4/4/2016

ComplaintDetails

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AnnexureA
FORMOFCOMPLAINT(TOBELODGED)WITHTHEBANKINGOMBUDSMAN
(FOROFFICEUSEONLY)
ComplaintNo 201516006006727
Date

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TheBankingOmbudsman
ReserveBankofIndia
Chennai

Name&Address

NameofComplainant: VDHASARATHAN

ComplaintCategory: IndividualmatterBusiness

EmailID: mgswaran007@gmail.com

TelephoneNumber: 08870327513

AddressLine1: S/oVeerapagu
AddressLine2: No.59ThiyagiAyothiStreet
Place: Thiruppuvanam

District: Sivaganga

State: Tamilnadu

PinCode: 630611

BankDetails

BankAccountCategory: ACCOUNT

BankAccountSubCategory: CURRENT

BankAccountNumber: 6240591629
BankCategory: NationalisedBanks
BankName: INDIANBANK
BankCenter,District&State:

THIRUPUVANAM,SIVAGANGA,TAMIL
NADU

NameofNodalOfficer: GOPALV
BankAddress:

ReceiptNumber:

BankBranchName: THIRUPPUVANAM
BankBranchCategory: SemiUrban
BSRCode: 02624409220634

KASIKANANTHASWAMIMADAM,MADURAIRAMNADMAINROAD,THIRUPPUVANAM,
THIRUPPUVANAM,630611MADURAIRAMNADMAINROADTHIRUPPUVANAM

ComplaintDetails

DateofComplaint: 04Apr2016
Subject:

01=>8(1)(a)Nonpaymentorinordinatedelayinthepaymentorcollectionofcheques,
drafts,billsetc.

AmountInvolved: 0

Compensation
0
Amount:

NEFTfailureon28&29ofSep15forAmountofRs.72,000&Rs55,500aswronglymentioned
Comments: Beneficiarya/cno.as1550001105992(AIRT1550001105992)UTRNo.IDIBH15271461646&
IDIBH15272489594.Soamountnotcreditedtobeneficiary.Kindlyrefundtheamount

DECLARATION

1.I/We,thecomplainant/shereindeclarethat:
a.theinformationfurnishedhereinaboveistrueandcorrectand
b.I/Wehavenotconcealedormisrepresentedanyfactstatedinaforesaidcolumnsandthedocumentssubmitted
herewith.
2.ThecomplaintisfiledbeforeexpiryofperiodofoneyearreckonedinaccordancewiththeprovisionsofClause9(3)(a)and
(b)oftheScheme.
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ComplaintDetails

3.

a.ThesubjectmatterofthepresentcomplainthasneverbeenbroughtbeforetheOfficeoftheBankingOmbudsman
byme/orbyanyoneofusorbyanyofthepartiesconcernedwiththesubjectmattertothebestofmy/our
knowledge.
b.ThesubjectmatterofthepresentcomplaintisnotinrespectofthesamewhichwassettledthroughtheOfficeofthe
BankingOmbudsmaninanypreviousproceedings.
c.Thesubjectmatterofthepresentcomplainthasnotbeendecidedbyanyforum/court/arbitrator.
4.I/Weauthorisethebanktodiscloseanysuchinformation/documentsfurnishedbyustotheBankingOmbudsmanand
disclosurewhereofintheopinionoftheBankingOmbudsmanisnecessaryandisrequiredforredressalofanyother
complaintorourcomplaint.
5.I/WehavenotedthecontentsoftheBankingOmbudsmanScheme,2006.

NOMINATION(Ifthecomplainantwantstonominatehisrepresentativetoappearandmakesubmissionsonhisbehalfbefore
theBankingOmbudsmanortotheOfficeoftheBankingOmbudsman,thefollowingdeclarationshouldbesubmitted.)No
I/Wetheabovenamedcomplainant/sherebynominateShri/Smt/Kumwhoisnot
anAdvocateandwhoseaddressisasmy/ourREPRESENTATIVEinallproceedings
ofthiscomplaintandconfirmthatanystatement,acceptanceorrejectionmadebyhim/hershallbebindingonme/us.He/Shehas
signedbelowinmypresence.
ACCEPTED
(SignatureofRepresentative)
(SignatureofComplainant

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