‘SBI Loan Ac No ECS NO: Form No E-5 Facility :HI/EI/Car Mandate Form Electronic Clearing Service(Debit Clearing) (Address Of The Deposit A/C Bank) TWorne: STATE BANK OF INDIA The Manager “Address : RACPC Mumbai South(17889) (etna npr tod Chega an, frelon soraasannsunsnsn? ee 1 hee adr am ci aan out Fane $e ye NTATE ANE OF DIGI UTmLY tovepever® UTILITY Rares AGRE WOMLAG BOLI) rourh Tes toa dare pedantry ea 1A SDIGITMICR CODENUMBEROFTHEAANKABRANCH | I j (Appearing on the MIGR choque issued by the Drawee Bank) 8. ACCOUNT TYPE (8.8. Account / Current Account or Cash Credit) ©. NAME OF THE AC HOLDER "(as appearing in SB/GA/ CC Account) D. ACCOUNT NUMBER I CI L (with drawee Bank) E, IFSCCODE = a Branch [DsleoFetioc Cog, [AnmntoThslaren| Sanctioned Root “BRIG F ‘ArouttotBitweh | Amount and | instalments fie Boy Code lremactnasen| EM! Usperuimt__| Sanctioned Datel due to SBI Date ofeffect: __/_/_ | nereby decare thatthe particulars givan above are correct and completa Ifthe transaction is delayed or roteffected tall for reasons of incomplete or incorrect information, {would not hold the user inatution responsible. Ihave read {he option invitation letter and agree to cischerge te resposillly expected cf me asa partcipantunder the scheme, In aise of my failure in maintaining sufcent balance forthe purpose, you can proceed egainst me as per the provisions of Payments and Settlements Act 2007 under section 25, RIW section 138 of Negotiable Inctrumants Act 4881 forrepaymentof money due. The clshonour of Electronics Funds Tiensfer amounts to an offence under section 215(1) ofthe Payments and Settiements Act 2007 rw Section 138 of Negotiable Instruments Act 1881, sees: ) Signatireofthe Customer PIncote, Mobi Date CCerifed that the particulars furnished above are core a per our records, PLEASE ENCLOSE ONE CHEQUE DULY CANCELLED ALONG WITH THIS MANDATE. (Gank’s Stamp) Signature verified without any rick or responsiblity on part of Bank ors employees, 7 ‘Signature ofthe Authorised a Official from the Drawee Bank fe: Mandate tobe obtained in 3 copies, Original or Stato Bank ofncia, One for User Co. and other or custome Note : After closure of the loan inform at ECS Counter. ernie Care : For Accounts maintained outside Mumbai the mandate needs to be countersigned by the bank in Mumbai conforming that ECS mandate will be honoured by them