Portal for Submission of Claims for Refund of Unitech Fixed Deposits

Non-Cummalative (A) Registration Form

Non-Cummalative (A)

Cummalative (B)

(Fields marked * are mandatory)

FD Number*

6 digit number, use 0 (zero) before a 5 digit number

New Password *

Confrim Password *

Name*

Upload Proof of ID*

PAN card, passport, aadhar, drivers licence; the file size must be less than 1 megabyte

Address

Date of Birth*

Mobile Number*

Upload FD Receipt*

Term of FD *

Amount Invested in FD(Rs.) *

Date of FD

Date of Maturity

FD Interest Rate (%)

As mentioned in the FD receipt

Amount Due on Maturity (Rs.)

Total Interest Payable by Unitech till Maturity (Rs.)

Total Amount of Interest Paid by Unitech Till Date (Rs.)

Details of Pending Case / Remarks (if any)

Upload Order Copy (if any)

Principal Amount Paid by Unitech (Rs.)

Does FD holder suffer from any Serios Medical Conditon *

Describe the Nature of the serious Medical Condition

Supporting Documents From Hospital/Institution

Upload scan of document from hospital/Medical Institution from which treatment for medical condition has been availed of

Name of Hospital/Doctor (Primary illness)

Date of Medical prescriptions uploaded on portal (latest one)

Expenses incurred for the medical treatment from 01.01.2021 onwards

Have the medical expenses been re-mbursed by the employer or claimed by him under any Medi-claim policy

Explanation (if any) of above

Undertaking *

The above information submitted by me/us is true and correct to the best of my/our knowledge. I/we undertake that I/we shall be held liable in case of any of the above Information is found to be incorrect.