ach slip - indusind bank · 2020. 10. 8. · indusind bank ach manda te instruction form o f f i c...
TRANSCRIPT
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INDUSIND BANK
AC
H M
AN
DA
TE
IN
ST
RU
CT
ION
FO
RM
O F F I C E U S E O N L Y
P E R S O N A L L O A N A / C N U M B E R
A P P L I C A T I O N I D
Signature as per Bank Record
Name as in bank records
Signature as per Bank Record Signature as per Bank Record
Name as in bank records Name as in bank records
I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank.
C I T I 0 0 0 0 2 0 0 0 0 0 0 0 3 7C I T I 0 0 0 P I G W
- This is to conrm that the declaration has been carefully read, understood & made by me/us. I am authorizing the user entity/ Corporate to debit my account, based on the instructions as agreed and signed by me.- I have understood that I am authorised to cancel/amend this mandate by appropriately communicating the cancellation / amendment request to the User entity / Corporate or the bank where I have authorized the debit.
PLEASE FILL IN BLOCK LETTERS ONLY
INDUSIND BANK
AC
H M
AN
DA
TE
IN
ST
RU
CT
ION
FO
RM
O F F I C E U S E O N L Y
P E R S O N A L L O A N A / C N U M B E R
A P P L I C A T I O N I D
Signature as per Bank Record
Name as in bank records
Signature as per Bank Record Signature as per Bank Record
Name as in bank records Name as in bank records
I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank.
C I T I 0 0 0 0 2 0 0 0 0 0 0 0 3 7
- This is to confirm that the declaration has been carefully read, understood & made by me/us. I am authorizing the user entity/ Corporate to debit my account, based on the instructions as agreed and signed by me.- I have understood that I am authorised to cancel/amend this mandate by appropriately communicating the cancellation / amendment request to the User entity / Corporate or the bank where I have authorized the debit.
PLEASE FILL IN BLOCK LETTERS ONLY
I have understood that the bank, where I have authorized the debit, may levy onetime mandate processing charges as mentioned in their latest schedule of charges published by the bank.I have understood that I am authorized to cancel / amend this mandate by appropriately communicating the cancellation / amendment request to the User entity / Corporate or the bank where I have authorized the debit.
Place : ____________________________ __ Date : _____________ ___ Signature : __________________________________
C I T I 0 0 0 P I G W
Signature as per Bank Record
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