To: The Manager,
The UniCredit Banca
*Date: D D MM Y Y Y Y
RTGS/NEFT Transaction Request Form
Please select () one option (mandatory):
RTGS NEFT
We hereby request you to kindly make the transfer as per the details given below:
Rupees Paise
*Amount to be remitted (` in
figures):
*Amount to be remitted (` in words):
*Beneficiary bank name:
*Branch name:
*Is the destination account an NRE account? Yes No
Applicant (remitter) details:
*Account title/name:
*Debit account number:
*Details/purpose of payments (maximum 140 characters):
Please tick () (mandatory):
*I am/We akhilijkjhk.j.jk.k
Stamp and signature(s) of authorised signatory
For bank use only
Signatures verified :
Fax indemnity received : Agreement exists
:
CBID Code:
*Please write in block letters
Version 2 2014