NEFT FORM
1 Investor/Customer’s Name
2 Address
3 EMAIL ID
4 Telephone No.
5 Particulars of Bank account
a) Name of the Bank
b) Name of the Branch
Address and Telephone No.
c) 9 digit code number of the Bank and
Branch appearing on the MICR cheque
issued by the Bank
d) IFSC Code of the branch
e) Type of account (Current/Savings/Cash
Credit with code 10/11/13)
f) Ledger and ledger folio No.
g) Account Number (appearing on cheque
Book)
6 Unique Contractor/ Vendor Code
7 GST No.
8 EPF No. and details
(In lieu of the bank certificate to be obtained as under, please attach a bank cancelled
cheque or photo copy of a cheque or front page of your saving pass book issued by your bank for
verification of the above particulars)
I hereby declare that the particulars given above are correct and complete. If the transaction is
delayed or not effected at for reasons of the incomplete or incorrect information. I would not hold the
user institution responsible. I have read the option invitation letter and agree to discharge the
responsibility expected of me as a participant under the scheme.
Certificate that the particulars furnished above are correct as per our records.
Date: Signature of the Investor/Customer
Bank’s stamp Signature of the Authorised
official of the Bank
Note: 1. This form is to be submitted, if not already submitted to Divisional Office, Electrical Branch,
Signature Not Salem.
Verified 2. The above columns should be furnished to make payment if any.
Digitally signed by P
K SELVAN Page 1 of 1
Date: 2023.02.20
15:04:34 IST
Reason: IREPS-CRIS
Location: New Delhi
