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Customer SI Debit Authorisation Form

This document is a customer debit authorization form for an HDFC Bank loan. It requests that the bank set up a standing instruction to debit the customer's bank account each month for the loan EMI payment. The key details provided are the loan amount, tenor, start and end dates of the EMI payments, the customer's bank account number, and an acknowledgement that the customer will maintain sufficient balance to cover the EMI amounts. It also states that failure to pay through this standing instruction will be considered a loan default.

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Deepak Chinu
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1K views1 page

Customer SI Debit Authorisation Form

This document is a customer debit authorization form for an HDFC Bank loan. It requests that the bank set up a standing instruction to debit the customer's bank account each month for the loan EMI payment. The key details provided are the loan amount, tenor, start and end dates of the EMI payments, the customer's bank account number, and an acknowledgement that the customer will maintain sufficient balance to cover the EMI amounts. It also states that failure to pay through this standing instruction will be considered a loan default.

Uploaded by

Deepak Chinu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Customer SI Debit Authorisation form

To Date:
The Branch Manager,
HDFC Bank,

__________________

__________________

Dear Sir / Madam,

I have taken a ______________ loan from HDFC Bank and would like to avail of the Standing Instruction
facility offered by your bank to make EMI repayments of my loan.

ØThe loan amount is Rs. _________ for a tenor of _______ months and EMI of Rs._________

Start Date (First Emi Debit Date) ___________ , End Date (Last Emi Debit Date) ____________

ØI request you to accept this mandate to debit my account number

with your ________________________ branch for the EMI amount towards the _____________
dues on my loan. These debits will be raised by HDFC Bank on ____________ of every __________
until the last Emi Debit date.

ØI undertake to maintain sufficient balance to cover the above Emi amount (and charges if any) on the
above due date and I understand that the failure to repay my loan amount through this standing instruction
shall be treated as a default in repayment of dues and all charges / penalties / levies as covered by the
agreement will hold good towards the non-payment of obligations.

ØPlease treat this as an irrevocable communication as an authorisation to debit my account every month
with the required EMIs towards the repayment of my loan.

ØIn the event of the above account getting closed/transferred for any reason, you are required to
intimate the Bank the new account opened with the bank for ______________ debit of the EMI amount
as per the agreement. Further, I/WE undertake the responsibility to provide the fresh set of Mandate
and 'security PDC's for such new account, (one cheque for every six months) / as per terms of the
agreement in lieu of existing instructions.

Thanking you,

Yours truly,
(Signature of account holder) (Name of the account Holder)
------------------------------------------------------------------------------------------------------------------------
Verified
 Customer Account Number & Signature
 Due Date’s & Frequency
 Emi Amount & Tenure
(Seal and Signature of HDFC Bank Official)

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