Head Office: Shri Vishnu Commercial Complex NH-30,

New Bypass, Near BP Highway Services Petrol Pump,

MADHYA BIHAR GRAMIN BANK Asochak, Patna-800016.
Phone – 0612-2385421

Date :

The Chief Manager,

NEFT Cell
………………………………….....................Bank

Dear Sir/Madam,

Tran Ref No - SD
UTR-

Date of transaction

Amount Rs.

Beneficiary’s Account No

Beneficiary’s Name

Reason for recall

Madhya Bihar Gramin Bank, hereby indemnifies and keep

…………………………………………….Bank indemnified, hold, save and harmless and
indemnified at all the times hereafter from and against all liabilities, losses,
damages, costs, charges and expenses which …………………………………….may sustain,
incur or suffer or be put to or become liable by reason or as a consequence of
reversal of the above payment instruction.

Kindly confirm the return Tran Ref No and date so that we can trace the same.

Thanking You,

Yours sincerely

Manager [ Stamp of branch ]