Branch Code / Name 2623/VIBHAV KHAND GOMTI NAGAR Maximum Limit for NEFT Transaction

Date 13/12/2021 HDFC Bank Customer No Limit

Time Non HDFC Bank Customer & Indo-Nepal NEFT Remittance Up to INR 50,000/-

You are requested to remit the proceeds as per details below through RTGS / NEFT . (Tick ü the appropriate Box) .
Attaching Cheque No. 002134 for Rs. 800000 (For RTGS draw cheque favouring “HDFC Bank Ltd – RTGS” and for NEFT
draw cheque favouring “HDFC Bank Ltd – NEFT”)
Beneficiary Details
Beneficiary Name Err:514
Beneficiary Account Number Err:514
Beneficiary Account Number Err:514
BenefiDiary Address Err:514
Beneficiary Bank Name & Branch Err:514
Beneficiary Bank IFSC Code Err:514 Account Type : Resident /Non Resident

Amount (in figures) to be credited 800000

Amount (in words) to be credited Eight Lakh Only
My / Our Details (Remitter)
Remitter (Applicant) Name CHANDRA KESH MISHRA
Remitter Account Number 26000000028
Cash Deposited (Non HDFC Bank Customer) NA
Mobile / Phone Number of Remitter ( Mandatory) +91-7600000025 E-Mail Id: cmishra24@yahoo.com
Address of the Remitter (Mandatory for Non – HDFC KAMTA NEAR SHAHEED PATH FAIZABAD ROAD LUCKNOW
Bank Customer)
Remarks
Terms & Conditions ü
* I / We hereby authorize HDFC Bank Ltd. to carry out the RTGS / NEFT transaction as per details mentioned above. (Tick the appropriate Box)
* I / We hereby agree that the aforesaid details including the IFSC code and the beneficiary account are correct.
* I / We further acknowledge that HDFC Bank accepts no liability for any consequences arising out of erroneous details provided by me/us.
* I / We agree that the credit will be affected solely on the beneficiary account number information and beneficiary name particulars will not be used for the same.
* I / We authorize the bank to debit my / our account with the charges plus taxes as applicable for this transaction.
* I / We agree that requests submitted after the cut off time will be sent in next batch or next working day as applicable.
* I / We hereby agree & understand that the RTGS / NEFT request is subject to the RBI regulations and guidelines governing the same.
* I / We also understand that the remitting Bank shall not be liable for any loss of damage arising or resulting from delay in transmission delivery or non-delivery of Electronic
message or any mistake, omission, or error in transmission or delivery thereof or in deciphering the message from any cause whatsoever or from its misinterpretation
received or the action of the destination Bank or any act or even beyond control.
* I/We agree that incase of NEFT Transaction if we do not have an account with the bank, we will produce Original identification proof while giving the request. In case
I/We submit form 60, we will also submit the address proof.
* In case the RTGS and NEFT option is not ticked by us, I / We authorize you to execute the transaction less than Rupees Two Lacs through NEFT and greater than or
equal to Rupees Two Lacs through RTGS and debit the charges as applicable.

____________________ ____________________ ____________________

Signature of Authorized
Signatory 1st Signatory 2nd Signatory 3rd Signatory
Please affix stamp wherever applicable

Branch Use Only

Transaction Reference Number
Transaction Inputted by Employee Code Signature
Transaction Authorized by Employee Code Signature

Transaction Authorized by (2nd level) (for amount > Rs. 5 lacs) Employee Code Signature Branch Stamp, Date &
KYC documentation done by (only for Non-HDFC Bank Customers) Employee Code Signature Sign
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Customer Acknowledgement
Received application for RTGS / NEFT for an amount of Rs. 800000 vide cash / cheque number to be credited to Account
Number A/C NO.XYZ02 of BANK NAME-XYZ02 Bank with IFSC Code XYZA0000002 Customers will be
guided by the Terms and Conditions mentioned in the form. HDFC Bank will accept no liability for any consequences arising out of erroneous details provided by the Customer.
Date 13/12/2021 Time _Branch Stamp & Sign __
26000000028-CHANDRA KESH MISHRA To XYZ-2
Acknowledgement

RTGS/ NEFT. (√ the appropriate box). Please remit the funds as per details provided through RTGS / NEFT. (√ the appropriate box).

Beneficiary Details Branch Name: 2623/VIBHAV KHAND GOMTI NAGAR Date: 13/12/2021 Time:
Name: XYZ-2 Customer Name: CHANDRA KESH MISHRA
Account No.: A/C NO.XYZ02 Account No.: 26000000028 Cheque No: 002134
Bank: BANK NAME-XYZ02 Mobile No.: +91-7600000025 Tel No.: 0522-2415148

Date: 13/12/2021 Beneficiary Details

Time: Name: XYZ-2
Cheque No.: 002134 Address: ADDRESS XYZ-02
Amount: 800000 Account No.: A/C NO.XYZ02 Confirm Account No.: A/C NO.XYZ02
Bank & Branch: BANK NAME-XYZ02 IFSC Code: XYZA0000002 A/c Type Resident Non Resident
Eight Lakh Only
Amount to be credited (in figures): 800000 (in Words):
Remarks:

Signature of
Authorized
Signature /Stamp by Bank Staff Signatory 1st Signatory 2nd Signatory 3rd Signatory
 CHANDRA KESH MISHRA "PROFESSIONAL ACCOUNTANT" w
OLD RTGS NEW RTGS me cmishra24@yahoo.com for All Type Return i.e. VAT,
FORM FORM SERVICE TAX,TDS, EPF, ESI, GST

BENEFICIARY BANK &

S.N. BENEFICIARY NAME BANK A/C No. BENEFICIARY ADDRESS
BRANCH NAME
1 ABC-01 A/C NO.ABC01 ADDRESS ABC-01 BANK NAME-ABC01
2 ABC-02 A/C NO.ABC02 ADDRESS ABC-02 BANK NAME-ABC02
3 ABC-03 A/C NO.ABC03 ADDRESS ABC-03 BANK NAME-ABC03
4 ABC-04 A/C NO.ABC04 ADDRESS ABC-04 BANK NAME-ABC04
5 ABC-05 A/C NO.ABC05 ADDRESS ABC-05 BANK NAME-ABC05
6 ABC-06 A/C NO.ABC06 ADDRESS ABC-06 BANK NAME-ABC06
7 ABC-07 A/C NO.ABC07 ADDRESS ABC-07 BANK NAME-ABC07
8 ABC-08 A/C NO.ABC08 ADDRESS ABC-08 BANK NAME-ABC08
9 ABC-09 A/C NO.ABC09 ADDRESS ABC-09 BANK NAME-ABC09
10 ABC-10 A/C NO.ABC10 ADDRESS ABC-10 BANK NAME-ABC10
11 ABC-11 A/C NO.ABC11 ADDRESS ABC-11 BANK NAME-ABC11
12 ABC-12 A/C NO.ABC12 ADDRESS ABC-12 BANK NAME-ABC12
13 ABC-13 A/C NO.ABC13 ADDRESS ABC-13 BANK NAME-ABC13
14 ABC-14 A/C NO.ABC14 ADDRESS ABC-14 BANK NAME-ABC14
15 ABC-15 A/C NO.ABC15 ADDRESS ABC-15 BANK NAME-ABC15
16 ABC-16 A/C NO.ABC16 ADDRESS ABC-16 BANK NAME-ABC16
17 ABC-17 A/C NO.ABC17 ADDRESS ABC-17 BANK NAME-ABC17
18 ABC-18 A/C NO.ABC18 ADDRESS ABC-18 BANK NAME-ABC18
19 ABC-19 A/C NO.ABC19 ADDRESS ABC-19 BANK NAME-ABC19
20 ABC-20 A/C NO.ABC20 ADDRESS ABC-20 BANK NAME-ABC20
21 ABC-21 A/C NO.ABC21 ADDRESS ABC-21 BANK NAME-ABC21
22 ABC-22 A/C NO.ABC22 ADDRESS ABC-22 BANK NAME-ABC22
23 ABC-23 A/C NO.ABC23 ADDRESS ABC-23 BANK NAME-ABC23
24 ABC-24 A/C NO.ABC24 ADDRESS ABC-24 BANK NAME-ABC24
25 ABC-25 A/C NO.ABC25 ADDRESS ABC-25 BANK NAME-ABC25
26 ABC-26 A/C NO.ABC26 ADDRESS ABC-26 BANK NAME-ABC26
27 ABC-27 A/C NO.ABC27 ADDRESS ABC-27 BANK NAME-ABC27
28 ABC-28 A/C NO.ABC28 ADDRESS ABC-28 BANK NAME-ABC28
29 ABC-29 A/C NO.ABC29 ADDRESS ABC-29 BANK NAME-ABC29
30 ABC-30 A/C NO.ABC30 ADDRESS ABC-30 BANK NAME-ABC30
31 ABC-31 A/C NO.ABC31 ADDRESS ABC-31 BANK NAME-ABC31
32 ABC-32 A/C NO.ABC32 ADDRESS ABC-32 BANK NAME-ABC32
33 ABC-33 A/C NO.ABC33 ADDRESS ABC-33 BANK NAME-ABC33
34 ABC-34 A/C NO.ABC34 ADDRESS ABC-34 BANK NAME-ABC34
35 ABC-35 A/C NO.ABC35 ADDRESS ABC-35 BANK NAME-ABC35
36 ABC-36 A/C NO.ABC36 ADDRESS ABC-36 BANK NAME-ABC36
37 ABC-37 A/C NO.ABC37 ADDRESS ABC-37 BANK NAME-ABC37
38 ABC-38 A/C NO.ABC38 ADDRESS ABC-38 BANK NAME-ABC38
39 ABC-39 A/C NO.ABC39 ADDRESS ABC-39 BANK NAME-ABC39
 40 ABC-40 A/C NO.ABC40 ADDRESS ABC-40 BANK NAME-ABC40
41 ABC-41 A/C NO.ABC41 ADDRESS ABC-41 BANK NAME-ABC41
42 ABC-42 A/C NO.ABC42 ADDRESS ABC-42 BANK NAME-ABC42
43 ABC-43 A/C NO.ABC43 ADDRESS ABC-43 BANK NAME-ABC43
44 ABC-44 A/C NO.ABC44 ADDRESS ABC-44 BANK NAME-ABC44
45 ABC-45 A/C NO.ABC45 ADDRESS ABC-45 BANK NAME-ABC45
46 ABC-46 A/C NO.ABC46 ADDRESS ABC-46 BANK NAME-ABC46
47 ABC-47 A/C NO.ABC47 ADDRESS ABC-47 BANK NAME-ABC47
48 ABC-48 A/C NO.ABC48 ADDRESS ABC-48 BANK NAME-ABC48
49 ABC-49 A/C NO.ABC49 ADDRESS ABC-49 BANK NAME-ABC49
50 ABC-50 A/C NO.ABC50 ADDRESS ABC-50 BANK NAME-ABC50
51 ABC-51 A/C NO.ABC51 ADDRESS ABC-51 BANK NAME-ABC51
52 ABC-52 A/C NO.ABC52 ADDRESS ABC-52 BANK NAME-ABC52
53 ABC-53 A/C NO.ABC53 ADDRESS ABC-53 BANK NAME-ABC53
54 ABC-54 A/C NO.ABC54 ADDRESS ABC-54 BANK NAME-ABC54
55 ABC-55 A/C NO.ABC55 ADDRESS ABC-55 BANK NAME-ABC55
56 ABC-56 A/C NO.ABC56 ADDRESS ABC-56 BANK NAME-ABC56
57 ABC-57 A/C NO.ABC57 ADDRESS ABC-57 BANK NAME-ABC57
58 ABC-58 A/C NO.ABC58 ADDRESS ABC-58 BANK NAME-ABC58
59 ABC-59 A/C NO.ABC59 ADDRESS ABC-59 BANK NAME-ABC59
60 ABC-60 A/C NO.ABC60 ADDRESS ABC-60 BANK NAME-ABC60
61 ABC-61 A/C NO.ABC61 ADDRESS ABC-61 BANK NAME-ABC61
62 ABC-62 A/C NO.ABC62 ADDRESS ABC-62 BANK NAME-ABC62
63 ABC-63 A/C NO.ABC63 ADDRESS ABC-63 BANK NAME-ABC63
64 ABC-64 A/C NO.ABC64 ADDRESS ABC-64 BANK NAME-ABC64
65 Err:514 Err:514 Err:514 Err:514
Below RTGS Details S.No. write in cell "G67" to fill RTGS Form
S.N. 1 2 3
1 BENEFICIARY NAME XYZ-1 XYZ-2 XYZ-3
2 BANK A/C No. A/C NO.XYZ01 A/C NO.XYZ02 A/C NO.XYZ03

3 BENEFICIARY ADDRESS ADDRESS XYZ-01 ADDRESS XYZ-02 ADDRESS XYZ-03

BENEFICIARY BANK &
4 BRANCH NAME BANK NAME-XYZ01 BANK NAME-XYZ02 BANK NAME-XYZ03
BENEFICIARY IFSC
5 CODE XYZA0000001 XYZA0000002 XYZA0000003

Same Bank Transfer A/c Details

S.No. BENEFICIARY NAME BANK A/C No. BENEFICIARY ADDRESS BENEFICIARY BANK

2
3
4
 5 1
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
ONAL ACCOUNTANT" write to
l Type Return i.e. VAT, ITR,
EPF, ESI, GST

BENEFICIARY IFSC
CODE
ABCD0000001
ABCD0000002
ABCD0000003
ABCD0000004
ABCD0000005
ABCD0000006
ABCD0000007
ABCD0000008
ABCD0000009
ABCD0000010
ABCD0000011
ABCD0000012
ABCD0000013
ABCD0000014
ABCD0000015
ABCD0000016
ABCD0000017
ABCD0000018
ABCD0000019
ABCD0000020
ABCD0000021
ABCD0000022
ABCD0000023
ABCD0000024
ABCD0000025
ABCD0000026
ABCD0000027
ABCD0000028
ABCD0000029
ABCD0000030
ABCD0000031
ABCD0000032
ABCD0000033
ABCD0000034
ABCD0000035
ABCD0000036
ABCD0000037
ABCD0000038
ABCD0000039
ABCD0000040
ABCD0000041
ABCD0000042
ABCD0000043
ABCD0000044
ABCD0000045
ABCD0000046
ABCD0000047
ABCD0000048
ABCD0000049
ABCD0000050
ABCD0000051
ABCD0000052
ABCD0000053
ABCD0000054
ABCD0000055
ABCD0000056
ABCD0000057
ABCD0000058
ABCD0000059
ABCD0000060
ABCD0000061
ABCD0000062
ABCD0000063
ABCD0000064
Err:514 2

4 5 6 7 8
XYZ-4 XYZ-5 XYZ-6 XYZ-7 XYZ-8
A/C NO.XYZ04 A/C NO.XYZ05 A/C NO.XYZ06 A/C NO.XYZ07 A/C NO.XYZ08

ADDRESS XYZ-04 ADDRESS XYZ-05 ADDRESS XYZ-06 ADDRESS XYZ-07ADDRESS XYZ-0

BANK NAME-XYZ04 BANK NAME-XYZ05 BANK NAME-XYZ0 BANK NAME-XYZBANK NAME-XY

XYZA0000004 XYZA0000005 XYZA0000006 XYZA0000007 XYZA0000008

BRANCH NAME/ IFSC

CODE
 9 10 11 12 13 14
XYZ-9 XYZ-10 XYZ-11 XYZ-12 XYZ-13 XYZ-14
A/C NO.XYZ09 A/C NO.XYZ10 A/C NO.XYZ11 A/C NO.XYZA/C NO.XYZ13 A/C NO.XYZ14

ADDRESS XYZ-09ADDRESS XYZ-10 ADDRESS XYZ-11 ADDRESS XYADDRESS XYZ-13 ADDRESS XYZ-

BANK NAME-XYZBANK NAME-XYZ10 BANK NAME-XYZ11BANK NAMEBANK NAME-XYZ1 BANK NAME-X

XYZA0000009 XYZA0000010 XYZA0000011 XYZA00000XYZA0000013 XYZA0000014

 15 16 17 18 19 20 21
XYZ-15 XYZ-16 XYZ-17 XYZ-18 XYZ-19 XYZ-20 XYZ-21
A/C NO.XYZ15 A/C NO.XYZ16 A/C NO.XYZ1 A/C NO.XYZ1A/C NO.XYZ19 A/C NO.XYZ20 A/C NO.XYZ21

ADDRESS XYZ-15 ADDRESS XYZ-16 ADDRESS XYZADDRESS XYZADDRESS XYZ-1 ADDRESS XYZ- ADDRESS XYZ-2

BANK NAME-XYZ15 BANK NAME-XYZ1BANK NAME-BANK NAME-BANK NAME-XYBANK NAME-XBANK NAME-XY

XYZA0000015 XYZA0000016 XYZA0000017XYZA000001 XYZA0000019 XYZA0000020 XYZA0000021

 22 23 24 25 26
XYZ-22 XYZ-23 XYZ-24 XYZ-25 XYZ-26
A/C NO.XYZ22 A/C NO.XYZ23 A/C NO.XYZ24 A/C NO.XYZ25 A/C NO.XYZ26

ADDRESS XYZ-22ADDRESS XYZ-23ADDRESS XYZ-24 ADDRESS XYZ-25 ADDRESS XYZ-26

BANK NAME-XYZBANK NAME-XYZBANK NAME-XYZ24 BANK NAME-XYZ25 BANK NAME-XYZ26

XYZA0000022 XYZA0000023 XYZA0000024 XYZA0000025 XYZA0000026

 27 28 29 30 31
XYZ-27 XYZ-28 XYZ-29 XYZ-30 XYZ-31
A/C NO.XYZ27 A/C NO.XYZ28 A/C NO.XYZ29 A/C NO.XYZA/C NO.XYZ31

ADDRESS XYZ-27 ADDRESS XYZ-28 ADDRESS XYZ-29 ADDRESS XYADDRESS XYZ-31

BANK NAME-XYZ27 BANK NAME-XYZ28 BANK NAME-XYZ29 BANK NAMEBANK NAME-XYZ31

XYZA0000027 XYZA0000028 XYZA0000029 XYZA00000XYZA0000031

 32 33 34 35 36 37 38 39 40
XYZ-32 XYZ-33 XYZ-34 XYZ-35 XYZ-36 XYZ-37 XYZ-38 XYZ-39 XYZ-40
A/C NO.XYZ32 A/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZ

ADDRESS XYZ-32 ADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XY

BANK NAME-XYZ32 BANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAME

XYZA0000032 XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000
 41 42 43 44 45 46 47 48 49 50
XYZ-41 XYZ-42 XYZ-43 XYZ-44 XYZ-45 XYZ-46 XYZ-47 XYZ-48 XYZ-49 XYZ-50
A/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZ

ADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XY

BANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAME

XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000
 51 52 53 54 55 56 57 58 59 60
XYZ-51 XYZ-52 XYZ-53 XYZ-54 XYZ-55 XYZ-56 XYZ-57 XYZ-58 XYZ-59 XYZ-60
A/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZ

ADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XY

BANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAME

XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000XYZA00000
 61 62 63 64 65
XYZ-61 XYZ-62 XYZ-63 XYZ-64 XYZ-65
A/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZA/C NO.XYZ65

ADDRESS XYADDRESS XYADDRESS XYADDRESS XYADDRESS XYZ-65

BANK NAMEBANK NAMEBANK NAMEBANK NAMEBANK NAME-XYZ65

XYZA00000XYZA00000XYZA00000XYZA00000XYZA0000065