/ fA NCC Bonk Natioanal Credit & Commerce Bank Limited

(RTGS Transaction Reouest Forml

Annexure-6

Thc Hcad of Branch Date: 6 TtrfaDId2la't

NCC llank Lin lcd
e4)A'S 9'r.)-aii',run.n
Dcar Sir.
Please arrange to process this paymcnt instruction by debiting rnv accr.runt as per irrformation provided hereunder

15 DAz
,A.ccount Number
t-l - o { 4 O 2 I U 0 2_l* g ] 2
Scnder's Namc
Stlnrr MD, .t\ALUAI-O?_- A AS H-1
Sender'J Contacl
vobire. o(7[ \ o)+2& 1 n-moir

Crrrrcncy \.4tr LrsD ('.1t) uritr

Sending Amoulr (ln F oo (Il rlordsl 9iq lc-c
Rcason for Paymcnt
4 hdtl
ACearrrvwf

t-Jiirrgh-
)luliiplc
Rcceiver's I nfornlxtion
Rccciving Bank rukB CoMMe- P-C-l4L RAvla e4,4
Rcccivirrg Branch Al(urnouringr.ro '4b 440 SSO
Receiver's Nante
3 A ffi UN. O sth
I
Rcccivcr's Accorrnt No I o tr a 3 7 3 oa o
dcclare/statc thar oll thc informarioo as provided abovc is concct to the best of my knowlcdgc
a 2-b 1
I lirrhcr
dcclarc stale rhat I havc rcad. undcrsrood and agrced rv ith thc tcnns & conditions prin tcd ovcrlcul-.

Signaturc of the Sender

oNr_y -C$-@rl
Ak, iU(d
FoR BANK.S usE
D Transaclion cnlcrcd as pcr delails ol
D Trattsaction Rei No.
abovc E
E
Sendcr.s sictratule vcrificdl
A urhor.izc,Ii (commcnts if auy) :
"A{
Autho, iTcd Ofllciirl Authorizcd Olficial
y')!
''cc
.r",u
Nationrl Credit & Commercc Btnk Limited Date
.......... ....,.Brsnch
: -r-t
Sendcr's lnJornletion Receiver's Information
.. Eank Narne

Branch Namc
Alc \o.
Anroulrt . Rccciler's Narnc
Reason tbr paynrent

llank's Scal
Si[narur" oi Auti'urizit ditii,ar
 Terms & Conditions in resoect of RTCS-fralsrctioIs

RighB rnd obllgrfl ors of sordcdcustomrr

Righls rnd Ohltgrtion of lhr Benk

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lred $irh nn
Grslomcr r[r.rs th0t no \I(ort cdktrlrons lhdl|I!. . rrhrd to anr RT(j\ nr(nt l. ! x!rnufr Drtr xtrt urth i
, L.IrLit nJcr thrs i!(..m.n

I lrr\e rcsd and rderslood the tcrms & condrri(nts

nnrl agNcd to h. hrLrnil h\ lhu sflnt. :61 I 2-w.so{7
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lSigratnre of thc n dcr/Account Holdcr)

ov I qlzeze