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    Ach Form

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    Dhiraj Paik
    1. Dhiraj Paika authorized TVS Credit Services Limited to debit a fixed amount of Rs. 11,125 from his State Bank of India account on a monthly basis between December 2023 to November 2053 for a consumer durables loan. 2. An employee of Roja Cell Point verified Dhiraj's identity documents which included his PAN card and Aadhaar card and captured the details and signature in the OSV declaration. 3. The documents were verified on October 29, 2023 at 11:20 AM at the given latitude and longitude.

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    Ach Form

    Uploaded by

    Dhiraj Paik
    22 views2 pages
    1. Dhiraj Paika authorized TVS Credit Services Limited to debit a fixed amount of Rs. 11,125 from his State Bank of India account on a monthly basis between December 2023 to November 2053 for a consumer durables loan. 2. An employee of Roja Cell Point verified Dhiraj's identity documents which included his PAN card and Aadhaar card and captured the details and signature in the OSV declaration. 3. The documents were verified on October 29, 2023 at 11:20 AM at the given latitude and longitude.

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    1. Dhiraj Paika authorized TVS Credit Services Limited to debit a fixed amount of Rs. 11,125 from his State Bank of India account on a monthly basis between December 2023 to November 2053 for a consumer durables loan. 2. An employee of Roja Cell Point verified Dhiraj's identity documents which included his PAN card and Aadhaar card and captured the details and signature in the OSV declaration. 3. The documents were verified on October 29, 2023 at 11:20 AM at the given latitude and longitude.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    22 views2 pages

    Ach Form

    Uploaded by

    Dhiraj Paik
    1. Dhiraj Paika authorized TVS Credit Services Limited to debit a fixed amount of Rs. 11,125 from his State Bank of India account on a monthly basis between December 2023 to November 2053 for a consumer durables loan. 2. An employee of Roja Cell Point verified Dhiraj's identity documents which included his PAN card and Aadhaar card and captured the details and signature in the OSV declaration. 3. The documents were verified on October 29, 2023 at 11:20 AM at the given latitude and longitude.

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    © All Rights Reserved
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    of 2

    UMRN Date 2 9 1 0 2 0 2 3

    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 3 5 1 1 1 5 1 6 4 9 7


    with Bank STATE BANK OF INDIA IFSC/MICR SB I N 0 0 0 6 9 3 5
    an amount of Rupees ELEVEN THOUSAND ONE HUNDRED AND TWENTY FIVE ONLY 11125 /-
    DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented

    Customer ID 0028102080 Prospect No. 3051CD0399550


    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 3
    To 0 3 1 1 2 0 5 3
    Or Until Cancelled
    Signature Primary Account Holder Signature Account Holder Signature Account Holder
    Phone No. 9178307627
    1. DHIRAJ PAIKA 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 3051CD0399550

    Snapshot of KYC Details


    Prospect Number 3051CD0399550
    Customer Name DHIRAJ PAIKA
    Employee/Dealership Name ROJA CELL POINT
    Employee Code/Dealership Code CD79168
    OSV Esign DateTime 29-10-2023 09:52 AM

    Id Proof - PAN Card Prospect Number - 3051CD0399550 Id Proof Number - HILPP1214H

    Original of Id Proof has been seen and verfied (Signature of Dealer/Employee) , as on 29/10/2023 11:20 AM
    Lat/Long 19.0637174 84.0893712
    Address Proof - AADHAAR Prospect Number - 3051CD0399550 Address Proof Number - 2607

    Original of Address Proof has been seen and verfied (Signature of Dealer/Employee) , as on 29/10/2023 11:20 AM
    Lat/Long 19.0637174 84.0893712

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