NEFT/ RTGS Mandate Form

Please fill in details as per instructions on page 2:

Beneficiary Bank having account in same Bank (Table 1 ):

1. Beneficiary Bank Name

2. Beneficiary Bank Address
9-Digit Code number of the
bank and branch appearing on
3.
the MICR cheques issued by
Bank
4 Account Number of the Bank
IFSC (Financial Security Code)
5
Code of the bank
Type of Account
Current Account(Yes/No)
6
If any other account please
specify type
7 Email address
8 Contact No

Beneficiary bank having account in correspondent Bank (Table

2):

1. Correspondent Bank Name

2. Correspondent Bank Address
9-Digit Code number of the
bank and branch appearing on
3.
the MICR cheques issued by
Bank
4 Account Number of the Bank
IFSC (Financial Security Code)
5
Code of the bank
Type of Account
Current Account(Yes/No)
6
If any other account please
specify type
7 Email address
8 Contact No
 We hereby declare that all information provided herein is correct and
we are solely liable if information is incorrect and remittance is made
as per the instructions provided by us.

For Beneficiary Bank (Table 3):

Name and Signature of Branch

Manager of beneficiary Bank:

Seal of the Branch:

For Correspondent Bank (Table 4):

Name and Signature of Branch

Manager of correspondent Bank:

Seal of the Branch:

Instructions:

1. Bank to fill in Table 1 & 3 only if EFT payment is to be made to the

beneficiary bank directly.
2. If beneficiary bank is not having EFT facility then the beneficiary bank
to provide the details of correspondent bank in which EFT payment is
to be made by getting Table 2 & 4 filled by correspondent bank.
Beneficiary Bank to fill in point 1 & 2 of Table 1 and verify all details by
filling Table 3.
3. In case beneficiary bank is having account in same bank (having
electronic transfer facility) and wants electronic transfer to be made in
same bank only Table 3 and Table 4 are not required to be filled.