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Mandate Form

This document contains a mandate form for electronic payment through the internet and RBI. It includes details such as the name and address of the party, bank particulars including name, branch, MICR code, account type and number. The party declares that the information provided is correct and complete and undertakes to advise any changes to facilitate payment. The bank certifies that the particulars match their records.

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Syed Qaisar Imam
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908 views2 pages

Mandate Form

This document contains a mandate form for electronic payment through the internet and RBI. It includes details such as the name and address of the party, bank particulars including name, branch, MICR code, account type and number. The party declares that the information provided is correct and complete and undertakes to advise any changes to facilitate payment. The bank certifies that the particulars match their records.

Uploaded by

Syed Qaisar Imam
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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SCHEDULE - VIII

MANDATE FORM FOR ELECTRONIC PAYMENT THROUGH INTERNET & RBI


To
Hindustan Copper Limited,
……………………………………….
……………………………………….
Dear Sir,
Sub: Authorization for release of payment due from HCL,-----------------------------------------through
Electronic fund transfer (RBI-EFT)/ Internet /RTGS.
Refer Work Order No…………………. dated…………....
(Please fill in the information in CAPITAL LETTERS. Please TICK wherever it is applicable)
1. Name of the Party :
2. Address of the Party :…………………………………………….
………………………………………..
City:…………….Pin Code…………..
E-mail Id:……………………………..
Permanent Account Number:……………………………………..
3. Particulars of Bank:
Bank Name Branch Name
Branch Place Branch City
Pin Code Branch Code
MICR No
(9 Digits code number appearing on the MICR Band of the Cheque supplied by the Bank.
Please attach Xerox copy of a Cheque of your bank for ensuring accuracy of the Bank name,
Branch name and Code number)
Account Type Savings Current Cash Credit
Account Number (as appearing
in the Cheque Book)

Page 145 of 146


RTGS/IFSC Code

4. Date from which the mandate should be effective:

I hereby declare that the particulars given above are correct and complete. If any transaction is delayed
or not effected for reasons of incomplete or incorrect information, I shall not hold Hindustan Copper
Limited responsible. I also undertake to advise any change in the particulars of my account to facilitate
updation of records for purpose of credit of amount through RBI EFT/Internet/RTGS.

Place:
Date: Signature of the Party/Authorized Signatory

Certified that the particulars furnished above are correct as per our records.

Bank‟s Stamp:
Date: (Signature of the Authorized Official from the Banks)

N.B.:RTGS / NEFT charges, if any, shall be borne by the party.

Page 146 of 146

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