Date:

The Branch Manager

Eastern Bank Limited

________________________ Branch

Dear Sir/Madam,
Subject: Letter of Authorization
I / we,. ., here by authorize Mr./Mrs..
Address..mobile nowho is
my/ourin relation to collect the below mentioned item from your counter on my /our behalf.
[ ] Cheque Book

[ ] Sanchyapatra / Bond

[ ] No Objection Certificate

[ ] Account statement

[ ] Loan certificate

[ ] DPS advice

[ ] Account certificate
[ ] FD Advice

[ ] Unpaid clearing cheque (Ch. no.. amount drawn on .Bank

)[ ] Other Item (pls specify)..
In this connection, I/we indemnify the Bank that, I/we will bear all the risks and responsibilities that may arise due
to handing over the mentioned item(s) to the authorized person.

Signature of the Account holder(s)

Signature of Authorized Person

Name:
A/C NO:
Contact Number:
(Signature attested by a/c holder)

For Bank use only

[ ] Signature, Mandate & Call Back Confirmed (As per call Back Process)
Contact number-----------------------------Date & time: ---------------------------------.
(Signature with seal)

..

....

Delivered by Officer with seal & ID

Approved by BM / BSSM / BOM with seal &ID

_____________ Received; Acknowledged By: __________________________ Date: _______ Time:

______
Signature of the Account holder(s)