Scribd
Upload
161 views

Ecs Form

The document is an electronic clearing service mandate form for employees to receive payments through credit clearing. It collects the employee's name, designation, ID number, date of birth, and bank details including bank name, branch, 9-digit code number, account type, account number, and IFSC code. The employee must attach a cancelled cheque and agrees that any delays or failures in transactions due to incorrect information are not the responsibility of the institution.

Uploaded by

GAJAB SINGN
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
161 views

Ecs Form

The document is an electronic clearing service mandate form for employees to receive payments through credit clearing. It collects the employee's name, designation, ID number, date of birth, and bank details including bank name, branch, 9-digit code number, account type, account number, and IFSC code. The employee must attach a cancelled cheque and agrees that any delays or failures in transactions due to incorrect information are not the responsibility of the institution.

Uploaded by

GAJAB SINGN
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

ELECTRONIC CLEARING SERVICE (CREDIT CLEARING)

(MODEL MANDATE FORM)


EMPLOYEES OPTION TO RECEIVE PAYMENT THROUGH CREDIT CLEARING MECHANISM
(Scheme name and the periodicity of payment)

1. NAME OF FIELD SURVEYOR/ENUMERTOR :_____________________________


2. DESIGNATION :_____________________________
3. ID NUMBER :_____________________________
4. DATE OF BIRTH :_____________________________
5. BANK DETAILS:
a. BANK NAME :_____________________________
b. BRANCH NAME & ADDRESS :_____________________________
:_____________________________
:_____________________________
Telephone No.:_________________
c. 9 DIGIT CODE NUMBER OF THE BANK & BRANCH :_____________________________
(As appearing on the MICR cheque issued by the
Bank)
d. ACCOUNT TYPE (Saving Bank Account or Current :_____________________________
Account)
e. ACCOUNT NUMBER (As appearing on the cheque :_____________________________
Book)
f. IFSC CODE :_____________________________

(Please attach a bank cancelled multi-city cheque having name , account number, MICR code &
IFSC code issued by your bank for verification for above particulars).

I 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 would not
hold the user institution responsible.

DATE: ___/___/______

Signature of the employee


Mobile No.
Counter Sign By Supervisor

You might also like