APPLICATION FOR INTERBANK FUND TRANSFER UNDER

RTGS/NEFT
To,
The Chief/Manager,
Bank of Maharashtra,
N-3, Cidco Branch, Aurangabad.

Mahabank RTGS/NEFT Funds Transfer application form:

Sr.no. /CP/ (brcd/CP/xx) Date: 21/07/2022 (4488)
Name of the applicant: Suryakant Shirpewar A/C No. 20040294287 (5500)
Please Remit a sum of Rs. 1,22,400/- (Rupees One Lakh Twenty Two Thousand Four Hundred Only) (4488)
Enclosed Cheque no. 294391 Dated 21/07/2022 to be debited to my above account.

Details of the beneficiary:

1. Beneficiary name: Thomas Cook India Ltd (5561-2)
2. IFSC code: ICIC0000005 3. Account No. & Type: 000505006661 (5561-1)
4. Bank Name and Branch: ICICI Bank Ltd, Bund Garden Road, Pune
5. City: Pune

I authorize to debit my account with your Branch alongwith the charges if any & remit the same fund as
per details given above. I/We agree to abide by the terms and conditions stipulated by RBI for
RTGS/NEFT fund remittance.
Applicant’s Signature
9403682762 For Suryakant Shirpewar

Branch Seal and Signature.

Note: Remittance would be effected as per RBI’s rules.

(For Office Use Only)

Amount of fund transfer Rs. 1,22,400/-
Date: 21/07/2022 Time: 12:00 pm
Credit to 60005845072 (RTGS Rem. A/c) with TIBB branch (1365)

Maker Checker Authoriser

(To be treated as Credit Voucher of CO a/c) Trn. Seq. Journal no.

ACKNOWLEDGEMENT
Date: 21/07/2022
Received from Suryakant Shirpewar A/c. no. 20040294287
request to remit a sum of Rs. 1,22,400/- (Rupees One Lakh Twenty Two Thousand Four Hundred Only) in
ICICI Bank Ltd, Bund Garden Road, Pune RTGS/NEFT Funds Transfer on IFSC code ICIC0000005
Suryakant Shirpewar, Bank of Maharashtra Cheque no. 294391