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    Ach Form

    Uploaded by

    datamaintains

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Ach Form

    Uploaded by

    datamaintains
    18 views3 pages

    Original Title

    ACH_FORM

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    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    18 views3 pages

    Ach Form

    Uploaded by

    datamaintains

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 3

    UMRN Date 2 0 1 0 2 0 2 4

    Utility Code Create Modify Cancel


    Sponsor Bank Code I/We hereby authorize TVS Credit Services Limited

    to debit (tick ) SB/CA/CC/SB-NRE/SB-NRO/Other Bank a/c number 5 0 1 0 0 3 3 8 7 1 0 9 4 1


    with Bank HDFC BANK IFSC/MICR HD F C 0 0 0 0 2 9 1
    an amount of Rupees ELEVEN THOUSAND EIGHT HUNDRED AND THIRTY ONLY 11830 /-
    DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented

    Customer ID 0036656350 Prospect No. 3112CD0154091


    1.I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank. 2.This is to confirm that the declaration
    has been carefully read, understood & made by me/us. I am authorizing the User entity / Corporate to debit my account. 3.I have understood that I am authorized to cancel/amend this mandate by
    appropriately communicating the cancellation / amendment request to the User entity / corporate or the bank where I have authorized the debit.

    From 0 3 1 2 2 0 2 4
    To 0 3 1 1 2 0 5 4
    Or Until Cancelled
    Signature Primary Account Holder Signature Account Holder Signature Account Holder
    Phone No. 9137167756
    1. CHETAN MANCHEKAR 2. Name as in bank records 3. Name as in bank records

    UMRN Date D D M M Y Y Y Y
    Utility Code Create Modify Cancel
    Sponsor Bank Code I/We hereby authorize TVS Credit Services Limited

    to debit (tick ) SB/CA/CC/SB-NRE/SB-NRO/Other Bank a/c number

    with Bank IFSC/MICR

    an amount of Rupees
    DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented

    Customer ID Prospect No.


    1.I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank. 2.This is to confirm that the declaration
    has been carefully read, understood & made by me/us. I am authorizing the User entity / Corporate to debit my account. 3.I have understood that I am authorized to cancel/amend this mandate by
    appropriately communicating the cancellation / amendment request to the User entity / corporate or the bank where I have authorized the debit.

    From D D M M Y Y Y Y

    To D D M M Y Y Y Y
    Or Until Cancelled
    Signature Primary Account Holder Signature Account Holder Signature Account Holder
    Phone No.
    1. Name as in bank records 2. Name as in bank records 3. Name as in bank records

    UMRN Date D D M M Y Y Y Y
    Utility Code Create Modify Cancel
    Sponsor Bank Code I/We hereby authorize TVS Credit Services Limited

    to debit (tick ) SB/CA/CC/SB-NRE/SB-NRO/Other Bank a/c number

    with Bank IFSC/MICR

    an amount of Rupees
    DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented

    Customer ID Prospect No.


    1.I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank. 2.This is to confirm that the declaration
    has been carefully read, understood & made by me/us. I am authorizing the User entity / Corporate to debit my account. 3.I have understood that I am authorized to cancel/amend this mandate by
    appropriately communicating the cancellation / amendment request to the User entity / corporate or the bank where I have authorized the debit.

    From D D M M Y Y Y Y

    To D D M M Y Y Y Y
    Or Until Cancelled
    Signature Primary Account Holder Signature Account Holder Signature Account Holder
    Phone No.
    1. Name as in bank records 2. Name as in bank records 3. Name as in bank records
    TVS Credit Services Limited
    Consumer Durables Loan
    OSV Declaration
    I hereby confirm that I have verified the original KYC document of the below customer, and that the documents and details given below pertain to
    verification of Loan Number 3112CD0154091

    Snapshot of KYC Details


    Prospect Number 3112CD0154091
    Customer Name CHETAN GANPAT MANCHEKAR
    Employee/Dealership Name maxx mobile
    Employee Code/Dealership Code CD136348
    OSV Esign DateTime 22-10-2024 07:58 PM

    Id Proof - PAN Card Prospect Number - 3112CD0154091 Id Proof Number - BDMPM0689K

    Original of Id Proof has been seen and verfied (Signature of Dealer/Employee) , as on 22/10/2024 07:58 PM
    Lat/Long 19.4531496 72.8128777
    Address Proof -
    Prospect Number - 3112CD0154091 Address Proof Number - 9386
    AADHAAR

    Original of Address Proof has been seen and verfied (Signature of Dealer/Employee) , as on 22/10/2024 07:58 PM
    Lat/Long 19.4531496 72.8128777
    DOVD Address Proof -
    Prospect Number - 3112CD0154091 DOVD Address Proof Number - 001521832467
    Electricity Bill

    Original of DOVD Address Proof has been seen


    (Signature of Dealer/Employee) , as on 22/10/2024 07:58 PM
    and verfied
    Lat/Long 19.4531496 72.8128777

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