Hebpeerke=Àle keÀe³ee&ue³e : DeeF&[eryeerDeeF& ìe@Jej, [yu³etìermeer keÀe@cHueskeÌme, keÀHeÀ Hejs[, cegbyeF& 400 005
[er[er / SveF&SHeÀìer / DeejìerpeerSme kesÀ efueS DeeJesove JesyemeeFì : www.idbi.com
REGD. OFFICE : IDBI Tower, WTC Complex,
Application for DD / NEFT / RTGS Cuffe Parade, Mumbai 400005.
Website : www.idbi.com
MeeKee / Branch leejerKe/ Date D D M M Y Y
ke=ÀHe³ee [er[er peejer keÀjW / Please issue DD kesÀ ceeO³ece mes efveefOe³eeb Òesef<ele keÀjW / remit funds through RTGS NEFT
Hej os³e (mLeeve)/Payable at (Place)
ueeYeeLeea keÀe veece /Name of Beneficiary
केवल ueeYeeLeea Helee /Beneficiary Address
आरटीजीएस/
ueeYeeLeea Keelee meb./ Beneficiary A/c No
एनईएफटी के लिए) ieueeYeeLeea keÀe Keelee ÒekeÀej/ Beneficiary A/c Type ye®ele yeQkeÀ SB ®eeuet Keelee CA meermeer CC Dev³e Oth.
/ Only for ueeYeeLeea yeQkeÀ / Beneficiary Bank
RTGS /NEFT ueeYeeLeea yeQkeÀ DeeF&SHeÀSmemeer Beneficiary Bank IFS Code
jeefMe Amount Òesef<ele kewÀMe kesÀ efJeJejCe Details of Cash Remitted
keÀceerMeve Commission ©. Rs. सं.Pcs ©. Rs. पै.P.
kegÀue Total 1000 x
kegÀue jeefMe MeyoeW ceW :Total Amount in Words: 500 x
100 x
50 x
ceQ/nce DeeHekesÀ He#e ceW GHe³eg&keÌle jeefMe keÀe ®ewkeÀ meb............mebueive keÀj jns nw. We 20 x
enclose Cheque No.……… favoring yourself for the above amount. 10 x
efveHeìeve ceW, ceQ/nce SleodJeeje DeeHekeÀes cesjs/nceejs Keeles keÀes DeeHekesÀ ÒeYeejeW meefnle efvecveevegmeej 5 x
[sefyeì keÀjves kesÀ efueS ÒeeefOeke=Àle keÀjlee/keÀjles nw In settlement, I / We hereby
सिक्के Coins
authorize you to debit my / our account together with your
charges as follows कुल Total
ceQ/nceves [er[er/DeejìerpeerSme/SveF&SHeÀìer keÀer MeleeX keÀes Hetjer lejn mes He]{ efue³ee nw Deewj ceQ/nce GvekeÀe Heeueve keÀ©biee/keÀjWies. I / We have fully read the terms and
conditions of DD/RTGS / NEFT and shall abide by the same.
DeeJesokeÀ kesÀ efJeJejCe (kesÀJeue iewj-KeeleeOeejkeÀeW kesÀ efueS) Applicant Details (only for non a/c holders)
veece Name Helee
Address
Hewve PAN
HeÀesve veb.Phone No. F& cesue DeeF&[er, ³eefo keÀesF& nes, E Mail id, if any:
Òes<eCe keÀe Òe³eespeve Purpose of Remittance
DeeJesokeÀ / DeeJesokeÀeW kesÀ nmlee#ej Signature of the Applicant/s
डीडी / एनईएफटी और आरटीजीएस की पावती
ACKNOWLEDGEMENT for DD/ NEFT / RTGS
MeeKee / Branch leejerKe/ Date D D M M Y Y
ie´enkeÀ DeeF&[er / Customer ID.
eqkeÒes<ekeÀ keÀe veece / Remitter Name
eqkeÒes<ekeÀ Keelee meb. / Remitters A/c No.
ke=ÀHe³ee [er[er peejer keÀjW / Please issue DD kesÀ ceeO³ece mes efveefOe³eeb Òesef<ele keÀjW / remit funds through RTGS NEFT
Hej os³e (mLeeve)/Payable at (Place)
ueeYeeLeea keÀe veece /Name of Beneficiary
केवल ueeYeeLeea Helee /Beneficiary Address
आरटीजीएस/
ueeYeeLeea Keelee meb./ Beneficiary A/c No
एनईएफटी के लिए) ieueeYeeLeea keÀe Keelee ÒekeÀej/ Beneficiary A/c Type ye®ele yeQkeÀ SB ®eeuet Keelee CA meermeer CC Dev³e Oth.
/ Only for
ueeYeeLeea yeQkeÀ / Beneficiary Bank
RTGS /NEFT
ueeYeeLeea yeQkeÀ DeeF&SHeÀSmemeer Beneficiary Bank IFS Code
jeefMe Amount efveHeìeve keÀer efJeOeer Mode of settlement vekeÀo Cash ®eskeÀ Chq DeblejCe Trf
keÀceerMeve Commission yeQkeÀ DeefOekeÀejer kesÀ nmlee#ej Signature of Bank Official
kegÀue Total
ceQ / nce FmekesÀ odJeeje cesjer / nceejer Deesj mes Þeer megÞeer / .................................................................................. [er[er ÒeeHle keÀjves kesÀ efueS DeefOeke=Àle keÀjles nw.
efpemekesÀ nmlee#eCe veer®es mel³eeefHele veer®es efkeÀS ieS nQ. I / We hereby authorize Mr. /Ms. …………………………………………………...……………….. whose
signature is attested here below to collect the DD on my / our behalf
ÒeefleefveefOe kesÀ nmlee#ej Signature of representative ...................................................................................................
DeeJesokeÀ odJeeje mel³eeefHele Attested by the Applicant ...................................................................................................
[er[er ÒeeHlekeÀlee& kesÀ nmlee#ej Signature of the person receiving DD ............................................................................
kesÀJeue yeQkeÀ kesÀ GHe³eesie kesÀ efueS For Bank use only
DeeF&[eryeerDeeF& Deesceveer Hes / yeQkeÀ Dee@HeÀ Fbef[³ee Hej peejer [^eHeÌì / DeejìerpeerSme / SveF&SHeÀìer Hej peejer
Issuance of IDBI Omni pay / Draft on Bank of India / Draft on HDFC Bank / RTGS / NEFT
³etìerDeej / SveF&SHeÀìer meb. UTR / NEFT Ref No
[er[er meb.: DD No:
uesve - osve DeeF&[er. Transaction id.
ÒeefJeefäkeÀlee& : Entered by:
mel³eeHevekeÀlee& : Verified by:
¡ðýáÀó×ðó¡ðýá ×ðøü¨ òâðòÙð¾÷À, Ñðü¸ðó¨öîÃð ¨îðÚððáâðÚð: ¡ðýáÀó×ðó¡ðýá ¾ðùãðÜ, À×âÚðõ¾óçðó ¨îðùÙÑâð÷©çð, ¨îÒî ÑðÜ÷À, Ùðôü×ðýá - 400005.
IDBI Bank Limited, Regd. Office: IDBI Tower, WTC Complex, Cuffe Parade, Mumbai – 400005.
ò¨ çðó Øðó âðøüÀâððýÐð / Ùðð÷×ððýâð Ò ð÷Ðð çð÷ âð±ðÐð÷ ãððâðð ¾ð÷âð Ô ó Ððü×ðÜ: 1800-200-1947 / 1800-22-1070, ±ðøÜ-¾ð÷âð Ô ó Ððü×ðÜ: 022-66937000.
Toll Free Numbers reachable from any landline/Mobile phones: 1800-200-1947 / 1800-22-1070,Non - Toll Free Number: 022-66937000.
TM
èÙððÜ÷ Úðèðû òãðòºð¾ ¨ Ü÷ü / Visit us: www.idbi.com
