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CHANGE OF STATUS

My FBO ID is

and my name is Last Name | First Name | Middle Name

I would like to change/add/delete the following details in the system:


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

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

2) Change of Address: Is this a change of Home Country OR Address Update?

If ticked, please submit


copy of Aadhar/ 3) Contact Information:
Passport/Election
Card/Bank Statement/ Landline:
Driving License/
Voter ID/Light Bill or Mobile:
Electricity Bill showing
address page.
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
Company.

Quick Tip: To have your information updated faster, submit a scanned copy of this
form with signatures via email to admin@flpindia.net
FBO Signature Spouse’s Signature

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 05/10/17

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