Kotak Mahindra Bank
Form for Modification in Customer / Account Details
(Demat)
I request you to update your records as per details provided below.
Client ID
Customer Relationship Number
To Change

Old

New

Mailing Address

Permanent Address

Telephone Number (Office)
Telephone Number (Residence)
Mobile Number
Fax Number
Email Address
Bank Name
Branch Name & Address

Account Number
MICR Number
1.
2.

For change in address, please provide proof of the new address by submitting a copy of Passport / Driving Licence / Election Card / Utility Bills.
Please submit seperate request for different client IDs

Signature(s)
Account Holder

Account Holder

Account Holder
Branch

Date
For Bank use
Date and time of Acceptance

Date of input

Receiver’s stamp

New Branch

Signature verified by

Signature verified by

Documents sent to CPC on

Authorised by