Application for Funds Transfer through RTGS /NEFT

√RTGS NEFT (Select RTGS or NEFT as remittance type)

To
The Branch Manger/
Sarjapur road Branch/
Date 0 9 0 2 2 0 2 3
Dear Sir/ D

Please remit through NEFT/ RTGS a sum of Rs 1,92,000/- (Rupees in words) One lakh ninety two thousand only

only as per details give below:

Cash(only for NEFT) Cheque Debit of my/our account (only for NEFT)
√
In case of cash please fill in the pay-in-slip
To be filled by the Applicant in CAPITAL LETTERS
DETAILS OF APPLICANT (REMITTER)
Account Number 5 0 3 1 7 0 0 0 9 8 7 4 Cheque Date/
Cheque Number 0 0 1 3 5 8 9 0 9 0 2 2 0 2 3
Remitter's Name
Address A C C E N T U R E I N D I A P V T L T D

Mobile / Other Number/

0 8 0 6 1 1 8 0 0 0 2

DETAILS OF BENEFICIARY
Beneficiary's Name/ A M I T H V I S H W A N A T H
Account Number/
8 4 1 3 1 0 1 1 0 0 0 2 8 3 9
Bank Name
IFSC Code (11-digit)/ B A N K O F I N D I A
(11 ): B K I D 0 0 0 8 4 1 3
Branch Address/
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: J A Y A P R A K A S H
Confirm Account Number
Again N A G A R A R
8 4 1 3 1 0 1 1 0 0 0 2 8 3 9

Remarks (if any)/ :

PURPOSE CODE FOR RTGS/

Cash Management Transfer/ Supplier Payment

CASH INTE Interest/ SUPP
/
Trade Settlement Payment/
CORT LOAN Loan /� TAXS Tax Payment

Pension Payment/
DIVI Dividend � PENS TRAD Trade /
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Government Payment / SALA

Salary Payment/
TREA Treasury Payment/
GOVT
Value Added Tax Payment/
HEDG Hedging/ SECU Securities / VATX

Intra Company Payment/� Social Security Benefit/

INTC SSBE � WHLD With Holding/�
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 Terms and Conditions/

 This transfer is required for a single transaction/ะ�√

 The fund transfer will be governed by the terms and conditions given on our website www.icicibank.com/ะ� ส ษ ฦ�ล�ʤ�獐 �ʤ怀��
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 I / We authorise ICICI Bank to recover charges as may be applicable by debiting my account as mentioned aboveʤ / �ʤ ʤ�獐�獐 ʤ怀ท ท뙚�ข ��翷าสʤทJ า� ษทJฦท�ฦ�, พ�ʤʤʤ�ธ�ฦท뙚รẾ 怀
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 I / We understand that as per the RBI circular dated October 14, 2010, transfer of funds through electronic mode will be executed only on the basis
of the account number of the beneficiary provided while initiating the transaction; name will not be considered as a criteria for providing credit./ʤ /
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 I understand that this facility is available only at select locations and banks covered under Electronic Funds Transfer facility offered by RBI /ʤJ怀 J� � �Jะ� ���ษ� �怀獐 ʤ J�� ฦ��J��าʤ
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 By signing on this RTGS Payment Instruction, the Customer agrees and acknowledges that this RTGS Payment Instruction and the ICICI Bank RTGS
Facility is subject to the Terms and Conditions, the Notice and these terms, and requests the execution of these instructions in terms thereof/ � �
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 Terms used but not defined herein shall have the meaning ascribed to them in the Terms and Conditions/ ะ�� ʤJ�ท พ�สʤ��า獐�ฦ ห�หf�翷� �ฦส�獐 �Jทะนะ��,�ท� ว�ส สะʤJJ �ฦ ʤ � m ธฦ�뙚น�|ะ� สขษ�f�ฦ ว�� ฦน²ฦ สะʤ��า獐, สะʤ���ฦPʤ �ʤ� �ø�|

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 The Customer understands that the terms enumerated in this RTGS Payment Instruction are in addition to and not in derogation of the Terms and
Conditions/�� �
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 Subject to ICICI Bank’s right, at its sole discretion, to accept or reject the RTGS Payment Instructions, ICICI Bank shall endeavor to duly execute these
instructions, except when, inter alia, this RTGS Payment Instruction is incomplete or has been filled in wrongly or the instructions herein cannot be
executed under the RTGS. An acknowledgement of receipt of this RTGS Payment Instruction shall not be construed as binding ICICI Bank to execute
the same, other than in terms of the Terms and Conditions / �
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 ICICI Bank has not made any warranty and makes no representation about the quality, nature or availability of the ICICI Bank RTGS Facility/ ʤ�獐 ʤ�獐 ʤ 怀ท �
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 ICICI Bank shall have no obligations to any person including any beneficiary (or any person claiming under or through such beneficiary) other than the
Customer for the execution of this RTGS Payment Instruction/ ʤ�獐 ʤ�獐 ʤ怀ท ท뙚�� �
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 The Customer is hereby notified that there is a risk of non - payment to the beneficiary on the day of the transaction. The same may be for any reason
whatsoever, including a holiday at the beneficiary's branch. ICICI Bank or RBI or any other participant in NEFT / RTGS shall not be liable, in any manner
whatsoever, to the Customer for any such delay / J��ท뙚�翷 ผฦ�Jทะพ�ฦ��Jาʤส-怀JสทJ �J怀า�翷�วtท뙚翷ขนฦ�สสท�สʤท�พ뙚 ธʤ�,ะ��Jท�翷獐ท��ล�ʤ�뙚�ทฦ�� , พ�ʤ า�翷�วtท �ธ�ʤ ฝJ7J翷獐�� ʤา � ʤ�獐 ʤ�獐 ʤ怀ท ะ� �怀獐 ะʤ �สʤ�ฬ
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 For NEFT: Transfer of an amount up to `49,999/- in cash is permissible using this facility. KYC to be provided by non customer. Cheque is mandatoryfor remittance above
`100,000/-. /�� �ข �뙚翷 ท翷 �뙚翷ชน ท뙚ทจ `49,999/ - ฦท ท สท翷 뙚翷 � ทจ �pJ翷J+ฦ ท øJ뙚ท ฦ �뙚翷 น뙚뙚 J翷� J翷뙚 KYC 翷翷ส �Jท翷 พ翷ส翷 � ท �뙚| `100,000/- �จ �뙚뙚 ทจ Jจ翷 ทจ า� ผจท ส�翷翷’ �뙚翷

Customer Signature (S)/

Accenture India PVT

ACCENTURE INDIA PVT LTD NA NA

(Primary Applicant)
For Bank Use Only

1. Employee ID (Maker): ARUN UTHPAL

2. Employee ID (Checker): SHIVKUMAR SRIDARAN

3. UTR / PIO Number: WER79URHJ

4. Transaction ID: 1044KL09ACEY

Customer Acknowledgement
Customer name /
Accenture India Date:9 /02/2023
Beneficiary name / Mode of payment /
AMITH VISHWANTH

Beneficiary bank name /HDFC Beneficiary account

number/า 841310110002839
Transaction reference
number /�: 1044KL09ACEY Amount / 1,92,000
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Name OF Bank official / �: ARUN UTHPAL
Customer Acknowledgement

0 9 0 2 2 0 2 3
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