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DCB Neft Form

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sandeeppatil22
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2K views

DCB Neft Form

Uploaded by

sandeeppatil22
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Request for Remittance through NEFT / RTGS / IMPS

(To be filled in by the applicant in BLOCK LETTERS)

Branch:

Request: NEFT RTGS IMPS Cheque is mandatory for requests not directly received from the customer.

DETAILS of the APPLICANT (Remitter)


Title of Account: Account No.:
Branch where account is maintained: Type of Account: Savings Current Cash Credit
Mobile Number: Overdraft NRE NRO
Status: Resident Non-Resident Email ID:

DETAILS of BENEFICIARY BANK


Bank Name: Branch:
City: IFS Code:

DETAILS of BENEFICIARY
Beneficiary Bank Account Name (As per beneficiary’s bank record):

Beneficiary Address:
Beneficiary Bank Account Number: Beneficiary Bank Account Number Re-confirmed:

Type of Account: Savings Current Cash Credit Overdraft NRE NRO

Amount to be remitted ` (in figures): (Rupees in words)

Remark for remittance: (to be captured)

Remit the amount as per above mentioned details, by debiting my / our account or I/we herewith tender cheque no. dated

for ` /- drawn on our account for the amount of remittance plus your charges.
Rupees in words :
DETAILS OF LEGAL ENTITY IDENTIFIER (LEI) CODE
(Mandatory for remittance amount of INR 50 crore and above for other than Individual and Government)

LEI code of Remitter / Sender:

LEI code of Beneficiary / Receiver:


TERMS AND CONDITIONS
I/We shall abide by the following terms and conditions: 3. I/We understand that RTGS / NEFT / IMPS request submitted after the cut off time will be
1. It is being understood that the remittance is to be sent at my/our own risk and responsibility and on processed/sent on the next working day.
the distinct understanding that no liability whatsoever is to be attached to the Bank for any loss or 4. I/We understand that the RTGS / NEFT / IMPS request is subject to the RBI / NPCI regulations and
damages arising or resulting from delay in transmission, delivery or non-delivery of the message or guidelines governing the same.

2855-Ver 1.4-December, 2018 / M024 / Jan 23 / 3.1


for any mistake, exchange or error in transmission or delivery thereof or in deciphering the message 5. I / We agree that the credit will be effected solely on the beneficiary account number information and
for whatsoever cause or from its misinterpretation when received or the action of the destination beneficiary name particulars will not be used for the same.
Bank or due to RBI (Reserve Bank of India) /NPCI (National Payments Corporation of India) RTGS / 6. I/We understand and agree that standard charges shall be applicable to me/us as per the schedule
NEFT/IMPS system not being available or failure of internal communication system at the recipient of service charges of the Bank.
bank/branch or incorrect information provided by me/us or any incorrect credit accorded by the
recipient bank/branch due to information provided by me/us or any act or event beyond control or
from failure to properly identify the person's name.
2. I/We understand that the process of RTGS / NEFT / IMPS request is subject to availability of clear
Date _____________________ Signature of account holder/s ___________________________
funds in my/our account at the time of processing the request.
FOR BANK USE
Debited Applicant's A/c. Request Received Date & Time
Verified cheque details and Signature Yes Request Processed Date & Time
Signature verified by BSOM / BH Yes SDC / Transaction No.
Cheque No. & Date
Cheque Amount
RTGS UTR No.
NEFT Ref No.
IMPS Ref No. Authorised Signatory (Maker) Authorised Signatory (Checker)

Acknowledgement to the Customer


Received request for remittance through RTGS / NEFT / IMPS from Account Number ________________________________ for an amount of ` ________________
vide cheque number _____________________________ to be credited to _______________________________________ (beneficiary name) in Account Number
________________________________ with _______________________________ Bank bearing IFS Code ____________________. DCB Bank will accept no liability
for any consequences arising out of erroneous details provided by the customer / applicant.

DCB Customer Care 022 68997777, 040 68157777 or email: [email protected] or visit www.dcbbank.com
DCB Bank Limited Signature of Branch Official with Seal

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