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CHANGE OF STATUS

* My FBO ID is
I would like to change/add/delete the following details in the system: *Name as on record
Last Name | First Name | Middle Name

(Please tick the applicable boxes of the information that you would like to change:)

1) Correction of Name: Previous Name (Last, First, Middle) New Name (Last, First, Middle)

Current Address New Address


2) Change of Address:
If ticked, please submit

copy of Aadhar/
Passport/Election
Card/Bank Statement/
Driving License/Voter
ID/Light Bill or Electricity
Bill showing address
page.

* 3) Contact Information: Current Information New Information

* Landline: * Landline:

* Mobile: * Mobile:
* Email: * Email:

4)*Permanent Account Number (PAN):


If ticked, please submit copy of PAN Card. PAN has to be of applicant in who’s name the FBO ID is in.

5) Change Spouse as Primary Applicant / 6) Delete Spouse’s Name: Name (Last, First, Middle)
If ticked, Spouse’s signature is mandatory

7) Any special request:

I understand that requesting the above mentioned changes me/or my spouse


will adhere to the rules, regulations and current policies set forth by the * FBO Signature Spouse’s Signature
Company.
* FBO ID# of the person submitting the form:
Quick Tip: To have your information updated faster, submit a * Name of the person submitting the form:
scanned copy of this form with signatures via email to admin@flpindia.net * Signature of the person submitting the form:

(*) Marks field are mandatory to fill up Submit this form at the below mentioned address for THE ADMINISTRATION DEPARTMENT
Mailing Address: Forever Plaza, 74, Hill Road, Opp. St. Stanislaus High School, Bandra (W), Mumbai 400 050. Version 11/08/18