Indusind RTFG Form Application Form

Download RTFG/NEFT Sample Application form for Indusind Bank in word/doc format 

IndusInd Bank Ltd.

Date : May 25, 2013

Application cum Debit Authority Form for RTGS/NEFT Transfer

                                                            

1	Payment Type (Please tick appropriate type)	:	RTGS           OR                    NEFT
2	DEBIT Account Number	:	- - - - - - - - - - - - -
3	Name of Account Holder	:	Rocket Sales Ltd.
4	Receiving Bank IFSC Code	:	I B - - - - - - - - -
5	RECEIVING Bank Name	:	IDBI Bank Ltd.
6	Receiving Bank’s Branch	:	Mumbai Main Branch
7	Name of Beneficiary	:	Rocket Sales Ltd.
8	Beneficiary Account Number	:	- - - - - - - - - - - - - - -
9	Additional Information	:	Nil
10	Amount (in figures) INR	:	Rs.50,00,000/-
11	Bank Charges (in figures) INR	:	Rs. Nil
12	Total Amount (In figures)	:	Rs. 50,00,000/-
13	Total Amount (In words)	:	Rupees : Fifty lac only

Remit the amount as per above details, by debiting our Account for the above mentioned amount.

We confirm having read the terms of remittance on the reverse.

AUTHORISED  SIGNATORIES

FOR BANK’S USE ONLY

Signature verified by                                                                 Logged by

Reviewed by                                                                             Authorized by

Bank’s Outward Reference No.

1. Remitting bank shall not be liable for any loss or damage arising or resulting from delay in transmission delivery or non delivery of Electronic message or any mistake, omission, or error in transmission or delivery thereof or in deciphering the message from any cause whatsoever or from its misinterpretation received or the action of the destination Bank or any inaccuracy of the particulars provided in the application or any act or event beyond control.

2. All payment instructions should be checked carefully by the remitter. Customer agrees that in the event of any delay in the completion of the Funds Transfer or any loss on account of error in the execution of the Funds Transfer pursuant to a payment order, the bank's liability shall be limited to the extent of payment of interest at the Bank Rate for any period of delay in the case of delayed payment and refund of the amount together with interest at the Bank Rate up to the date of refund, in the event of loss on account of error, negligence or fraud on the part of any employee of the bank.  Bank assumes no liability for non-execution of the remittance for any reason, beyond its control, including the technical reasons in the security procedure and natural calamities.

3. Messages received after cut-off time will be sent on the next working day.

4. Customer agrees that payment order becomes irrevocable and customer shall be bound by any payment order executed by the Bank in good faith and in compliance with the security procedure followed by the Bank.

5. Customer hereby authorizes the Bank to debit customer’s account any liability incurred to the Bank or any other charges for execution of any of the payment order issued by the customer and shall ensure availability of funds in the account for execution of remittance. If, however, Bank executes the payment order without sufficient funds being available in the account, customer shall be bound to pay to the Bank the amount debited to customer’s account for the remittance together with the charges and interest payable to the Bank.

For ROCKET SALES LTD.

AUTHORISED  SIGNATORIES