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    Indemnity Formats - Name Change

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    Web Spring
    Roopali is requesting to change the name on her mutual fund investment from "Roopali Rathi" to "Roopali" due to an error on the original application form. [1] She provides details of the original investment made in 2001. [2] To allow the name change, Roopali signs an indemnity bond agreeing to indemnify and hold harmless ICICI Prudential Mutual Fund against any losses or claims resulting from the name change. [3] She verifies the information provided is true and correct.

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    Indemnity Formats - Name Change

    Uploaded by

    Web Spring
    233 views2 pages
    Roopali is requesting to change the name on her mutual fund investment from "Roopali Rathi" to "Roopali" due to an error on the original application form. [1] She provides details of the original investment made in 2001. [2] To allow the name change, Roopali signs an indemnity bond agreeing to indemnify and hold harmless ICICI Prudential Mutual Fund against any losses or claims resulting from the name change. [3] She verifies the information provided is true and correct.

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    Indemnity formats

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    Roopali is requesting to change the name on her mutual fund investment from "Roopali Rathi" to "Roopali" due to an error on the original application form. [1] She provides details of the original investment made in 2001. [2] To allow the name change, Roopali signs an indemnity bond agreeing to indemnify and hold harmless ICICI Prudential Mutual Fund against any losses or claims resulting from the name change. [3] She verifies the information provided is true and correct.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    233 views2 pages

    Indemnity Formats - Name Change

    Uploaded by

    Web Spring
    Roopali is requesting to change the name on her mutual fund investment from "Roopali Rathi" to "Roopali" due to an error on the original application form. [1] She provides details of the original investment made in 2001. [2] To allow the name change, Roopali signs an indemnity bond agreeing to indemnify and hold harmless ICICI Prudential Mutual Fund against any losses or claims resulting from the name change. [3] She verifies the information provided is true and correct.

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    © All Rights Reserved
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    Indemnity formats -Name change

    ANNEXURE 1
    On Rs. 500 stamp paper
    INDEMNITY BOND

    To,
    The Trustees
    ICICI Prudential Asset Management Company Ltd.
    Nirlon Knowledge Park, 2nd Floor,
    Block B-2, Western Express Highway,
    Goregaon, Mumbai – 63

    Dear Sirs,

    Re: Change of name – Folio Nos.​ 295400/89

    Whereas, I,​ Roopali ​, s/d/o ​ Ramakant Rathi ​ aged ​ 29 ​ years, residing at ​ Flat no. -1001,
    Lion Group Society ,GH no. -30-31, Sector-2, Ballabgarh, Faridabad, Haryana
    (121004)​, have made an investment in ICICI Prudential ​ Child Care Fund (GIFT PLAN)
    (hereinafter called as ‘the said Scheme(s)’), of ICICI Prudential Mutual Fund.

    Whereas, I/my broker have/has erroneously written my name in the application form no.
    423117 ​ dated ​ 31/08/2001 ​, as ​ Roopali Rathi​, instead of ​ Roopali ​and the application
    form is under my signature.

    Whereas the units under the said scheme(s) in the above-referred folios have been allotted
    in the name of ​ Roopali Rathi ​ , instead of ​ Roopali ​ because of the above-said error.

    NOW in consideration of ICICI Prudential Asset Management Co. Ltd. (the AMC) allotting
    units in my correct name i.e. ​ Roopali ​ under the said scheme(s) in the above-referred
    folios, I, DO SOLEMNLY AFFIRM, UNDERTAKE AND DECLARE ON BEHALF OF
    MYSELF, MY SUCCESSORS, ASSIGNS AND EXECUTORS THAT:

    I shall at all times hereafter save, defend and keep harmless and indemnified the AMC/
    Trustees of ICICI Prudential Mutual Fund and its employees, Directors, Officers against any
    losses, damages, costs or expenses which may be suffered or incurred by them as a result
    of claims, legal costs, fines, penalties raised by any investor(s)/ claimant/third party or by
    any regulatory or administrative authority and for any other incident of a financial nature
    which they may be required to meet in connection with the AMC having allotted the units in
    the name of ​ Roopali ​ under the said Scheme(s) in the above referred folios. Such costs
    may exceed the value of the transaction itself which I agree to indemnify, unconditionally
    and irrevocably and without recourse to any further litigation if a claim is made by the AMC.

    I agree that it is only upon the above assertion being made by me that the AMC is
    permitting such a change and changing the name on good faith and is subject to approval
    by the Trustees of ICICI Prudential Mutual Fund, if necessary, and confirms that the above
    facts may be filed by ICICI Prudential Mutual Fund with the appropriate regulatory authority
    (ies).
    I confirm that neither will I be violating any laws/rules/regulations by seeking such a name
    change nor do I intend to evade any taxes/cesses or any other statutory dues/charges.

    I shall hold the AMC/ Trustees of ICICI Prudential Mutual Fund and its employees harmless
    and fully indemnified against claims and damages which may be made in respect hereof by
    any person (s)/third party claiming to be the beneficial holder of the said Investment or in
    any way interested therein.

    And, I, undertake that, this Indemnity shall be enforceable against me and my respective
    Successors and Assigns and the benefits of this Indemnity shall inure for the benefit of the
    AMC, its successors and assigns and shall be irrevocable until discharge by them of all
    obligations devolving upon hereunder.

    This indemnity and all rights and liabilities attached to this indemnity in case of dispute shall
    be enforceable at Mumbai and the dispute, if any, shall be triable by competent court
    having its jurisdiction in and over Mumbai.

    IN WITNESS WHEREOF I, ​ Roopali ​ , execute these presents on the ​ 6th ​ day of


    November ​ 2020.

    Signed and delivered by the following

    (a)Name: Roopali

    Address: Flat no. -1001, Lion Group Society ,GH no. -30-31, Sector-2, Ballabgarh,
    Faridabad, Haryana (121004)

    Signature: ______________________

    In presence of:

    VERIFICATION

    I solemnly verify and confirm that what has been stated above are true and correct to the
    best of my knowledge and belief and nothing material has been concealed.

    Date: 6 November 2020


    Place: Faridabad

    _____________
    Signature of Deponent(s)

    Indemnity Formats
    Name change

    Signature and Seal of Notary


    Before me Public / Magistrate

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