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 your requests through the nearest ICICI Bank Demat Servicing Branches)
Letter of Surety

Date D D M M Y Y Y Y DP ID Client ID

Sole/First Holder

Second Holder

Third Holder

Name of Surety *
Permanent Residential
Address

Pin
Age Permanent Account No. **
* A person cannot stand as surety for spouse/ family member ** Furnish proof of PAN

(Fill in any one or more of the following boxes, whichever is applicable)

A.Details of Employment
1. Name of Employer :
2. Place of Employment :
3. Annual salary :

B. Details of immovable property owned

(Absolutely in own name and not as member of a joint & undivided Hindu family. Specify whether the immovable

property consists of houses or mere land)

1. Within the municipal limits :

2. Situation :

3. Value :

C.Details of business owned

(absolutely in own name and not as a partner)
1. Name of organisation :
2. Nature of business and location :
3. Annual turnover :

Date : D D M M Y Y Y Y

Full Name and Address of Bank Manager Signed in the presence of

(Bank Manager)
Pin
V-Dec 2017

(Signature of Surety) This document file has been downloaded from Yappe.in