Annexure - 1

Declaration by the Applicant for engagement as CSP

(to be obtained by Link Branch)

I, Mr. Rajmani Vishwakarma son of Ramashray Vishwakarma residing at Motiram

Patil Nagar, Near Sai Temple, Atali, Ambivali (West). Kalyan. PIN: 421102
have applied for engagement as Customer Service Point of M/s … Atyati
Technologies Pvt. Ltd … (National / Circle BC), who is working on behalf of State
Bank of India, at Ambivali to provide financial inclusion services. Our Link branch
will be SBI Titwala branch.

2. I declare that I have not paid any amount as of now to the BC for CSP code. I
shall submit the receipt as and when the amount is paid by me.

3. I also undertake to submit money receipt received from all service / goods
provider before generation of CSP code.

4. I also declare that no unauthorized money has been paid by me to BC / bank

official.

5. I understand that the Bank has initiated this procedure to obviate any chances
of wrongdoing / misleading on the part of all concerned.

Yours faithfully,

(Rajmani V) Place:Ambiavli
S/o:Ramashray V Date : 10/07/2020
Address:Motiram Nagar,Ambivali West,
Kalyan

Mobile No:8454877639
Email address:rajvishwakarma639@gmail.com