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Mandate Form 34925294

Gulam Mustafa authorizes Hero Fincorp Ltd. to debit Rs. 92,891 from his State Bank of India account number 612070288477 on a monthly basis starting from December 2022 until cancelled. The debit is referenced by mandate ID 500001102371752497 and reference number 34925294. Gulam agrees for the bank to debit mandate processing charges as per their schedule of charges.
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0% found this document useful (0 votes)
44 views1 page

Mandate Form 34925294

Gulam Mustafa authorizes Hero Fincorp Ltd. to debit Rs. 92,891 from his State Bank of India account number 612070288477 on a monthly basis starting from December 2022 until cancelled. The debit is referenced by mandate ID 500001102371752497 and reference number 34925294. Gulam agrees for the bank to debit mandate processing charges as per their schedule of charges.
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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UMRN Date 2 3 1 0 2 0 2 2

Sponsor bankcode Utility Code NACH00000000002558

I/We hereby Authorize HERO FINCORP LTD To Debit SB/ CA/ CC/ SB-NRE/ SB-NRO/ OTHER

CREATE
MODIFY Bank a/c Number 6 1 2 0 7 0 2 8 8 4 7
CANCEL

With Bank State Bank of India IFSC S B I N 0 0 3 1 1 7 0 or MICR 3 3 4 0 0 2 0 2 1

an amount of Rupees Ninety Two Thousand Eight Hundred and Ninety One Rupees 92891
Frequency Monthly Qtly H-Yrly Yearly As & when prensented Debit Type Fixed Amount Maximum Amount

Reference 1 34925294 Phone Number 9680490353

Reference 2 EMail ID
PERIOD I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of bank

From 0 8 1 2 2 0 2 2
To* Sign. Primary Acc. Holder Sign Acc. Holder Sign Acc. Holder

Or Until Cancelled GULAM MUSTAFA

This is to confirm that declaration has been carefully read, understood & made by me/us. I'm authorizing the user entity/Corporate to debit my account, based on the instruction as agreed and signed by me. I've
understood that I'm authorized to cancel/amend this mandate by appropriately communicating the cancellation/amendment request to the user/entity/corporate or the bank where I've authorized the debit.

MandateId : 500001102371752497 Reference1 : 34925294

UMRN Date 2 3 1 0 2 0 2 2
Sponsor bankcode Utility Code NACH00000000002558

I/We hereby Authorize HERO FINCORP LTD To Debit SB/ CA/ CC/ SB-NRE/ SB-NRO/ OTHER

CREATE
MODIFY Bank a/c Number 6 1 2 0 7 0 2 8 8 4 7
CANCEL

With Bank State Bank of India IFSC S B I N 0 0 3 1 1 7 0 or MICR 3 3 4 0 0 2 0 2 1

an amount of Rupees Ninety Two Thousand Eight Hundred and Ninety One Rupees 92891
Frequency Monthly Qtly H-Yrly Yearly As & when prensented Debit Type Fixed Amount Maximum Amount

Reference 1 34925294 Phone Number 9680490353

Reference 2 EMail ID
PERIOD I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of bank

From 0 8 1 2 2 0 2 2
To* Sign. Primary Acc. Holder Sign Acc. Holder Sign Acc. Holder
Or Until Cancelled GULAM MUSTAFA

This is to confirm that declaration has been carefully read, understood & made by me/us. I'm authorizing the user entity/Corporate to debit my account, based on the instruction as agreed and signed by me. I've
understood that I'm authorized to cancel/amend this mandate by appropriately communicating the cancellation/amendment request to the user/entity/corporate or the bank where I've authorized the debit.

MandateId : 500001102371752497 Reference1 : 34925294

UMRN Date

Sponsor bankcode Utility Code NACH00000000002558

I/We hereby Authorize HERO FINCORP LTD To Debit SB/ CA/ CC/ SB-NRE/ SB-NRO/ OTHER

CREATE
MODIFY Bank a/c Number
CANCEL

With Bank IFSC or MICR

an amount of Rupees
Frequency Monthly Qtly H-Yrly Yearly As & when prensented Debit Type Fixed Amount Maximum Amount

Reference 1 34925294 Phone Number

Reference 2 EMail ID
PERIOD I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of bank

From
To* Sign. Primary Acc. Holder Sign Acc. Holder Sign Acc. Holder

Or Until Cancelled
This is to confirm that declaration has been carefully read, understood & made by me/us. I'm authorizing the user entity/Corporate to debit my account, based on the instruction as agreed and signed by me. I've
understood that I'm authorized to cancel/amend this mandate by appropriately communicating the cancellation/amendment request to the user/entity/corporate or the bank where I've authorized the debit.

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