All India Council for Technical Education

7th Fl. Chandralok Bldg., Janpath, New Delhi:- 110001

Mandate Form (For Institute)

(PLEASE Submit 1 Original and 1 self Attested Copy )
Name of Institute
Govt./ Govt. Aided/ University/ University Aided/Unaided-
Status
Pvt.
Address of
Communication

State PIN
Permanent Account
No.(PAN)
Fax No, Telephone No
E-Mail Address

Name of Bank
Branch Name Br. Code:-
Address

State PIN
Fax No, Telephone No

Account Type Savings Bank / Current Account

Account Number (16
Digit)
Banker’s IFSC Code:
Banker’s MICR Code:

I/ We declare that all the information I / We have provided are true in all respect and it is my/our Main
Account and I/We am/are authorized signatory for the Account/Organisation.

Signature of Account holder

or Authorised Signatory with Seal