PART LIQUIDATION FORM - Centrum Finance Company Limited

PART LIQUIDATION FORM

Layout

Date of Liquidation: (DD/MM/YY)

Date of Maturity: (DD/MM/YY)

INVESTOR DETAILS

Layout

Customer ID:

BVN

Corporate Name (If Applicable):

Layout

Name

First

Last

Phone

PAYMENT INSTRUCTION

Layout

Amount (Words):

Total Investment:

New Rate (%) P.A.:

Amount (Figure):

Balance After Part-Liquidation:

Account Name:

Account Number:

Bank:

Account Holder Signature

Click or drag a file to this area to upload.

Kindly upload a picture of your signature

Joint Signatory (if applicable)

Click or drag a file to this area to upload.

Kindly upload a picture of your signature

THIRD PARTY INDEMNITY (For Third Party Payment Requests only)

I/We are investors in the Centrum Finance Company Limited Investment Product Fund and request that you issue the proceeds of the redemption as set out above, in favour of the beneficiary whose details appear on the payment instruction set out above. In consideration of Centrum Finance Company Limited honouring the request, I/We hereby for myself /ourselves and my/our legal representatives, agree to keep Centrum Finance Company Limited indemnified against all actions, proceedings, claims and demands
which may be brought or made against Centrum Finance Company Limited or any of its Authorized Representatives in consequence of complying with My/Our request to pay the proceeds to the above -named Beneficiary. I/We further agree to pay on demand all payments, losses and expenses suffered or incurred by Centrum Finance Company Limited in consequence thereof or arising therefrom.

Layout

Name of investor

Investor Signature

Click or drag a file to this area to upload.

Date

Name of Witness

Witness Signature

Click or drag a file to this area to upload.

Date

INVESTOR DETAILS

PAYMENT INSTRUCTION

THIRD PARTY INDEMNITY (For Third Party Payment Requests only)

FOR OFFICIAL USE ONLY:

PAYMENT APPROVAL: