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151 views

Dummy

Uploaded by

kelicomillindia
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Application Form For Funds Transfer Through

Real Time Gross Settlement (RTGS) / National Electronic Funds Transfer (NEFT)
Branch Code / Name Maximum Limit for NEFT Transaction
Date HDFC Bank Customer No Limit
Time Non HDFC Bank Customer & Indo-Nepal NEFT Remittance Up to INR 50,000/-

You are requested to remit the proceeds as per details belowthroughRTGS / NEFT . (Tick  the appropriate Box).
Attaching Cheque No. -- for Rs. /-. (For RTGS draw cheque favouring“HDFC Bank Ltd – RTGS” and for NEFT draw cheque
favouring“HDFC Bank Ltd –NEFT”)

Beneficiary Details
Beneficiary Name
Beneficiary Account Number
Beneficiary Account Number
Beneficiary Address
Beneficiary Bank Name & Branch
Beneficiary Bank IFSC Code Account Type:Resident / NonResident
Amount (in figures) to be credited
Amount (in words) to be credited

My / Our Details (Remitter)


Remitter (Applicant) Name
Remitter Account Number
Cash Deposited (Non HDFC Bank Customer)
Mobile / Phone Number of Remitter ( Mandatory) E-Mail Id:
Address of the Remitter (Mandatory for Non – HDFC
Bank Customer)
Remarks
Terms & Conditions
* I / We hereby authorize HDFC Bank Ltd. to carry outtheRTGS / NEFT transaction as per details mentioned above. (Tick  the appropriateBox)
* I / We hereby agree that the aforesaid details including the IFSC code and the beneficiary account arecorrect.
* I / We further acknowledge that HDFC Bank accepts no liability for any consequences arising out of erroneous details provided byme/us.
* I/Weagreethatthecreditwill beaffectedsolelyonthebeneficiaryaccountnumberinformationandbeneficiarynameparticularswill notbeusedforthesame.
* I / We authorize the bank to debit my / our account with the charges plus taxes as applicable for thistransaction.
* I / We agree that requests submitted after the cut off time will be sent in next batch or next working day asapplicable.
* I / We hereby agree & understand that the RTGS / NEFT request is subject to the RBI regulations and guidelines governing thesame.
* I/WealsounderstandthattheremittingBankshallnotbeliableforanylossofdamagearisingor resultingfromdelayintransmissiondeliveryornon-deliveryofElectronic message or any
mistake, omission, or error in transmission or delivery thereof or in deciphering the message from any cause whatsoever or from its misinterpretation received or the
action of the destination Bank or any act or even beyondcontrol.
* I/Weagree thatincaseofNEFTTransactionifwedonothaveanaccountwiththebank,wewillproduceOriginalidentificationproofwhilegivingtherequest.IncaseI/We submit form 60, we
will also submit the addressproof.
* Incase theRTGSandNEFToptionisnottickedbyus,I/Weauthorizeyoutoexecutethetransactionless thanRupees Two Lacs throughNEFTandgreaterthanor equal to
Rupees Two Lacs through RTGS and debit the charges asapplicable.

Signature of
Authorized
Signatory
1stSignatory 2ndSignatory 3rd Signatory
Please affix stamp wherever applicable

Branch Use Only


Transaction Reference Number

Transaction Inputted by
Employee Code Signature

Transaction Authorized by
Employee Code Signature
Transaction Authorized by (2nd level)
(for amount > Rs. 5 lacs) Employee Code Signature
KYC documentation done by (only for Non-HDFC
Bank Customers) Employee Code Signature Branch Stamp, Date & Sign
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Customer Acknowledgement
Received applicationforRTGS /NEFT for an amount ofRs._______ _____ vide cash / chequenumber____________________to be credited toAccount

Number ___________ ___ of ______________ Bank with IFSC Code____________...........................................................................Customers willbe


guided by the Terms and Conditions mentioned in the form. HDFC Bank will accept no liability for any consequences arising out of erroneous details provided by the Customer.

Date Time _Branch Stamp &Sign

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