(A wholly owned subsidiary of Union Capital Limited)
Noor Tower, 4th Floor73, Sonargaon Road, Dhaka - 1205Phone: 9632161-2, Fax: 9632163
Special Request (if any):
I/We intend to withdraw the above stated amount of Taka from my/our portfolio account maintained with you. Therefore, I/We would appreciate if you please issue cheque(s) for the above amount at the earliest.
I/We also do hereby declare that no purchase will be made against the amount requested for withdrawal as well as the proportionate loan amount.
Signature (1st / Joint / POA holder)