ELECTRONIC CLEARING SERVICE

MANDATE FORM

NOTE : ECS Facility is available only at

Mumbai, Chennai, New Delhi

and Calcutta.

Reg. Folio No. : _________________________________

1
Bondholder's Name

2

Particulars of Bank Account

(a) Bank Name:

(b) Branch Name:
Address:
Telephone No.:

(c) Digit code number of the Bank & Branch appearing on the MICR cheque issued by the Bank:

(d) Account Type (S.B. account/Current account or cash credit) with code 10/11/13:

(e) Ledger No./Ledger Folio No.:

(f) Account Number:
(as appearing on the cheque book)
(Please attach a blank cancelled cheque, or photocopy of a cheque of your bank for verification of the above particulars.)

I, hereby, declare that the particulars given above are correct and complete. If the transaction is delayed or not effected at 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 of me as a participant under the scheme.

(................)

Date:.................. Signature of the Bondholder

Note : This Facility is not available for Flexi-3 and IDBI Shares

1	Bondholder's Name
2	Particulars of Bank Account
	(a) Bank Name:
	(b) Branch Name: Address: Telephone No.:
	(c) Digit code number of the Bank & Branch appearing on the MICR cheque issued by the Bank:
	(d) Account Type (S.B. account/Current account or cash credit) with code 10/11/13:
	(e) Ledger No./Ledger Folio No.:
	(f) Account Number: (as appearing on the cheque book) (Please attach a blank cancelled cheque, or photocopy of a cheque of your bank for verification of the above particulars.)