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Mandate

The document is a mandate form for individuals to set up Electronic Clearing Service (ECS) for receiving payments via RTGS. It includes details about the account holder, bank account information, and a declaration of correctness. The form requires the signature of the customer and certification from the bank, along with instructions for submission.

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kaushikkumarpappu82
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20 views1 page

Mandate

The document is a mandate form for individuals to set up Electronic Clearing Service (ECS) for receiving payments via RTGS. It includes details about the account holder, bank account information, and a declaration of correctness. The form requires the signature of the customer and certification from the bank, along with instructions for submission.

Uploaded by

kaushikkumarpappu82
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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MANDATE FORM EOR INDIVIDUALS

Electronic Clearing Service (Credit Clearing/Real Time Gross Settlements (RTGS) Facility for
Receiving Payment
A. Details of Account Holder

1. Name of the Account


Holder Aman Raaj
2. Complete contact address 173, Urlaha, Urlaha, palasi, Araria, Bihar - 854333
3. Telephone
number/fax/email 462987486

B. Bank Account Details:

1 Bank Name IDBI Bank


2 Branch name with complete Tbet Bank purnia, Raví Co mmercial Co mplex,
address, telephone number andNavratan Hata ,NH-31, pUrn ea, purnia,Bihar
email PIN-854301 Tele- 06454-244831
3. Whether branch is
computerized Yes
4. Whether the branch is RTGS
enabled. If yes, what is the IFSC yes IBK LOO01022
code?

5 Is the branch also NEFT enabled


6. Type of bank account (SB,
Current/Cash credit)
Savings Bank Account
7. Complete bank account number
(latest) 1022 1o4000 143100
MICR code of the bank 854259102

Date of Effect

Ihereby declare that the particulars given are correct and complete. If the transaction is delayed, or not
effected at allfor reasons of incomplete or incorrect information, Iwould not hold the user institution
responsible. Ihave the read option invitation letter and agree to discharge responsibility expected of me as a
participant under the Scheme.

Signature of Customer
Certified that theiarturnished above are correct as per records.
(Bank Stam LRAHUL RMSHRA

Dated:-.... -102 oB)o)25 Signategr tne Aukhgtiotromthe


Bank
CODE:
BANK
1.Please attach aphatocepyof cheque along with Y t o a o r g Bank.

2. in case your Bank Branch is presently not , "RTGS enrupon up gradation to RTGS Enabled"
branch. Please submit the information again in the above proformato the Department at the earliest.

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