Registered Office:   Corporate Office:   FD Department:

“Knowledge House”, Shyam Nagar, Off Jogeshwari - Future Retail Home Office, 247 Park, ‘C’ Tower, LBS City Gold Mall, 3rd Floor, Near Shyamal Cross Road,
Vikhroli Link Road, Jogeshwari (East), Mumbai – 400 060 Marg, Vikhroli (West), Mumbai – 400 083. Tel: +91 22 132, Feet Ring Road, Satellite, Ahmedabad -380 015
Tel: +91 22 6644 2200 Fax: + 91 22 6644 2201; 6119 0000 Fax: + 91 22 6199 5019 Customer Care Email: fdcare@felindia.in
Website : www.felindia.in, Email: fel.deposit@futuregroup.in, Customer Care No. - 1800 572 7773
CIN L52399MH1987PLC044954  fel.deposit@felindia.in

 
 
MULTIPURPOSE REQUEST FORM

Date _ _/_ _/_ _ _ _

To,
Future Enterprises Limited
FD Department, City Gold Mall, 3rd Floor, Near Shyamal Cross Road,
132 Feet Ring Road, Satellite, Ahmedabad -380 015

Dear Sir / Madam,

Reference number: My/Our Fixed Deposit No……………………../ Customer ID number …………………....
I am / we are maintaining the captioned fixed deposit with your Company.
(Please  the appropriate box) / Strike off whichever is not applicable
 Duplicate Fixed Deposit Receipt
Kindly arrange to issue me Duplicate Fixed Deposit Receipt for fixed deposit number
…………………………………as the original fixed deposit receipt has been lost / misplaced / mutilated /
damaged.
Duly executed and stamped Affidavit and Indemnity Bond for issuing duplicate fixed deposit receipt is
attached herewith, further I / we, am / are ready to bear the charges thereof, if any.

 Premature withdrawal

Please terminate my fixed deposit bearing receipt number …………………. prematurely and transfer
proceeds to the registered bank account after deduction of premature charges applicable. Aforementioned
Fixed Deposit Receipt in original duly signed by me / us is enclosed herewith.
 Change of name

Please change my name as Mr / Mrs. ………………………………………………………………..…………..

From Mr. /Ms………………………………………………………………………………………………………...

(copy of marriage certificate/ Gazette notification / Affidavit and Indemnity Bond other proof is enclosed
herewith).
 Attained majority

My Son / Daughter / Ward has attained majority on ………………………. . Please change / update your
record accordingly. (copy of PAN Card and proof of change as per KYC guidelines of FEL FD Form).
 Change of address

My new address is …………………………………………………………………………………………………

…………………………………………………………………………………………………………………………
…………………………………………………..……………………………………………PIN ………………….
Kindly make necessary changes in your records. (proof of change as per KYC guidelines of FEL FD
Form).

Initial  Initial  Initial 

     

Sole/First Applicant (Guardian in case of Minor) Second Applicant Third Applicant

 
 Registered Office:   Corporate Office:   FD Department:
“Knowledge House”, Shyam Nagar, Off Jogeshwari - Future Retail Home Office, 247 Park, ‘C’ Tower, LBS City Gold Mall, 3rd Floor, Near Shyamal Cross Road,
Vikhroli Link Road, Jogeshwari (East), Mumbai – 400 060 Marg, Vikhroli (West), Mumbai – 400 083. Tel: +91 22 132, Feet Ring Road, Satellite, Ahmedabad -380 015
Tel: +91 22 6644 2200 Fax: + 91 22 6644 2201; 6119 0000 Fax: + 91 22 6199 5019 Customer Care Email: fdcare@felindia.in
Website : www.felindia.in, Email: fel.deposit@futuregroup.in, Customer Care No. - 1800 572 7773
CIN L52399MH1987PLC044954  fel.deposit@felindia.in

 
 

 Change of Bank Account Details of Sole / First Depositor

Sole/ First Applicant Name
Bank Name
Branch Name
Current / Savings Account Number
MICR Code
IFSC Code
(Please attach cancelled cheque for verification)
 Updation of phone number / email address
My new phone number ………………………………………………………………………………………….
My new email ID …………………………………………………………………………………………………..
 Updation of Signature

My / our updated signature is………………………………………………………………………………………

(Bank verification letter approving updated signature is attached herewith)

 Addition/ Deletion of nominee’s names in FDR

Name of the existing nominee holder(s):………………………………………………………..
I/we request you to add / delete / replace the name of: ………………………………………………….
Relation with Sole/ First Depositor ……………………………….........................................................
(Enclosed herewith the Updated Nomination Request Form)
 TDS Certificate
i. TDS certificate for the FY 20_ _ - 20 _ _
ii. Interest Certificate request for the FY 20_ _ - 20 _ _
iii. TDS Certificate not received for the FY 20_ _ - 20 _ _
 Any other request

SIGNATURE(S) OF APPLICANT(S)

  Date: 
Sole/First Applicant   
(Guardian in case of Minor) Second Applicant  Third Applicant  Place: 
Note: Documentary proofs are required to be self-attested by all Depositors with initial on all pages including
this Multipurpose Request Form.