From

To
....................................... The Branch/Chief Manager
....................................... State Bank of India,
Phone: ............................ ...............................................

Dear Sir,
REQUEST FOR
 CLOSURE OF ACCOUNT
 CONVERTING THE ORDINARY S.B. ACCOUNT TO CHEQUE FACILITY A/C
 CONVERTING THE S.B. A/C TO JOINT A/C
*(Please tick the appropriate box)
 CLOSURE OF A/C
1. I/We request to you to close my/our Account No. ........................................ and arrange to pay me/us the balance by Cash/Credit
to my/our Account No. ........................................... The passbook/the unused cheque leaves bearing No. ................................. to
............................ are enclosed.
Reason for closing the Account : a) In need of money
b) Leaving the place
c) ............................
(Specify, if any other)
Place :
_______________________
Date     : Signature
 CHEQUE FACILITY A/C
2. I/We request you to convert my/our ordinary Savings Bank Account No. ............................... to Cheque Facility Account. I/We
undertake to maintain a minimum balance of `..................................... in the account. A fresh application form duly introduced
by a person accep able to the Bank is submitted herewith. For this purpose, three copies of my/our recent passport size
photograph(s) are enclosed.
Place :
_______________________
Date     : Signature
 JOINT ACCOUNT
3. I request you to convert my S.B. Account No........................................... to a Joint Account by adding the name of
Shri/Smt. ................................... Furnished herewith the address and specimen signature of the proposed joint account holder.
For this purpose 3 copies of recent passport size photograph of Shri / Smt. ....................................... is enclosed.
Address:
.............................................................. ............................................................
(Specimen signature of joint a/c holder)
.............................................................
Place :
_______________________
Date     : Signature
 DUPLICATE PASS BOOK
4. I/We request you to issue me/us a Duplicate Pass Book in lieu of the one lost / spoiled. The requisite Bank Charges may be
debited to my/our S.B. A/c. No. ............................... I undertake to advise the Bank if and when the original is traced and avoid its
misuse.
Circumstances in which the pass book is lost.
.................................................................................................................................................................................................
(Briefly state reason)
Place :
_______________________
Date     : Signature
------------------------------------------------------------------------------------------------------------------------------
FOR OFFICE USE

Signature / Photograph verified Interviewed & Allowed

___________________ ______________________
(Signature) (Signature)
Desk Officer Manager
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