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    ACH_FORM-173

    Uploaded by

    jangidkaran374

    Copyright:

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

    ACH_FORM-173

    Uploaded by

    jangidkaran374
    1 views2 pages

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1 views2 pages

    ACH_FORM-173

    Uploaded by

    jangidkaran374

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    UMRN Date 0 9 1 2 2 0 2 4

    Utility Code Create Modify Cancel


    Sponsor Bank Code I/We hereby authorize TVS Credit Services Limited

    to debit (tick ) SB/CA/CC/SB-NRE/SB-NRO/Other Bank a/c number 0 0 0 0 0 0 4 0 3 3 7 8 8 6 7 9 1


    with Bank STATE BANK OF INDIA IFSC/MICR SB I N 0 0 1 7 2 1 8
    an amount of Rupees ELEVEN THOUSAND TWO HUNDRED AND FIFTY ONLY 11250 /-
    DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented

    Customer ID 0025931217 Prospect No. 3009CD1044448


    1.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. 2.This is to confirm that the declaration
    has been carefully read, understood & made by me/us. I am authorizing the User entity / Corporate to debit my account. 3.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.

    From 0 3 0 1 2 0 2 5
    To 0 3 0 1 2 0 3 5
    Or Until Cancelled
    Signature Primary Account Holder
    Signature Account Holder Signature Account Holder
    Phone No. 6001483598 SADDAM HUSSAIN
    1. 2. Name as in bank records 3. Name as in bank records
    LASKAR

    UMRN Date D D M M Y Y Y Y
    Utility Code Create Modify Cancel
    Sponsor Bank Code I/We hereby authorize TVS Credit Services Limited

    to debit (tick ) SB/CA/CC/SB-NRE/SB-NRO/Other Bank a/c number

    with Bank IFSC/MICR

    an amount of Rupees
    DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented

    Customer ID Prospect No.


    1.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. 2.This is to confirm that the declaration
    has been carefully read, understood & made by me/us. I am authorizing the User entity / Corporate to debit my account. 3.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.

    From D D M M Y Y Y Y

    To D D M M Y Y Y Y
    Or Until Cancelled
    Signature Primary Account Holder Signature Account Holder Signature Account Holder
    Phone No.
    1. Name as in bank records 2. Name as in bank records 3. Name as in bank records

    UMRN Date D D M M Y Y Y Y
    Utility Code Create Modify Cancel
    Sponsor Bank Code I/We hereby authorize TVS Credit Services Limited

    to debit (tick ) SB/CA/CC/SB-NRE/SB-NRO/Other Bank a/c number

    with Bank IFSC/MICR

    an amount of Rupees
    DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented

    Customer ID Prospect No.


    1.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. 2.This is to confirm that the declaration
    has been carefully read, understood & made by me/us. I am authorizing the User entity / Corporate to debit my account. 3.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.

    From D D M M Y Y Y Y

    To D D M M Y Y Y Y
    Or Until Cancelled
    Signature Primary Account Holder Signature Account Holder Signature Account Holder
    Phone No.
    1. Name as in bank records 2. Name as in bank records 3. Name as in bank records
    TVS Credit Services Limited
    Consumer Durables Loan
    OSV Declaration
    I hereby confirm that I have verified the original KYC document of the below customer, and that the documents and details given below pertain to
    verification of Loan Number 3009CD1044448

    Snapshot of KYC Details


    Prospect Number 3009CD1044448
    Customer Name SADDAM HUSSAIN LASKAR
    Employee/Dealership Name MAYUR MOBILE
    Employee Code/Dealership Code CD09033
    OSV Esign DateTime 09-12-2024 04:45 PM

    Id Proof - PAN Card Prospect Number - 3009CD1044448 Id Proof Number - BFLPL0896L

    Original of Id Proof has been seen and verfied (Signature of Dealer/Employee) , as on 09/12/2024 04:56 PM
    Lat/Long 12.9138221 77.6782635
    Address Proof - Driving
    Prospect Number - 3009CD1044448 Address Proof Number - KA0120240015649
    License

    Original of Address Proof has been seen and verfied (Signature of Dealer/Employee) , as on 09/12/2024 04:56 PM
    Lat/Long 12.9138221 77.6782635

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