Autodebit Authority Letter

This is with further reference to the personal loan granted to me by ICICI Bank
on my joining ICICI Manipal Academy, Bangalore for pursuing PGDB
certification course with Manipal Global Education Services Private Limited
under ICICI Bank PO Programme which commenced on -----------------------I hereby undertake and authorise ICICI Bank to effect autodebit in my account
no________________________ by Rs 3,78,604/- being the sanctioned proceeds
of the personal loan as per the following details:
a) Rs.3,62,250/- (Loan amount of Rs.3,15,000/- Plus applicable Service
Tax, which is presently at 15%)
b) Rs.16,354/- (Cost of Tablet + Cover + SD Card Cost + VAT)
Total amount: Rs.3,78,604/-

in favour of Manipal Global Education Services Private Limited, Account No

000205002286 on my behalf, towards payment of the fees for pursing PGDB
certification course in three installments as soon as loan is disbursed to me as
under: Rs 1,37,104/- in first trimester
Rs 1,20,750/- in 2nd trimester
Rs 1,20,750/- in 3rd trimester
This amount be autodebited when ICICI Bank credit my ICICI Bank account
no_____________________ with Rs.3,78,604/- in three installments as above, as
part of the loan applied for the above purpose.

Name of the Applicants

Signature of the applicant

Temp ID of the Applicant