Annexure A

APPLICATION FORM for Inter Bank APPLICATION FORM for Inter Bank Fund Transfer Through RTGS TRANSFER ONLY
Fund Transfer Through RTGS
For Office Use Only
RTGS Trans. Ref RTGS UTR No. Date & Time of Entry / Verification in Finacle.
No.

_______________________ BRANCH ___________________________ BRANCH

Date : __________________ Date : ______________________ Clerk’s Sign Officer’s Sign.

Received from Sh / Ms/M/S
_______________________Rs.______ (
Rupee _______________________Only,
Cheque No. _______dated_____ for
RTGS Transfer to :
Bank : IFSC Code
________________________
Branch
:________________________
IFSC Code : _______________________
Beneficiary Name
:__________________
Beneficiary A/C
No:__________________
Amount Rs.
________________________
Charges Rs.
________________________
Total Rs.
__________________________
(Rupees in words
____________________
______________________________Only
) Contact Number (s)(Landline / Mobile )______________________________________________
____________________________________
To be filled by the Bank
Please remit through Real Time Gross Settlement as per details below :
Details of Beneficiary Particulars of Amount
Centre / City :_______________________________________________________________________ Amount to be remitted : Rs __________________
Bank :_______________________________________________________________________ Commission : Rs. __________________
:_______________________________________________________________________ Total : Rs. __________________
Beneficiary Name :_______________________________________________________________________
Beneficiary A/C No :_______________________________________________________________________ Total (In words) Rupees ______________________
Branch :_______________________________________________________________________ ________________________________________only.
Type of a/c Savings Current Cash Credit Loan
I/We understand and agree that in case if there is a holiday or weekly off at beneficiary branch, funds will be credited to beneficiary's account on the next working
day. If, for any reason, the funds are returned because beneficiary’s bank cannot apply them, I / we understand and agree that the returned funds will be recredited
to my/our account, thereafter.
All RTGS transactions are irrevocable. No Stop Payment allowed.
I / We have read, understood and hereby agree to the terms and conditions of e-Remit ( RTGS) mentioned overleaf.
Applicant’s A/C Type __________________A/C Number ______________________________
Cheque No. _________________ dated : _____/_____/__________ Amount ________________
Applicant’s Name & Address ____________________________________________________
______________________________________________________________________________

Date and Time of Receipt: Applicant’s Signature ___________ Authorised Signatory

_____________________________
DD MM YY

Remittance would be effected as per

RBIs RTGS Scheme, Subject to terms
of remittance detailed overleaf.

_____________________________
Bank's Authorised signatory
 (Reverse side of the RTGS application form)
TERMS AND CONDITIONS OF TRANSFER TERMS AND CONDITIONS OF TRANSFER

1. Remitting Bank shall not be liable for 1. Remitting Bank shall not be liable for any loss or damage arising or resulting from delay in transmission, delivery or non-delivery of Electronic message or any mistake, omission, or
any loss or damage arising or resulting error in transmission or delivery thereof or in deciphering the message from any cause whatsoever or from its misinterpretation received or the action of the Destination Bank or
from delay in transmission, delivery or any act or event beyond control.
non-delivery of Electronic message or
any mistake, omission, or error in 2. All payment instructions should be checked carefully by the remitter. Bank shall not be liable for crediting remittance amount to wrong beneficiary on account of incorrect
transmission or delivery thereof or in information furnished by the customer in this application form.
deciphering the message from any
cause whatsoever or from its 3. Application received after cut-off time will be processed on the next working day.
misinterpretation received or the
action of the Destination Bank or any 4. Beneficiary bank may levy charges on inward remittance and may deduct the same from remitted amount.
act or event beyond control.
2. All payment instructions should be 5. Beneficiary's bank may not send any confirmation of having credited funds to the beneficiary’s account
checked carefully by the remitter.
Bank shall not be liable for crediting 6. All RTGS transactions are irrevocable. There is NO facility for giving STOP PAYMENT instruction in respect of remittances through RTGS.
remittance amount to wrong
beneficiary on account of incorrect
7. In case of certain Banks, the beneficiary account may be credited only on next working day, if the transaction day happens to be a holiday or weekly off
information furnished by the customer
in this application form.
3. Application received after cut-off time
will be processed on the next working
day.
4. Beneficiary bank may levy charges on
inward remittance and may deduct the
same from remitted amount.
5. Beneficiary's bank may not send any
confirmation of having credited funds
to the beneficiary’s account.
6. All RTGS transactions are irrevocable.
There is NO facility for giving STOP
Payment instruction in respect of
remittances through RTGS.
7. In case of certain Banks, the
beneficiary a/c may be credited only
on next working day, if the transaction
day happens to be a holiday or weekly
off.