R"FGs· /_NEFT Request Form
0 RTGS □ NEFT
For RTGS / NEFT
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Maximum Limit for NEFT Transaction - -
HDFC Bank Cus.tomer No Limit
HDFC Bank Customer - lndo Nepal NEFT Remittance via AccounJ - Up to INR 200000/-
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Non HOFC Bank Customer & lndo Nepal NEFT Remittance Up to INR 50,000/-
Purpose of Rem.ittance to Nepal - tick one (Famlly Maintenance/ Retirement Fund/ Pension Fund/ Others -
Time
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Customers Name _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Account n o - - - - - - - - - Chq no - - - - - - - - favouring HDFC Bank Ltd for NEFT/RTGS ( whichever applicable)
Mobile No _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Tel No _ _ _ _ _ _ _ _ _ _ _ ____,...........,....---
Remitter Legal Entity Identifier Code (LEI) I.____.I____._I__._-I__.____,____.____._.......__....,_...____.....___.__.___.___,__I_.__I-___.____.____......
I._I
ronly applicable for Rs.50 a & above transaction for non-lndMdual accounts)
LEI Expiry1IDate: I D I D I M I MI.YI Y I Y I Y I
Address of Remitter (Mandatory for Non HDFC Bank Customer) _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
- - - - - - - - - - - - - - - - - - - - - - Email Id - - - - - - - - - - - - - - -
In case of Non HDFC Bank Customer Amount of
Cash Deposited _ _ _ _ _ _ _ _ _ _ __
Beneficiary details :
Name
--,.----------------=-------=-----,- :--=--=-=~---------------
Add ress_ _ _ _ _,,_--,-~r--""P.""'!~~~..,....~-,-~~=~~_.,-~-- ,----,~--~=--::---:-~~
~:~:~: ~ccount no: I I I I I I I I I I I I I I I I-I -
Bank Name & Branch :· - - - - - -
- - - - - - - - - IFSC Code - - - - - - - - - - -
Ale Type : D Resident D Non Resident
Beneficiary Legal Entity Identifier Code (LEI) ,_.I--.-_----.--_..,.....J~1-1-r_l_-_...-J_-.---_~I
__---I_-,---.-I---.I-I_.,.,....,.,__,.._..-I-"T-I--.-I---, -·1
r0ny applicati,e for Rs.SO a & above tra11saction for non-individual accounts)
7
LEI Expiry Date: ID ID IMI MI y r- y 1 y ·1 y I
Amount to be credited (in figures): _ _ _ _ _ _ _ _ _ _ (In Words): _ _ _ _ _ _ _ _ _ _ __
Remarks: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
I/we agr:ee to temils and conditions mentioned overleaf. For Inda N~pal remittance. I/we declare that the purpose of T'"
....
0
remittance is for above selected purpose only. ~
f:jl
Signature of Authorized signatory 0
l'i
~
N
0
a;
1st Signatory 2nd Signatory 3rd signatory St
N
0)
For bank Use onl~ •
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-
Processed by (Emp code aod sign) Authorized by (Emp code and sign)
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- - r- ....
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--
DD I MC I urR No - - Ref No
Charges Recovered Rs (applicable only for Non Customer): Day end Checked by
Transaction Authorized by (2nd Level) (for amount > 5 lacs).
I ~
KYC documentation done by (only for Non-HDFC Bank Customers)
customem Copy
Received appllcaUon for' Rll'GS / NEFT for an amount of Rs. _ _ _ _ _ _ _ vlde Cash / Cheque number
to be credited to Account number of
_ _ _ _ _ _ _ _ Bank with IFSC Code . Customers will be guided by the Tenns
and CondlUons mentioned In the form. HDFC Bank will accept no llablllly for any consequences arising out of eronous
details provided by the Customer. For HDFC Bank
Requut for MC / DD / RTGS and NEFT can also be placed using Netbanklng
DD / MC Appllcatlon Form
( Appllcntlon rorm to be oooompony cheque only. In case of laauonoa
...
a.; ·~ HDFC DANK
Wo undoro1ond your world
ag11ln1l Coah, MC I DO I NEFT the amount would not exceod Rs.49,999/·)
Date:_ _ _ _ _ _ _ _ __
Please Issue (Tick•• Appllcable)
Branch:-
------------ -
0 Managers Cheque D Demand Draft payable at _ _ _ _ _ _ _ __
Favorin
----------- ----------- ----------- ---
For amount Rs _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (In figures) _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _,(In words)
Mode .of Payment :- Cash / Cheque No.
Purchaser Name:
------------ ------------ ----
------------ ------------ ------------ -
Ptease deliver the Demand Draft / Managers Cheque to Mr/ Ms. _ _ _ _ _ _ _ _ _ _ _ Whose signature
Is appended below
Bearers Signature Customers signature
(Purchaser)
I acknowledge Receipt of the DD / MC as requested
Signature of Recipient Customers Name
(Purchaser)
I / We enclose Cheque no. _ _ _ _ _ _ drawn on my /our above account In favour of" HDFC Bank Ltd for DD/MC.
I / We Authorize you to Debit my / our above account towards: issuance of the above DD / MC through Cheque .
I / We further authorize you to debit the aforesaid account for the service charges / tax, as applicable.
I/ We acknowledge that In case I/ we have Issued single cheque /'Instruction for debit to my/ our account for issuing
more than one Demand Draft I Managers Cheque, then the same will effect as multlple debit entries In my / our account
DD/ MC against cash wfll be Issued below Rs 50,00Q/.. to Non- customers and should be accompanied
with KYC documents
For ban.k Use only
Processed by (Emp code and sign) D Mandatory UCIC and ~nnad Oodupo Verified for OD/ MC
against cash. Tick only If oppllcoblo
Authorized by (Emp code and sign)
DD I MC I UTR No Ref No
Char es Recovered s a llcable n Customer :
Transaction Authorized b 2rd Level for amount-> 5 lacs .
KYC documentation done by (only for_ Non-HDFC Bank
T1nn1 ■nd condition■: 1}_ I/ We hereby euth()fize HDFC Bank ltd to carry out the RTGS / NEFiT' trnnsadlon ea par the detail■ menUoned obovo ( 1lck thQ opproprloto field).
2) I/ We horeby agree that the aforesaid detalls-lncludl~g the IFSC code end tho beneficiary account are correct. 3) Wlo fUrthar acknowledge thot HDFC bank oocepts no
Uablllly rOf any consequences arising out.or erroneous dQtnlla provided by me I us. 4) II We agree that the credit will be affected solely on the boneflclary ac:counl number
lnrormaUon and beneflcfary nomo portlculors will not be used for the same. 5) I/ we euU1orize U1a bank lo debit my/ our account wlU1 the charges plus Tuxes os appllcable for
this transaction 6) I/ We agree that requests submltl~ after the cut off Ume wlll be sent In next batch or next working day as oppllcablo. 7) I/ We hereby agroe nnd understand
that the remltUng bank shall nol be llablo for any loss of damage arising or rosulUng rrom delay In transmission delivery or non-deUvory of Boclronlc message or ony mlstako,
omission, or error In tranamlasion or delivery thereof or In deciphering the message from any cause whatsoever or from Its mlalntorprateUon recolvod or tho ectton of the
destination Bonk or any oct or beyond conlroi. 8) I /We agree that Inessa of NEFT lronsactlon If we do not have an account with tho bank. we WIU produco Original ldontlOcaUon
proof whlle giving the request In case 1/Wo submit form 6P, we will also submit the address proof. 9) lo case the.RTGS end NEFT opUon Is not Uckod by us, 1/Wo eulhorizo tho
tran18cllon leas than Rupees Two Lacs through NEFT end greater than or equal to Rupees Two Lacs hrough RTGS end debit charues os applicable.
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Qu1tom1r, Copv
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(To be produced by customer whlle oollecling DD/MC from bank)
DD/ MO (or Rs.,_ _ _ _ _ _ _ Drawn on _ _ _ _ _ __
Chq No:_ _ _ _ _ __
Customer Name: _ _ _ _ _ _ _ __
Customer& Ale number_ _ _ _ _ _ _ _ _ __
For HDFC Bank
Reque•t for MC /OD/ RTGS and NEFT can also bo placed using Notbanklng
PTO
