ECS FORMAT

To,

Citibank N.A.
____________

____________

Dear Sir,

RE: AUTHORISATION TO PAY CITIBANK N.A MONTHLY REPAYMENT THROUGH THE

ELECTRONIC DEBIT CLEARING MECHANSIM

a) Name: ____________________________________________________________________

b) Loan Account No: _______________________________________________

Particulars of Bank Account:

c) Name of account holder: __________________________________________________________________

d) Bank Name: ____________________________________________________________________

e) Branch Name: ___________________________________________________________________

f) 9 digit code number of the bank and: _______________________________________________

branch appearing on the MICR Cheque
issued by the bank _______________________________________________

(Please enclose a photocopy of blank, cancelled cheque issued by your bank for verifying the accuracy of
the code number)

g) Account Type: _____________________________________________________

(i.e. Savings / Current / CC Account)

h) Ledger Folio Number: _______________________________________________

(if appearing in the cheque book)

i) Account Number: ___________________________________________________

(if appearing in the cheque book)

___________________
Date: _____________ Customer Signature
 ECS FORMAT (page 2 of 4)

Date:

The Branch manager

Citibank NA

Sub: Savings / Current Account Number:

Dear sir,

This is with reference to the above account held by me at your branch.

I have availed a loan from CITIBANK N.A and would like to avail of the Electronic Debit Facility offered by
the Reserve Bank of India towards settlement of my monthly dues, presently to the tune of
Rs.____________.

However, I/We acknowledge that on account of interest rate fluctuations the said amount may vary,
provided that the said amount shall not exceed Rs. ______________ and hereby unconditionally and
irrevocably authorise Citibank N.A to raise debits of such amounts. This is aimed at our mutual
convenience in reducing the paper work

This is to irrevocable and unconditionally instruct you to accept the debit raised by CITIBANK N.A through
electronic clearing regularly every month and the debit the same to my above savings / current account. I
confirm that these instructed to act in accordance herewith.

Please acknowledge receipt and confirmation of this instruction.

Sincerely yours,

Customer Signature
 ECS FORMAT (page 3 of 4)

I ___________________________________________ S/o _________________________________

being the beneficiary of a loan vide loan agreement dated _____________ unconditionally and

irrevocably authorize you to raise a demand on _____________________________ (Name of the bank).

I being the borrower of CITIBANK N.A hereby express my unconditional consent to debit payment of my
installment referred to above through participation in ECS of the National Clearing Cell of the Reserve
Bank of India, and hereby unconditionally and irrevocably authorize Citibank N.A to raise debit on such
regular installments, till such time all dues to CITIBANK N.A as referred to above are cleared through this

scheme by debits against my bank account number ________________________ with

_______________________________________________ bank

I hereby declare that the particulars given above are correct and complete. If the transaction is delayed or
not effected at all for reasons to incomplete or incorrect information, I would not hold CITIBANK N.A
responsible.

This mandate does not prejudice the absolute right to CITIBANK N.A at any time hereafter, to discontinue
this arrangement and opt to revert to insisting on my submitting post-dated cheques to CITIBANK N.A

ADDRESS:

__________________________
Signature of borrower

__________________________
Name
 ECS FORMAT (page 4 of 4)

SCHEDULE OF EMI MAINTENANCE

CUSTOMER NAME : ____________________________________________________

Loan Amount : ____________________________________________________
Rate of Interest : ____________________________________________________
Tenor : ____________________________________________________

Monthly Instalments

Number of Interest Payments :

(As per Schedule given below)

Number of EMI Payments :

EMI Amount EMI Start Date EMI End Date

SCHEDULE FOR INTEREST PAYMENTS

S.No Date Interest Amount

(DD / MM/ YYY) Rs.

I understand that –

Interest payments are allowed only for under-construction properties during the construction period for a
maximum period of 30 months
st
For all other cases, interest option is allowed only for the 1 month succeeding the first disbursal, if the
th
disbursal date is on or after 24 of a month.

In the event of the monthly installment varying in accordance with the loan agreement, the Bank may
debit an amount different from the above, which could be higher or lower than the amount mentioned, but
shall not exceed Rs.___________________.

Date:_____________ Customer Signature

____________________________________________________________________________________________
NOTE : BELOW FORMAT IS FOR PROVIDING GUIDANCE ON HOW TO FILL UP THE ECS
FORM. FOR SUBMISSION TO THE BANK, PLEASE USE THE ABOVE BLANK FORM.
____________________________________________________________________________________________

ECS FORMAT

To,

Citibank N.A.
____________

____________

Dear Sir,

RE: AUTHORISATION TO PAY CITIBANK N.A MONTHLY REPAYMENT THROUGH THE

ELECTRONIC DEBIT CLEARING MECHANSIM
Your Name (as per loan
a) Name: sanction letter)

b) Loan Account No: Your Citibank Loan

Number (as per loan
sanction letter)

Your Name (as per Bank

Particulars of Bank Account: passbook / bank statement
where you hold the
c) Name of account holder: account)

d) Bank Name: Name of the bank

where you hold
the account.
customer
e) Branch Name:
Name of the branch
where account is held

f) 9 digit code number of the bank and: 9 digit MICR code as

branch appearing on the MICR Cheque mentioned in cheque
issued by the bank leaf
(Please enclose a photocopy of blank, cancelled cheque issued by your bank for
verifying the accuracy of the code number)
Account type as
mentioned in the
cheque leaf.
g) Account Type:
(i.e. Savings / Current / CC Account)
Ledger folio
number as per
bank records
h) Ledger Folio Number:
(if appearing in the cheque book)
Bank account number
i) Account Number: of the customer as
(if appearing in the cheque book) appearing in Cheque
leaf / pass book/ bank
statement.

Date: _____________ Customer Signature

Signature of the
customer (to match with
the signature as per the
bank records from
which ECS is provided
by the customer)
 ECS FORMAT (page 2 of 4)

Date:

The Branch manager

Citibank N.A

To be filled in
Sub: Savings / Current Account Number: Monthly EMI
- Post liaison
amount of the
with the
Dear sir, Citibank loan
Citibank
This is with reference to the above account held by me at your branch.

I have availed a loan from CITIBANK N.A and would like to avail of the Electronic Debit Facility offered by
the Reserve Bank of India towards settlement of my monthly dues, presently to the tune of
Rs.____________.

However, I/We acknowledge that on account of interest rate fluctuations the said amount may vary,
provided that the said amount shall not exceed Rs. ______________ and hereby unconditionally and
irrevocably authorise Citibank N.A to raise debits of such amounts. This is aimed at our mutual
convenience in reducing the paper work

This is to irrevocable and unconditionally instruct you to accept the debit raised by CITIBANK N.A through
electronic clearing regularly every month and the debit the same to my above savings / current account. I
confirm that these instructed to act in accordance herewith.

Please acknowledge receipt and confirmation of this instruction.

Sincerely yours,

Signature of
the customer
Customer Signature
 ECS FORMAT (page 3 of 4)

I ___________________________________________________ S/o ____________________________

being the beneficiary of a loan vide loan agreement dated _____________ unconditionally and
irrevocably authorize you to raise a demand on __________________ (Name of the bank).

I being the borrower of CITIBANK N.A hereby express my unconditional consent to debit payment of my
installment referred to above through participation in ECS of the National Clearing Cell of the Reserve
Bank of India, and hereby unconditionally and irrevocably authorize Citibank N.A to raise debit on such
regular installments, till such time all dues to CITIBANK N.A as referred to above are cleared through this
scheme by debits against my bank account number ________________ with
________________________ bank

I hereby declare that the particulars given above are correct and complete. If the transaction is delayed or
not effected at all for reasons to incomplete or incorrect information, I would not hold CITIBANK N.A
responsible.

This mandate does not prejudice the absolute right to CITIBANK N.A at any time hereafter, to discontinue
this arrangement and opt to revert to insisting on my submitting post-dated cheques to CITIBANK N.A

ADDRESS: Name of the bank

where account is Bank account number of
held the customer as
appearing in Cheque leaf
_________________ / pass book/ bank
Signature of borrower Signature of statement
the borrower

__________________________
Name Name of the
Borrower
 ECS FORMAT (page 4 of 4)

SCHEDULE OF EMI MAINTENANCE

CUSTOMER NAME : _________________________________

Loan Amount : _________________________________
Rate of Interest : _________________________________
Tenor : _________________________________

Monthly Instalments

Number of Interest Payments :

(As per Schedule given below)

Number of EMI Payments :

EMI Amount EMI Start Date EMI End Date

SCHEDULE FOR INTEREST PAYMENTS

S.No Date Interest Amount Repayment

Monthly EMI (DD / MM/ YYY) Rs. (EMI) end
amount as date
mentioned in loan
sanction letter /
interest rate
revision letter)
Repayment
(EMI) start
date
I understand that –

Interest payments are allowed only for under-construction properties during the construction period for a
maximum period of 30 months
st
For all other cases, interest option is allowed only for the 1 month succeeding the first disbursal, if the
th
disbursal date is on or after 24 of a month.

In the event of the monthly installment varying in accordance with the loan agreement, the Bank may
debit an amount different from the above, which could be higher or lower than the amount mentioned, but
shall not exceed Rs.___________________.

Interest
repayment
Signature of
schedule (for
the customer
under
construction
Date:_____________ property) Customer Signature
 Signature to
match with
ECS Form &
Bank records

Name of the Customer

Account Number (To match the name
which needs to be Ledger folio filled in the ECS Form)
mentioned in ECS number
Form.

Account Type
Cheque Number

9 Digit Micr Code

Note: In case of Joint accounts where the mode of operation states that the account should be
jointly operated by the account holders, the ECS mandate form too will have to be signed by all
the joint holders.