To,
The Branch Manager,
____________ (Name of the Bank)
____________ (Branch Address)

Date: __/__/____ (Date),

Subject- Application for surrending locker _________ (locker number)

Respected sir,

I, ____________(Name) availing a locker facility have locker number ____________ (locker) in your branch. I am writing this letter to request you to surrender my locker ____________ (locker number). The reason for surrendering is ___________ (reason for locker surrender).

Details of the locker are mentioned below:
Locker number: ____________
Locker Size: _______________ (If applicable)
Name of the Branch: ____________

I request you to kindly surrender the locker. I hereby authorize you to debit charges related to the locker as per bank norms.

As per bank requirement, I am enclosing ___________ (Locker surrender application form, KYC, other documents if applicable) with the application.

Thanking you,

Kind regards,
____________ (Name)
____________ (signature)
____________ (Address),
____________ (Contact Number)

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