THE SURAT DISTRICT CO
CO-OPERATIVE
OPERATIVE BANK LTD.
The Branch Manager, Date:
Time :
. . . . . . . . . . . . . . . . .Branch.
The Surat District Co-op.
op. Bank Ltd.
Dear Sir/Madam,
Re:- Positive Pay confirmation for cheques presented in CTS Clearing.
I (Name of the Account holder) having an account
(Account Number) in your (name of the Branch)
I hereby confirm that I have issued the following cheque/s in the captioned account with details as
mentioned hereunder:-
Sr. Cheque Amount Payee's Name Cheque Date Transaction
No. Number Codes
(*) 2 digits
its Transaction code is available on the Right Side of the MICR Band of the cheque.
I understand that Bank may reject any/all of the cheque/s at the time of presentment in clearing due to
any mismatch in the particulars of the cheque/s with the provided inputs as above. I also confirm to
maintain sufficient balance in the account to honour aforesaid cheque/s.
(Seal/Signature must be tallied with the record)
(Name of the signatory/signatories)
(Registered mobile number)
Note — All authorized signatories/signatory as per the operational instructions iin the account can
provide this confirmation. Original signed form will only be accepted during the Banking hours of the
Branch.
For Office Use only
Confirmation entered at Time & Date Signature of maker
Confirmation verified at Time & Date Signature of checker
chec
(Confirmations verified up to 06.00 PM will only be processed for next clearing session. Afterward, all
the confirmations will be processed for subsequent clearing session)
