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Fund Transfer Application

Branch

Transfer Mode Demand Draft Pay Order RTGS

NEFT IMPS Internal Transfer

Remitter Details

Remitter’s Name

Remitter’s Address

Account No. (to be debited)

Beneficiary Details

Name

Address

Account No. Bank Name and Branch

IFSC
Beneficiary Account Type (SB, CA, OD, CC, NRE, Credit Card)

Payment Details

Amount Transferred in nos.

Amount Transferred in words

Sender to Receiver Information Currency

Intermediary Bank Charges Beneficiary Remitter

QNB Charges Beneficiary Remitter

Terms and Conditions for Fund Transfer

1. I/We have checked the funds transfer instructions/particulars given 6. I/We agree that the credit will be effected based solely on the
in the application and I/we shall be liable to compensate the Bank for beneficiary account.
any loss arising on account of any error in payment order/amendment/ 7. I/We agree that in the event of any delay in the completion of the
cancellation thereto. funds transfer or any loss on account of error in the execution of the
2. I/We understand that the messages given after cut-off time will be sent funds transfer pursuant to my/our payment order, the Bank’s liability
only on the next batch/working day. shall be limited to the extent of the amount involved in the funds
3. The transfer is effected for legitimate personal/business needs. transfer plus interest (at the RBI LAF Repo rate plus two percent) for
4. I/We shall ensure availability of funds properly applicable to the any period of delay.
payment order before execution of the payment order by the Bank 8. I/We authorize the Bank to debit my/our account for the charges plus
and understand that if the Bank executes the transfer order without taxes as applicable.
properly applicable funds being available in my account, I/we shall be 9. I/We agree that in case the RTGS or NEFT option is not ticked by us,
bound to pay to the Bank the amount debited to my account together I/we authorize the Bank to execute the transaction less than Rupees
with charges including interest payable to the Bank provided the Two Lakhs through NEFT and greater than or equal to Rupees Two
transfer was effected as per my order. Lakhs through RTGS and debit the charges as applicable.
5. I/We understand that in case the payee branch does not have NEFT 10. I/We also agree to abide with all the other terms and conditions
facility, the funds will be credited back to my/our account as and when contained in the model agreements/application forms or other terms/
it is returned by the beneficiary bank. rules/regulations governing NEFT transactions as enumerated by RBI.

Customer Signature Date D D M M Y Y Y Y

For Bank Use Only

Entered by Checked by

Initials Initials

Date D D M M Y Y Y Y Date D D M M Y Y Y Y

IN/1/3/45 V1.0

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