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    Revised ECS Mandate Format

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    Monu Sharma
    This document is an electronic clearing service (debit clearing) mandate form that customers can fill out to authorize their bank to debit their account for payments to ICICI Bank Limited through ECS debit clearing. The form requests information such as the customer's account number and type, the debit details including amount and frequency, and requires the customer's signature to authorize the transactions. Upon obtaining the necessary information and signature, the bank can then process ECS debit clearing transactions on behalf of the customer.

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    Revised ECS Mandate Format

    Uploaded by

    Monu Sharma
    86 views1 page
    This document is an electronic clearing service (debit clearing) mandate form that customers can fill out to authorize their bank to debit their account for payments to ICICI Bank Limited through ECS debit clearing. The form requests information such as the customer's account number and type, the debit details including amount and frequency, and requires the customer's signature to authorize the transactions. Upon obtaining the necessary information and signature, the bank can then process ECS debit clearing transactions on behalf of the customer.

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    This document is an electronic clearing service (debit clearing) mandate form that customers can fill out to authorize their bank to debit their account for payments to ICICI Bank Limited through ECS debit clearing. The form requests information such as the customer's account number and type, the debit details including amount and frequency, and requires the customer's signature to authorize the transactions. Upon obtaining the necessary information and signature, the bank can then process ECS debit clearing transactions on behalf of the customer.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    86 views1 page

    Revised ECS Mandate Format

    Uploaded by

    Monu Sharma
    This document is an electronic clearing service (debit clearing) mandate form that customers can fill out to authorize their bank to debit their account for payments to ICICI Bank Limited through ECS debit clearing. The form requests information such as the customer's account number and type, the debit details including amount and frequency, and requires the customer's signature to authorize the transactions. Upon obtaining the necessary information and signature, the bank can then process ECS debit clearing transactions on behalf of the customer.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    of 1

    FORM NO.

    E-5

    Appendix VIII

    LAN No.
    (Only for official use)
    ELECTRONIC CLEARING SERVICE (DEBIT CLEARING) MANDATE FORM
    Please fill-in the information in Capital letters
    The Manager

    Copy to the User Company

    (Bank Name)___________________________________________________________
    (Branch Name)_________________________________________________________
    (Address) _____________________________________________________________
    Telephone No._________________________________________________________

    Name ---------------------------Address -----------------------------------------------------------Telephone No.------------------

    I (* Account Holder Name) ________________________________________________________________________ (as per Bank records) hereby


    authorize you to debit my account for making payment to `ICICI Bank Limited 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

    Savings : (10 / 31) / Current : (11 / 29) / Cash Credit : (13) / NRE / NRO

    C. LEDGER NO / LEDGER FOLIO NO.


    :
    D. * ACCOUNT NUMBER (As per Bank Records)

    Name of the Scheme

    Date of effect Periodicity


    (M/BiM/Qly/etc.)

    E.

    Date of effect

    Amount of installment/ Amt Number of installments/ Valid


    of bill with upper limit
    up to (in case of utility bills)

    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.
    () ()
    (.) (.) Signature of the
    Customer (Account Holder/s) - In case of Joint A/c holders, Signature is required of all A/c holders.
    Date :
    Certified that the particulars furnished above are correct as per our records.
    (Banks Stamp)
    Date :

    --------------------------------------------Signature of the Authorized official from the Bank

    (Note:- Mandate to be obtained in 3 copies, Original for Bank, One for User Co. and other for customer)
    For ICICI BANK LTD Use only (To be filled by Business Team)
    Name of the Applicant __________________________________________________________________________________
    Name of the co-applicant________________________________________________________________________________
    Bank Name___________________________________ Branch____________________ City __________________________
    Application
    Number_____________________________________________________________________________________
    Fresh_____________Swap__________________ In case of Swap previous mode________________________________

    * Mandatory Fields

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