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14 03 2023

Sponsor Bank Code KKBK0RTGSMI INDB00477000028001


Tick ( 3)
✔ ABFLBIJU 3) ✔

Bank a/c number 1 0 8 6 1 4 6 4 2 1 0


with Bank State Bank Of India SB I N0 0 0 0 6 0 5 or

Sixty Three Thousand Rupees Only ` 63000


✔ Mthly Qtly H- ✔
94011991068613 Phone No.

I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank*

From 0 5 0 5 2 0 2 3
x
Or ✔ 1. Nidhi Bisht 2.
3.
This is to confirm that the declaration has been carefully read ,understood and made by me/us .I am authorizing the User entity / Corporate to debit my account.
I have understood that I am authorized to cancel / amend this mandate by appropriately communicating the cancellation / amendment request to the User entity/ Corporate or the bank where I have authorized the debit.

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