NEFT TRANSFER REQUEST FORM
Date: ____________________
   To:
   The Branch Manager
   _________________________ (Bank Name)
   _________________________ (Branch)
Remitter Details
Name                                  _________________________
Account Number                        _________________________
Contact Number                        _________________________
Beneficiary Details
Name                                  _________________________
Account Number                        _________________________
Bank Name                             _________________________
Branch Name                           _________________________
IFSC Code                             _________________________
Amount (in figures)                   _________________________
Amount (in words)                     _________________________
Purpose of Transfer                   _________________________
Mode of Payment                       ■ Cash   ■ Debit from Account No: ___________________
Remitter’s Signature                  _________________________
   For Bank Use Only:
   Transaction Reference No: ___________________________
   Processed by: ____________________________________
   Date & Time: _____________________________________