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Accounl Number
Cheque Number
Renritfer's Nome
tti
Address
Accounl Nunrber
tr l/We ouihorise Axis Borrl< 1o recover chorges os n'loy be opplicoble by debrirng my occounl
os rlenlroned obove
l/We underslorrd lhot os Per the RBI Circulor dcrted Oclober 'l4, 20lO, tronsfer of funds through
eleclronic nrode will be execured only orr
the bosis of the occounl number of the beneficiory provided wlrilo.irpitioting ihe ironsoclion.
Nome will Nor be conside'ed os o criterro for
provlorno credtl
i thol this focility is ovcriloble only ot selecl locollions ond bonks covered under Electr.onic Funds Tr.crnsfer
'ndu"t-ond focilily offered bv
,-]
Isl
RBI
ll
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