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Mandate Form Format

The document is a mandate form for the Electronic Clearing Service (Credit Clearing) and Real Time Gross Settlement (RTGS) facility for receiving payments. It requires details from the account holder, including personal information and bank account specifics, and includes a declaration of correctness from the customer. The form also necessitates certification from an authorized bank official to confirm the accuracy of the provided information.

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samarthconstore
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277 views1 page

Mandate Form Format

The document is a mandate form for the Electronic Clearing Service (Credit Clearing) and Real Time Gross Settlement (RTGS) facility for receiving payments. It requires details from the account holder, including personal information and bank account specifics, and includes a declaration of correctness from the customer. The form also necessitates certification from an authorized bank official to confirm the accuracy of the provided information.

Uploaded by

samarthconstore
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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MANDATE FORM

Electronic Clearing Service (Credit Clearing)/ Real Time Goss Settlement (RTGS)
Facility for receiving payments.

A. Detalis of Account Holders:-

Name of Account Holder


Coomplete Contact Address
Telephone Number/Fax/E-mail
B. Bank Account Details:-
Bank Name
Branch Name With Complete Address,
Telephone No.
E-mail
Wheter the Branch is Computerized?
Wheter the branch is RTGS enabled? If yes than
What is the Branch's IFSC Code?
Is the Branch also NEFT enabled?
Type of Bank Account (SB/Current/Cash Credit)
Complete Bank Account No. (Latest)
Micr Code of Bank
B.S.R Code

Date of Effect:-

I hearby declare that the particulars given above are correct and complete. If the transaction is delayed or not
effected at all for reasons of incomplete or incorrect information. I would not hold the use Institution responsible. I
have read the option invitation letter and agree to discharge responsibility expected of me a participant under the
Scheme.

Signature of Customer
Date:-
Certified that the particulars furnished above are correct as per our records

(Bank's Stamp)

(………………………………………………………….)
Signature of the Authorized Official of the Bank
Date:

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