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Ecs Form

This document is a mandate form for making electronic payments through debit clearing for loan EMIs. It contains information about the customer such as their name, loan account number, and bank account details including bank name, branch, MICR code, account type, ledger/folio number, and account number. The customer declares that the information provided is correct and agrees to the terms of the electronic payment scheme. The bank certifies that the customer's details match their records.

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amit
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
21 views

Ecs Form

This document is a mandate form for making electronic payments through debit clearing for loan EMIs. It contains information about the customer such as their name, loan account number, and bank account details including bank name, branch, MICR code, account type, ledger/folio number, and account number. The customer declares that the information provided is correct and agrees to the terms of the electronic payment scheme. The bank certifies that the customer's details match their records.

Uploaded by

amit
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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stv.~\C~".~ct \.10.
ECS Service Provider
LlC Housing Finance Ltd.
Code No.
_

\.~~~US\~~~::0906'

coot

ELECTRONIC

CLEARING SERVICE (DEBIT CLEARING)


MANDATE FORM

CUSTOMER'S ADVICE TO MAKE PAYMENTS THROUGH DEBIT CLEARING


LICHFL LOAN AlC 'NO.:
PAYMENT OF EMI

II I I I I I I II
..

1. CUSTOMER'S NAME
2. PARTICULARS OF BANK ACCOUNT
A. BANKNAME
B. BRANCHNAME
C. 9-DIGIT CODE NUMBER OF THE
BANK & BRANCH
APPEARING

ON THE MICR CHEQUE

(PLEASE ATTACH

THE PHOTOCOPY

A BLANK CANCELLED
FOR VERIFYING

CHEQUE

ISSUED BY THE BANK


OF A CHEQUE

OR

I I I I I 11 1 1 I

ISSUED BY YOUR BANK

THE ACCURACY

OF THE CODE NUMBER)

D.ACCOUNTTYPE
(S.B.Account 1Current Account or Cash Credit)
with code 10/11/13
E.LEDGER

NOJLEDGER FOLIO NO.

F. ACCOUNTNUMBER
(as appearing on the cheque book)
3. DATE OF EFFECT
Ihereby declare that the particulars given above are correct and complete.lf the transaction is delayed or
not effected at all for reasons of incomplete or incorrect information,l would not hold the user institution
responsible. Ihave read the invitation tetter and agree to discharge the responsibility expected of me as a
participant under the scheme.

Date
Place

Signature of the Customer


_

II II I II II
I II I II

Loan AlC No.1


FileNo.

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

B~nk's Stamp:

Date:

Signature of the the Authorised IOfficial


from the Bank

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