Professional Documents
Culture Documents
Payment Details
[In case payment details are the same for all ISIN’s, kindly state the complete details only at one place and mention “Same as above” at
remaining places]
Sr. Consideration
No.
ISIN Qty
Amount (₹)
Payment date/Date Mode of Payment Transferee ’s Name(s) Transaction
For Electronic and Instrument Payment
of Instrument (Please tick any reference no. /
(DD-MMM-YY ) one ) Bank Name Bank Branch Name Bank Account Instrument no.
Number (Cheque)
Instrument
1 Electronic
Cash
Instrument
2 Electronic
Cash
Instrument
3 Electronic
Cash
Instrument
4 Electronic
Cash
Instrument
5 Electronic
Cash
*
1.___________________________________________2._____________________________________________3.____________________________________________
Authorised Signatory (ies)