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    Ecs - Donations

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    api-274799987
    This document is a mandate form for electronic clearing service (ECS) debit authorization. It contains information about the customer, including their name, address, bank details, and ECS debit scheme details. The customer is authorizing their bank to debit amounts from their account and make payments to Atharavu Iyakka Arakkattalai through ECS clearing as per the specified periodicity and number of installments. The customer confirms the information provided is correct and acknowledges their responsibilities as a participant in the scheme. The form requires the customer and bank signatures to certify the details.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Ecs - Donations

    Uploaded by

    api-274799987
    10K views2 pages
    This document is a mandate form for electronic clearing service (ECS) debit authorization. It contains information about the customer, including their name, address, bank details, and ECS debit scheme details. The customer is authorizing their bank to debit amounts from their account and make payments to Atharavu Iyakka Arakkattalai through ECS clearing as per the specified periodicity and number of installments. The customer confirms the information provided is correct and acknowledges their responsibilities as a participant in the scheme. The form requires the customer and bank signatures to certify the details.

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    ecs - donations

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    This document is a mandate form for electronic clearing service (ECS) debit authorization. It contains information about the customer, including their name, address, bank details, and ECS debit scheme details. The customer is authorizing their bank to debit amounts from their account and make payments to Atharavu Iyakka Arakkattalai through ECS clearing as per the specified periodicity and number of installments. The customer confirms the information provided is correct and acknowledges their responsibilities as a participant in the scheme. The form requires the customer and bank signatures to certify the details.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    10K views2 pages

    Ecs - Donations

    Uploaded by

    api-274799987
    This document is a mandate form for electronic clearing service (ECS) debit authorization. It contains information about the customer, including their name, address, bank details, and ECS debit scheme details. The customer is authorizing their bank to debit amounts from their account and make payments to Atharavu Iyakka Arakkattalai through ECS clearing as per the specified periodicity and number of installments. The customer confirms the information provided is correct and acknowledges their responsibilities as a participant in the scheme. The form requires the customer and bank signatures to certify the details.

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    © All Rights Reserved
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    APPENDIX VIII

    FORM NO.E-5
    MANDATE FORM
    ELECTRONIC CLEARING SERVICE (DEBIT CLEARING)

    Copy to Organization
    Atharavu Iyakka Arakkattalai, No 21 Nehru street Extn,
    Arumaikkaranthottam, 15Velampalayam .po ,Tirupur.dt
    Tamilnadu India. pin code;641652. cell 98423 41607, 99653 49643

    MEMBERS (CUSTOMERS) HOME ADDRESS


    Name: _____________________________________________________________________________________________________________________________
    Address ____________________________________________________________________________________________________________________________
    City ____________________________________________STATE:___________________________________________ MOB: ________________________________
    TO

    The Manager
    MEMBERS BANK DETAILS
    (Bank Name:____________________________________________________ Branch Name): ________________________________________________________
    (Address): ____________________________________________________________________________________________________________________________
    City: _____________________________________________________________ State:_____________________________________________________________
    I __________________________________________________________ hereby authorize you to debit from my account for making payment to
    Atharavu Iyakka Arakkattalai through ECS (Debit) clearing as per the details given as under.
    A.

    9-DIGIT CODE NUMBER of the Bank & Branch (Appearing on the MICR Cheque issued by the Bank):

    B.

    ACCOUNT TYPE Current account-CC/OD):________________________________________

    C.

    ACCOUNT NUMBER

    NAME OF THE SCHEME

    Date of effect

    Periodicity
    (monthly/Quarterly/
    Half Yearly / Yearly

    Amount of
    Installment

    No. of Installments/valid upto (Ex:60


    months/31-7-2015)

    Atharavu Iyakka
    Arakkattalai Donation

    D.

    Date of effect: ________________________________________

    I hereby declare that the particulars given above are correct and complete. If the transaction is delayed or not effected all for reasons of incomplete or incorrect
    information, I would not hold the user institution responsible. I have read the option invitation letter and agree to discharge the responsibility expected me as a
    participant under the scheme.
    Date: ________________________________________
    Place: ________________________________________
    -----------------------------------------------------------------Signature of the customer
    For Official Purpose

    We certify that the particulars furnished above are correct as per our records.

    Bank Stamp/Date

    (Signature of the authorized official from the bank)

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