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Bank Mandate: Electronic Clearing Service (Debit Clearing) BSE Limited

1. The document is a bank mandate form authorizing electronic clearing of payments from a customer's bank account to BSE Limited through their service provider. 2. It provides the customer's reference number, bank name and branch, account details, and names of account holders. 3. The customer declares the information is correct and authorizes the bank to debit their account for payments to BSE as well as any mandate verification charges.

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Nitin Patil
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241 views2 pages

Bank Mandate: Electronic Clearing Service (Debit Clearing) BSE Limited

1. The document is a bank mandate form authorizing electronic clearing of payments from a customer's bank account to BSE Limited through their service provider. 2. It provides the customer's reference number, bank name and branch, account details, and names of account holders. 3. The customer declares the information is correct and authorizes the bank to debit their account for payments to BSE as well as any mandate verification charges.

Uploaded by

Nitin Patil
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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BANK MANDATE

Electronic Clearing Service (Debit Clearing)


BSE Limited
Regd. Office : Floor 25, P.J Towers , Dalal Street , Fort , Mumbai – 400001 , Maharashtra

*Customer Reference No: *Mandate Reference No:


(UCC) UI
Code:
The Manager
*Bank Name:
*Branch Name:
*Address:
Telephone No:
I hereby authorize you to debit my account (ECS Debit clearing) for making payment to BSE Limited (through their service provider) as per the details given
as under.

*Name of Account Holder:

*MICR - 9 Digit Code No.s of the Bank & Branch (Appearing on the MICR cheque issued by the bank):

*Mode of Holding: Single Joint Either or Survivor


*Account Type: S.B. Account Current Account Cash Credit
*Bank Account Number:
*Account holder names (As per bank’s record):
1st A/c Holder:
2nd A/c Holder:
3rd A/c Holder:
*Amount
Name of the Scheme * Start Date Periodicity (Upper Limit) *End Date

Daily

I/We hereby 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 user institution responsible. I have read the option invitation letter and
agree to discharge the responsibility expected of me as a participant under the scheme.
This is to inform that I/We have registered for the RBI’s Electronic Clearing Service (Debit Clearing)/ and that my payment towards my obligation in
BSE. Ltd. (thru its service provider) shall be made from my /our above mentioned bank account with your bank. I/We authorize the representative
carrying this ECS (Debit Clearing /Standing Instruction) mandate form to get it verified & executed.

I hereby authorize the bank to debit my/our account for Mandate verification charges if any.
Signature(s) of the account holder(s). (As per bank’s record)

*Date: 1. 2. 3.

*Indicates mandatory field.


For Bank Use Only
Certified that the particulars furnished above are correct and as per our records.

Bank’s Stamp
Date: Signature of the Authorized official from the Bank

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