BANK OF BARODA BANK OF BARODA

ANNEXURE-II PAYING-IN-SLIP FOR NEFT/RTGS Form No. 404

BRANCH: BHAGALPUR BRANCH : BHAGALPUR DATE: ______________ Time of Receipt____________

DATE: _____________ (FOR RTGS- AMOUNT MUST BE FOR ₹ 2 LACS OR MORE)

COUNTER FOIL (Application for Electronic Funds Transfer to a customer of another Bank through RTGS/NEFT.(to be filled in by customer)

Sender’s A/c Number 10010400009356 Sender’s A/c Number of base branch 1 0 0 1 0 4 0 0 0 0 9 3 5 6

Name of A/c Holder SRI SAI BABA GAS AGENCY Name of the A/c Holder (Sender) SRI SAI BABA GAS AGENCY
NEFT/RTGS: NEFT/RTGS:
Favouring (payee) Name BHARAT PETROLEUM CORP. LTD Favouring/beneficiary (Name) BHARAT PETROLEUM CORPORATION LTD.
Bank: STATE BANK OF INDIA Receiving Bank Name: STATE BANK OF INDIA
Branch: CAG BRANCH Receiving Branch Name: CAG Branch
IFSC Code: SBIN0009995 Receiving Branch IFSC Code: SBIN0009995
Beneficiary A/c No: 31233830855A149032 Beneficiary A/c No: 3 1 2 3 3 8 3 0 8 5 5 A 1 4 9 0 3 2
Beneficiary A/c Type: CURRENT Beneficiary A/c Type CURRENT
Message for Beneficiary (RTGS only)
Amount ₹ Amount ₹
Exchange ₹ Exchange ₹
Total Amount ₹ Total Amount ₹
Total Amount in words Total Amount in words
Beneficiary A/c No: 31233830855A149032 Beneficiary A/c No: 3 1 2 3 3 8 3 0 8 5 5 A 1 4 9 0 3 2
nd
Cheque No: (to be written 2 time as per RBI guidelines

I/We request you to make the above remittance. It is being understood that the remittance is to be sent at my/our own risk and
My/our responsibility and on the distinct understanding that no liability whatsoever is to attach to the Bank for any loss or damage
arising or resulting from delay in transmission, delivery or non delivery of the message or any mistake, exchange or error in
transmission or delivery thereof or in deciphering the message from whatsoever cause or from its misinterpretation when received or
Signature of Customer from failure to properly idenditity the persons name. I/We also hereby undertake to refund to bank any over remittance, which is
made as per RBI RTGS/NEFT scheme.
Tel/Mobile No : 9431455120
Please remit the amount as per above details by (i) debiting our OD A/C No: 10010400009356 with Bhagalpur Branch (ii) I/We
PAN : ABEFS3873L herewith tender cheque no ________________________ drawn on our a/c towards its cost including Bank charge.

Bank’s Seal
Signature Of Customer Sign. Of Operator Sign. Of Officer Sign. Of Officer
Sign. Of Clerk/Cashier/Teller TEL/Mobile No: 9431455120 (who created mesg) (who authorized) (who verified)
PAN : ABEFS3873L