RTGS/NEFT APPLICATION FORM

RTGS NEFT (Select RTGS or NEFT as remittance type)

Kotak Mahindra Bank, Date :

Branch

Please debit my account number vide Cheque# and remit through NEFT/RTGS
a sum of ` (Rupees in words
) as per details given below. Please also debit the said account with your service
charges and Govt. taxes as applicable for this remittance.
Purpose Code
(Mandatory for RTGS Transactions. Please select from table below)

Beneficiary Beneficiary
Current Savings NRE OVERDRAFT (OD) CASH CREDIT (CC) CREDIT CARD LOAN Others
Details Account Type

Full Name of Beneficiary : Beneficiary A/c Number

Confirm Beneficiary A/c Number IFSC Code

Bank Branch
Beneficiary LEI number* (* mandatory only if the amount is Rs. 50 Crore and above)
I/We hereby confirm that I/we have read and understood the terms and conditions mentioned overleaf.
Signature/s:
(Authorised Signatory/Account Holder)
Name

For Bank Use Only 1. Sign & Employee Code (Maker ) : 2. Sign & Employee Code (Checker) :

3. Date & Time : 4. UTR #

I/We hereby confirm the correctness of the details like beneficiary name, *account number, IFSC code of the beneficiary Bank Branch. #Legal Entity
Identifier (LEI) of remitter and/or beneficiary are valid & correct. I/We am/are aware that the Bank will get the valid discharge if the amount is
credited to the beneficiary account number requested in RTGS/NEFT application and the Bank shall not assume any liability arising out of incorrect
IFSC code, mismatch in the beneficiary name including but not limited to mismatch in the spelling.
I/We declare that I/we am/are authorized to request the Kotak Mahindra Bank (herein after referred to as Bank) for RTGS/NEFT Facility and all the
person authorized to operate the above mentioned accounts are also authorized, as per the present mode of operation, to present the RTGS/NEFT
fund transfer application form to Bank. I/we undertake to keep Bank informed of any changes in the mode of operation of any of the above
accounts.
I/We hereby confirm having read the term & conditions pertaining to RTGS/NEFT facility on Bank's website www.kotak.com (hereinafter referred to
as "Terms and conditions") and agree that use of the RTGS/NEFT facility shall be subject to and be governed by the Terms & Conditions. I/We further
undertake to keep ourselves aware of any revision made by Bank of the fees and/or other charges levied for providing access to or allowing the use of
the RTGS / NEFT facility. I/We are aware that the same shall be notified to us by hosting the same on Bank's website http://www.kotak.com /
termsconditions.html
*Please Note that as per RBI guidelines the credit to the beneficiary account will happen only on the basis of account number provided.
#Please note that bank will not be responsible for not processing transaction in absence of valid LEI number for remitter as well as beneficiary.
Purpose Code:
CASH Cash Management Transfer INTE Interest SUPP Supplier Payment
KMBL/Mar.21/V1.03

CORT Trade Settlement Payment LOAN Loan TAXS Tax Payment

DIVI Dividend PENS Pension Payment TRAD Trade
GOVT Government Payment SALA Salary Payment TREA Treaury Payment
HEDG Hedging SECU Securities VATX Value Added Tax Payment
INTC Intra Company Payment SSBE Social Security Benefit WHLD With Holding

Kotak Mahindra Bank Ltd. CIN: L65110MH1985PLC038137, Registered Office: 27 BKC, C 27, G Block, Bandra Kurla Complex, Bandra (E), Mumbai 400051, www.kotak.com

Customer Acknowledgement

Branch: Date :

We acknowledge the receipt of NEFT/RTGS instructions for an amount of ` vide cheque number
to be credited to the Account number of Bank.
UTR#
Bank Seal
Bank Officials Signature With Date & Time of Request