AFFIDAVIT FOR MINOR CORRECTION IN NAME

(Please read the instructions carefully)

I/We………………………………………………Son/Daughter of……………………………………………………...
aged …………..residing at …………………. ……………………………………………………………………………..
…………………………………………………………………………………………. Solemnly affirm and declare as
under: -

1. That I/We am/are, the holder of ………… number of equity shares in State Bank of India as detailed
below:

Folio Number No of Certificate Distinctive No. (From) Distinctive Nos. (To)

shares Numbers

2. That my/our name is/are Mr/Mrs……………………………………………… Son/Daughter of

………………………………………………which is mentioned in the PAN, Aadhar card/Passport/Election
voter card (copy enclosed) bearing number…………………….

3. That my/our name/surname/father’s name/mother’s name .................................................................is

wrongly mentioned /printed as (mention name here) in the share certificate issued by State Bank of India
bearing certificate no. …………………………… issued on………………………

4. That my/our name/surname/father name/mother name Mr/Mrs/Ms (as mentioned on the share certificate)
and Mr/Mrs./Ms (as mentioned in the supporting documents) is the one and the same person.

5. I/ We am/are making this Affidavit, to submit to the Bank(SBI)/its agent, the facts so stated in this Affidavit
and to effect, change and accordingly record my/our name/surname/father’s name/mother’s
name/husband’s name etc. as ............................................................... (as mentioned in the supporting
documents).

6. I /We hereby affirm that I / We shall not hold the Bank(SBI) or its agents anyway responsible for any
consequences that might occur directly or indirectly on account of the Bank(SBI) or its Agents acting on
my / our request herein stated on account of replacing the name ………………………………………………
(name on the share certificates) with .................................................................(name as per supporting
documents) in the Bank’s records and for the consequential acts/deeds by the Bank(SBI)/its agent.

7. This Affidavit is executed in favour of the Bank (SBI) /its Agent on my/our own volition and is in the form
as required by the Bank (SBI) /its Agent, forwarded to me/us vide its letter No ………… dated………….

8. Whatever stated herein above is true and correct to the best of my knowledge & belief and if the contents
of this affidavit are proved/found false at any moment of time, then I/we exclusively shall be liable for the
same and consequence thereof including legal action which the Bank (SBI) /its Agent may initiate under
applicable law of land.

Solemnly declared and affirmed on Identification at……………………On this…………. day of

………………………………….

Deponents

Name, Address & Signature of Witness

1.
2.

Executed before me ……………………………………

(Should be attested by First Class Judicial Magistrate/Notary)
 Instructions
1. This affidavit is to be certified by Notary Public / First Class Magistrate.

2. The Non-Judicial Stamp Paper must be purchased in the name of the shareholder. The date of
execution of Affidavit should be within six months from the date of purchase of Non-Judicial Stamp
Paper.

3. Before signing, Rs. 100 special adhesive stamps should be affixed.

4. The signatures of the shareholder(s) on this Affidavit and request letter / Demat request Form/ Share
Transfer Form / Transmission Form should match.

5. The date of execution of Affidavit should be same as the date of attestation by the Notary Public / First
Class Magistrate.

6. The Affidavit should be signed and affirmed by all the shareholder(s) in the presence of the certifying
Authority. Each page of the Affidavit should be signed by the shareholder(s) and should bear the seal
of the Notary Public /First Class Magistrate.

7. Full Address of the Notary Public / First Class Magistrate should be mentioned. Court fee /Notarial
stamps, as applicable (including registration Number) should be affixed on the Affidavit.

8. Notary Book No. and Serial No. should be specifically stated on the Affidavit.

9. Changes/Alterations/Overwriting made in the Affidavit should be authenticated by the same Notary

Public /First Class Magistrate, under their official seal.

10. The photocopy of supporting document(s) as mentioned above, duly certified by First Class Judicial
Magistrate/Notary should be attached.