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Government of Karnataka
Finance Department
Department of Treasuries
MANDATE FORM.
Electronic Clearing Service (Credit Clearing Real Time Gross Settlement RTGS)National Electronic
Fund Transfer (NEFT)facity for receiving payments
‘A.Details of Accounts Holders:-
frst Name:
[in capita letters),
Name of the Recipient peel
[in capital eters)
|Aadhar Number TT TTT TTT ttt
[address
complete Address faaaressa
lPCODE
[Mabile Number of the | Be ee
[e-Mail (e-mail ofthe ecplent)
[B. Bank Account Details ofthe redpient- [| [| [ [ J J TT
iBank Name
Branch Name
[select the type of Bank
saving Bank Jcurent
laccount -
[Account Number (as appearing
in the pass book)
[ digit WICR Code of Bank Branch
ifsc code ofthe bank |
Date of effect:
"hereby declare that the particulars glven above are correct and complete. Ifthe transaction is
delayed or not effected at all reasons of incomplete or incorrect information | Would not hold the
Department responsible. | have read the option invitation letter and agree to dstharge responsibilty
expected of me asa participant under the Scheme.
Date:
ture ofthe candidate
