Full Name *AddressContact NumberEmail Address *Amount Requested (In Words)Write in words the amount requestedAmount Requested *XCDAccount No.Effective DateDayMonthYearProof of IdentificationPassport/Driver License / I.D Card #Purpose for withdrawalI understand that due to the request for funds from my shares account I would be required to give the required three (3) months’ notice or pay the necessary fine of 3%.Please deduct withdrawal fee from: *Amount RequestedOrdinary DepositShare DepositConsent *Yes, I agree with the privacy policy and terms and conditions.Submit Request