MANDATE FORM

To,

The Zonal Manager,

APIIC Ltd,

Vijayawada.

Dear sir

Ref : Authorization for payment through Electronic Mode/system.

I/We, hereby authorize APIIC Ltd ,Vijayawada to make all our payment through Electronic

Mode/system.

The details for facilitating the payments are given below:

1) NAME OF THE COMPANY :

2) ADDRESS
3) TELEPHONE NO.
4) E-MAIL ADDRESS OF THE BENEFICIARY
5) PAN No
6) GSTIN No.
7) BENFICIARY BANK NAME,BRANCH & ADDRESS
8) BENEFICIARY BANK ACCOUNT No.
9) BANK ACCOUNT TYPE
10) IFSC CODE

Declaration :

I hereby declare that the particulars given above are correct and complete. If the