Name of the Trust …………………………………………………………………………………………………

Name of the Scheme …………………………………………………………………………………………………..

MLI Information
MLI Name ...……………………………………………………………………………………………………

MLI Type* Public Sector Bank SBI Associates

Private Sector Bank Co-operative Bank

Foreign Sector Bank NBFC

Regional Rural Bank Other

HQ Address ...…………………………………………………………………………………………………….

………………………………………………………………………………………………………

State …………………………………………………………………………………………………………

District ……………………………………………………………………………………………………………

Village/ Town/City ………………………………………………………………………………………………

Pin code ……………………………………………………………….

IFSC Code (If applicable) # …………………………………………………………

GSTIN Number ………………………………………………………………

Telephone No. ………………………………………………………………

Email ………………………………………………………………………………………………………

Website ………………………………………………………………………………………………………
MLI Admin Information
Admin Name ………………………………………………………………………………………………………..

Mobile No. ……………………………………………………………………

Email ………………………………………………………………………………………………………..

Signature

(Authorised Signatory) Bank Seal

Name …………………………….
Designation ………………………………….

* Schematic Eligibility for MLI Type applicable accordingly.

# IFSC Code for the Banks be linked to the IFSC Code of the Branch located in Head Office.
General Instructions:

Special Care to the following in reference to SPOC Form:

SPOC details furnished shall be complete since all the fields are mandatory.

E-mail id of the Admin should be his/her personal Id. It should not be the Common
e-mail Id of the Department since the User Id and the Password of the MLI are
sent through a Notification e-mail to the mentioned ID.