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Dematerialisation Request Form

This document is a Dematerialization Request Form (DRF) submitted to State Bank of India to dematerialize securities. It includes details of the account holder such as account number and DP ID. The applicant requests dematerializing various securities like equity shares, debentures, bonds, and units held in physical form and provides certificate numbers, distinctive numbers, quantity and face value. The applicant signs to confirm the original certificates are surrendered and free of any encumbrances. SBI verifies and certifies the details match and the holder has a beneficiary account before processing the request.

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Hemanth Aremanda
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2K views1 page

Dematerialisation Request Form

This document is a Dematerialization Request Form (DRF) submitted to State Bank of India to dematerialize securities. It includes details of the account holder such as account number and DP ID. The applicant requests dematerializing various securities like equity shares, debentures, bonds, and units held in physical form and provides certificate numbers, distinctive numbers, quantity and face value. The applicant signs to confirm the original certificates are surrendered and free of any encumbrances. SBI verifies and certifies the details match and the holder has a beneficiary account before processing the request.

Uploaded by

Hemanth Aremanda
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

INDOC No.

State Bank of India

DP ID No. : 13019300 SebI Regn. No.: IN-DP-CDSL-80-2000

DP Centralised Processing Cell, CMC House, C-18, Bandra-Kurla Complex, Bandra (East), Mumbai 400 051.
Help Desk: 1800 22 0488 (Toll free for MTNL/BSNL users) / Ph.: 022-26592123 Fax : 022-26592127 Email : querydp@[Link]

DEMATERIALISATION REQUEST FORM (CDSL)


Please fill all the details in Block Letters in English (FILL UP ISIN WISE SEPARATE DRF FOR FREE SECURITIES AND LOCKED-IN SECURITIES)

Account No.
D D

3
Y

0
Y

1
Y

0 DRN (to be filled by DP) Application Slip/Ref. No. /DRF No.

Date
M M Y

I/We request you to dematerialise the enclosed certificates registered in my/our name into my / our demat account.

Details of Securities Name of the Company ISIN Type of Security Folio No. I N

Free Securities

Locked-in-Securities

Equity Certificate No. From To

Debentures

Bonds Distinctive No.

Units

Other (Specify) Quantity

From

To

Total Number of Certificates (In words) Quantity to be Dematerialised (In Figures) (In words) Face Value of Securities Rs.

(If the space above is found to be insufficient, an annexure containing the certificate details duly signed in the same format may be attached.) In case of Locked-in Securities fill up a separate DRF for Locked - in Securities having different release dates. Lock-in Reason Lock-in Release Date The Original Certificates / documents are hereby surrendered by me / us for dematerialisation and the same are free from any lien or charge or encumbrance and represent the bona fide securities of the Issuer Company to the best of my / our knowledge and belief. Names Signature with DP Signature with RTA/Issuer/Co. First / Sole Holder Second Holder Third Holder

We have received the above mentioned securities bearing ISIN No.___________________ for Dematerialisation. The application form is verified with the Certificates / Documents surrendered for dematerialisation and we certify that the application form is in accordance with the details mentioned in the enclosed certificates / documents. It is also certified that the Holder(s) of securities have a beneficiary account with us in the name (s) and order of name(s). Signature verified

Participant Authorisation (From DP to RTA)


Acknowledgement (DP TO BO)

Name & Signature of Authorised Bank Official

State Bank of India

DP ID No. : 13019300 SebI Regn. No.: IN-DP-CDSL-80-2000

Application No. CDSL We hereby acknowledge the receipt of the following securities for dematerialisation subject to verification : Account No. 1 3 0 1 9 3 0 0 Sole / First Holder Name Name of the Company Type of the Security ISIN Branch Stamp & Signature

DP Centralised Processing Cell, CMC House, C-18, Bandra-Kurla Complex, Bandra (East), Mumbai 400 051. Help Desk: 1800 22 0488 (Toll free for MTNL/BSNL users) / Ph.: 022-26592123 Fax : 022-26592127 Email : querydp@[Link]

Equity Debentures No. of Securities

Bonds

Units Other Specify) No. of Certificates

Branch Name: Branch Code:

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