Request Form for Revalidation of Redemption / Dividend warrant

To
_____________________ Mutual Fund.
Sub:
Ref:

Revalidation of Redemption/Dividend Warrant

Folio No(s): _____________________________

Dear Sir/Madam,
I am unable to deposit the enclosed redemption / dividend warrant no. ____________ dated __________ for
Rs. _____________, drawn on ________________________________________________________________
issued by you.
The validity of the warrant has expired. Request you to revalidate the same and resend to my address in your
records.

Encl.: Redemption Warrant

Dividend Warrant

First Holder Name: ____________________

Signature of the First Holder: ___________________________
Date: __ / __ / ____

ACKNOWLEDGEMENT
We acknowledge the receipt of request for revalidation of Redemption / Dividend cheque no. _________
dated

_________

for

Rs.

_____________

from

Mr.

Ms.

M/s.

___________________________________________________ holding Folio No(s): _________________________

in _______________________ Mutual Fund.

Date of receipt at CAMS CSCs: _____________________

CAMS CSC seal