.

Registered Office: Pirojshanagar, Vikhroli, Mumbai 400 079

D 6796 3280 (Direct), 6796 5656 I 6796 5959 (Ext. 3280)
D Fax: 6796 1528
DE-mail: rp@godrej.com
CORPORATE PROCUREMENT, PLANT 11, 2"d FLOOR
National Electronic Fund Transfer (NEFT)
MANDATE FORM
Payment to Vendors I Contractors by Direct Credit in their Bank Accounts
1)

a) Vendor's I Contractor's name

b) Vendor Code No.

/1

NcoN lrGrHT IN vERTE'R.

ELEc/RICA-L-

c) E-mail ID .:
2)

Particulars of Bank account

A
Name of the Bank

STft1T 13~ ~ k CJ~ V~TllftL

f;J '1 Til L

Name of the Branch

A-

f\

Address
State
Pin code
Telephone No.

9-Digit code number of the Bank and

branch appearing on the MICR cheque
issued by the Bank

(Please attach a blank cancelled cheque or photocopy of a cheque for verification)

D

Enabled for NEFT

(Yes) D
(To be confirmed from your Bank branch)

11-Digit NEFT IFSC code number of the Banl, '.:>ranch

Type of the account (Current or

Cash Credit )

Account number
(as appearing on the cheque book)

(No)D

~urrent
(Code 11)
D Cash Credit (Code,13)

I/We hereby declare that the particulars given above are correct and complete. I/We request and authorize you to effect
Payment by NEFT to myIour above stated Bank account. 1/We confirm that I/we shall bear the charges, if any levied by
my/our bank for the credit in our above account through NEFT. If the transaction is delayed or lost because of
incomplete or incorrect information, we would not hold the company responsible.

Date :

Date
Place

~~ \ (

lP

Authorized Signature of the Vendor I Contractor