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ANNEXURES AND FORMS (1)

The document is a mandate form for vendors, contractors, or employees to provide details for DFT, ECS, RTGS, or NEFT payments. It requires information such as the name, address, PAN number, and bank account details, along with a declaration of correctness from the party. A cancelled cheque or a bank attestation for the IFS code is also required to be submitted.

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rohitrahul.kumar0
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10 views

ANNEXURES AND FORMS (1)

The document is a mandate form for vendors, contractors, or employees to provide details for DFT, ECS, RTGS, or NEFT payments. It requires information such as the name, address, PAN number, and bank account details, along with a declaration of correctness from the party. A cancelled cheque or a bank attestation for the IFS code is also required to be submitted.

Uploaded by

rohitrahul.kumar0
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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MANDATE FORM

BY
VENDOR/CONTRACTOR/EMPLOYEE FOR
DFT/ECS/RTGS/NEFT PAYMENTS

1. NAME OF THE FIRM/PERSON/PARTY:………………………………………………………………………………………………………


2. ADDRESS:.……………………………………………………………………………………………………………………………………………………………………….
..……………………………………………………………………………………………………………………………………………………………………………….
TELEPHONE NO & FAX NO: ……………………………………………………………………………………………………………………………………..
CELL PHONE: …………………………………………………….......... E-mail: ………….……………………………………………………………………..
3. P.A.N. NO. : ……………………………………………………………………………………………………………………………………………………………………….
4. PARTICULAS OF BANK ACCOUNT: ……………………………………………………………………………………………………………………….
(i) BANK NAME: …………………………………………………………………………………………………………………………………………………………….
(ii) BRANCH NAME & ADDRESS: …………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………………………………………………………………..
(iii) BANK BRANCH TELEPHONE NO:…………………………………………………………………………………………………………………..
(iv) Account type(whether SB or Current):……………………………………………………………………………………………………………
(v) ACCOUNT NO: …………………………………………………………………………………………………………………………………………………………...
(vi) BANK’S MICR CODE ……………………………………………………………………………………………………………………………………………..
(vii) BANK’S IFS CODE …………………………………………………………………………………………………………………………………………………..
5. DECLARATION OF THE PARTY :
I herby declare that the particulars given above are correct and complete. If the transaction
is delayed or Not Affected at all for reasons of incomplete and incorrect information, the User
Institution i.e., S.E.RAILWAY will not be held responsible. I have understood the scheme and agree
to discharge the responsibility for which I am liable as a participate under the scheme.

Date: Signature of the Supplier/Party/Employee

N.B.: One cancelled Cheque/photocopy of the Cheque is to be enclosed.


[Where the cheque does not carry IFS Code an attestation from Bank attesting the IFS Code should
be given.]

_________________________
SIGNATURE OF BANK OFFICIAL
(Where required)

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