Appendix S

Date:____________

To
IndusInd Bank Ltd.
________ Branch

SIGNATURE CHANGE REQUEST

Dear Sir,

Re: Account Name__________

Account No:____________

This is to advise you that my present signature differs from my old signature appearing in my
___________________________(document name) bearing No______________issued
on____________.

Please treat the signature signed by me under “Present Signature” as valid and accept the same for
all future banking transactions with yourselves.

Thanking You,

_______________________ ___________________
Old signature Present Signature

□ Tick if unable to repeat the exact old signature

For Bank Use only

This is to certify that the customer has signed both the signatures in my presence

-----------------------------------

Bank Official Name, Sign, ECN

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