount including interest, charges, TDS and/or any other related charges. I/We agree and understand that any charges as per the applicable tariff will be deducted from my/our account. I/We agree and understand that the Bank accepts no responsibility for any loss, delay, error , omission or mutilation which may occur in the transfer of funds or for any misinterpretation and I/We agree to indemnify the Bank against any actions, proceedings, claims and/or demands that may arise in connection with such loss, delay, error, omission, mutilation or misinterpretation.

Note : All account holders are required to sign this form and authenticate all corrections or amendments (if any).

Sole / First Account Holder

Joint / Second Account Holder

Third & Other Joint Account Holders

For Bank use only

Signature of Authorising Official

RMS Ref #

Name

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Information

2 pages

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