Mandate Instruction Form for NACH/ECS/DIRECT DEBIT

Etechaces Marketing And Consulting Private Limited URMN Date 2 5 0 4 2 0 1 9

Tick(√) Sponsor Bank Code Utility Code

Create √
g
b
c
d
e
f I/We hereby authorize Etechaces Marketing And Consulting Private Limited to debit (tick √) SB / CA / CC / SB NRE / SB NRO / Other
Modify c
d
e
f
g
Cancel c
d
e
f
g Bank a/c number 6 2 3 2 6 3 5 3 7 6 2

with bank STATE BANK OF HYDERABAD IFSC S B H Y 0 0 2 0 0 1 0 or MICR 4 3 1 0 0 4 3 1 7

an amount of rupees Ten Thousand Rupees ₹ 10000

frequency c Monthly g
d
e
f
g c Qtly g
d
e
f c H-Yrly g
d
e
f c Yrly g
d
e
f b As & when presented
c
d
e
f DEBIT TYPE c Fixed Amount g
d
e
f
g b Maximun Amount
c
d
e
f
Reference 1 PB21871165159683 Phone No. 9767387377

Reference 2 Email ID walmiksalunke111@gmail.com

I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank.

From 2 5 0 4 2 0 1 9
Signature of Account holder Signature of Account holder Signature of Account holder
To 2 5 0 4 2 0 3 9
1. Walmik Sudam Salunke 2. 3.
Or X Until Cancelled

· This is to confirm that the declaration has been carefully read, understood & made by me/ us. I am authorizing the User entity / corporate to debit my account.
· I have understood that I am authorized to cancel/amend this mandate by appropriately communicating the cancellation amendment request to the User entity/corporate or the bank where I have
authorized the debit.