Ecs Mandate

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ANNEXURE 1B

Electronic Clearing Service (Credit Clearing) Mandate Form

(Investor’s option to receive redemption proceeds/interest payments through Credit Clearing Mechanism)

1) Investor’s name (s) :

2) (a) Member ID No. / BLA No. :


(b) PAN/GIR No. * :
(c) Telephone No./Mobile No./E-mail ID :

3) Particulars of Bank account


A Name of the Bank :
B Name of the branch :
Address :
Telephone No. :
C 9-Digit code number of the bank and branch
appearing on the MICR cheque issued by the bank (Mandatory):
D 11-Digit IFSC Code of the bank and branch
appearing on the MICR cheque issued by the bank (Optional):
E Type of the account (S.B., Current or Cash Credit )
with code (10/11/13) :
F Ledger and Ledger folio number:
G Account number (as appearing on the cheque book):
(In lieu of the bank certificate to be obtained as under, please attach a blank
cancelled cheque or photocopy of a cheque or front page of your savings bank
passbook issued by your bank for verification of the above particulars)

4) Date of effect :

I/we hereby declare that the particulars given above are correct and complete. If the
transaction is delayed or not effected at all for reasons of incomplete or incorrect
information, I/we would not hold the user institution responsible. I/we have read the option
invitation letter and agree to discharge the responsibility expected of me/us as a participant
under the scheme.

Date: (.....................................)
Signature (s) of the Investor

(In case of joint holding, all the investors, whose signatures are registered with Agency bank, should sign here)

Certified that the particulars furnished above are correct as per our records.

Bank’s Stamp:

Date: (.................................)
Signature of the authorised
official of the Bank

* compulsory for investors due to receive maturity proceeds exceeding Rs. one Lakh

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