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    UniCap Investment Limited

    (A wholly owned subsidiary of Union Capital Limited)

    Noor Tower, 4th Floor
    73, Sonargaon Road, Dhaka - 1205
    Phone: 9632161-2, Fax: 9632163


    Client Name:

    Client Email:

    Client Code:

    Contact No.:


    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.

    Date (MM/DD/YYYY)

    Signature (1st / Joint / POA holder)