Transmission Form
Transmission Form
Transmission Form
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)
Transmission Form
(Deceased A/C)
Date: D D M M Y Y Y Y DP ID: Client ID: (Source a/c)
(DP ID of Deceased A/C Holder) (Client ID of Deceased A/C Holder)
Sole/First Holder
(Name of the First Holder as updated in Demat account)
Second Holder
(Name of the Second Holder as updated in Demat account)
Third Holder
(Name of the Third Holder as updated in Demat account)
of Mr./Mrs./Ms.
(Deceased Name)
the deceased, of which nomination//Probate of Will/Legal heir certificate probate/letter of administration/succession
certificate was duly granted to me/us on the day of hereby request you
(Please mention Day & Year)
to register me/us as the beneficial owner/s in respect of the securities standing in the name of said deceased under:
DP ID: Client ID: (Source a/c)
(DP ID of Deceased) (CLient ID of Deceased) (Deceased A/C)
I/We give hereunder the details of my/our account with a Participant to which the security balances are requested to be
Transmitted as under:
Recovery of dues
Direct Debit
Please debit my ICICI Bank account (A/c no. ) for recovery of any pending dues against
my account. (Please tick on the appropriate option for recovery of dues)
Cheque Payment
Cheque number.................................................................drawn on Bank.....................................................................................
Cash Payment UPI Payment .........................................................................................................................................
Declaration:
Joint Holder cases only): I/We declare and confirm that all the transactions in my/our Demat Account are true/authentic.
(Applicable only for legal heir(s)/legal representative(s) where deceased was a sole holder and no nomination in the
account Value of holding not exceeding `15 Lakh on the date of application)
We declare that the below mentioned person(s) are the only legal heir(s) of the deceased and there are not other legal
heir(s). Of these, as specified below, some/all of them are claimants and some of them have given a No Objection Certificate
in favour of other legal heir(s). Details are given below:
V- June 2022
Name of the legal heir(s) Specify whether the legal heir(s) is a claimant or
SR. No (Name of the legal heir who is claiming - Claimant)
has given a No Objection Certificate.
(Name of the legal heir who is giving NOC - No objection certificate)
Signatures of:
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I/We hereby submit the following documents to support my claim for the said securities.
Please tick whichever is applicable:
Death Certificate (duly attested by a Notary Public/
Indemnity Court Decree
Gazetted Officer)
Letter of Administration Affidavit for legal heir Settlement Deed
CML (In case of non ICICI Bank Target A/C) Legal heir certificate
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Copy of Will** (in terms of the Indian Succession Act, 1925),
evidencing rights of the legal heir(s) / claimant(s), attested by the
legal heir(s) / claimant(s) subject to verification with the original or
duly attested by a notary public or by a gazetted officer shall be
accompanied with a notarised Indemnity Bond from the legal
heir(s) / claimant(s) to whom the securities are transmitted ; Will
duly executed in terms of Indian Succession Act, 1925 shall be
accompanied with a notarized indemnity bond from the legal
heir(s)/claimant(s) to whom the securities are transmitted.
OR
Copy of Legal Heirship Certificate or its equivalent certificate issued
by a Competent Government Authority duly attested by a Notary
Public or by a Gazetted Officer or attested by the legal heir(s) / claim-
ant(s) subject to verification with the original to be accompanied with
a notarised Indemnity Bond and No objection from all the legal
heir(s) / non-claimant(s) stating that they have relinquished their
rights to the claim for transmission of securities duly attested by a
notary public or by a gazetted officer
Acknowledgement
We have received Transmission of shares request for:
DP ID: Client ID: Client ID:
Client ID: Client ID:
Demat A/C holder’s Name
Received by
Bank Official Signature Branch SR No
Date
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