Application form for RTGS
Date
To
IDBI Ltd /SBI / ICIC Ltd/ Axis Bank
______________Branch
A/c Number SOL ID : _______________________
A/c Name Branch :_______________________
Contact Person ___________ _______________________________
Contact Address ______________________________________________
______________________________________________________________
______________________________________________________________
Contact Details
Telephone no ____________________ Fax No.______________________
Email ID __________________________________________________
Email ID __________________________________________________
Relationship Manager :___________________________________________
Please debit my above account and remit value of Rs. ___________ (Rupees _____ _______ Only) to the below beneficiary’s account on ____/____/201__________
Beneficiary’s Details :
Name
of Beneficiary
|
Bank
Name
|
Branch
Name
|
Account
No.
|
Account
Type
|
Beneficiary
Bank’s
IFSC
Code
|
* I agree to the terms and conditions set out in the IDBI Ltd’s (Bank Name) RTGS terms & conditions document and will be bound by them.
Customers Signature (Signature Verified by Bank Staff)
EIN No.
(for Office Use only )
Unique Transaction Reference No. : _________________
Sequence Number :
Transaction Reference No. : _________________
Initials of Bank official :
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