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Click ‘Get Form’ to open it in the editor.
Begin by entering your account number(s) for the capital withdrawal in the designated field. Ensure accuracy as this is crucial for processing your request.
Select your title (Monsieur or Madame) and fill in your full name, address, civil status, date of birth, and telephone number. This information helps verify your identity.
Indicate whether you are requesting a full or partial refund by checking the appropriate box. If opting for a partial refund, specify the amount.
Choose the reason for your withdrawal from the provided options. Make sure to attach any required documentation as indicated.
Complete the payment details section with your financial institution's information, including account numbers and holder's address.
Finally, sign and date the form. If applicable, ensure that your spouse or registered partner also signs where required.

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