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SCHEME NAME : EMI PAYMENT HDFC LTD. UTILITY CODE (Please select Utility Code from the list for your city) PERIODICITY OF PAYMENT : MONTHLY : ______________________________ (Mandatory)
1. NAME OF THE CUSTOMER (As per Bank A/c): _______________________________ (Mandatory) 2. LOAN ACCOUNT No 3. TELEPHONE No Resi./Off. 4. MOBILE 5. E-MAIL ID 6. MAXIMUM AMOUNT 7. START DATE (Please check for allotted dates from the list for your city ) 8. END DATE (date of last EMI)
: _______________________________ (Mandatory) : _________________________________ : _________________________________ : _________________________________
: Rs. _____________________ **
: _______ From _________ _______ (Mandatory) (Date) (Month) (Year) : _______ From _________ _______ (Mandatory) (Date) (Month) (Year)
9. PARTICULARS OF THE BANK ACCOUNT : NAME OF THE BANK NAME OF THE BRANCH MICR CODE ACCOUNT TYPE
(Pl Specify SB/CA/CC/ NRE/NRO etc)
I, hereby declare that the particulars given above are correct and complete. If the transaction is delayed or not effected at all for reasons of incomplete or incorrect information, I would not hold the user institution responsible. I hereby authorise my Bank (as mentioned above) to debit my above mentioned account with the amount of installment and I agree to discharge the responsibility expected of me as a participant under the scheme. Date: __________________ ______________________________ Signature of the Account Holder (s)
(Mandatory) fieldCannot be blank ** Should be twice the Standard EMI Provision for Change in Repayment schedule of the Loan
CERTIFIED THAT THE PARTICULARS FURNISHED ABOVE ARE CORRECT AS PER OUR RECORDS.
_____________________________ Signature of Bank Official Important : Kindly attatch a blank cancelled cheque with this Mandate form.
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ECS-D
Branch
Agra Ahmedabad Amritsar Anand Aurangabad Bengaluru Bhilwara Bhopal Bhubaneshwar Bikaner Calicut (Kozhikode) Chandigarh Chennai Coimbatore Cuttack Dehradun Durgapur Erode Guwahati Gwalior Haldia Hyderabad Indore Jaipur Jalandhar Jamshedpur Jammu Jodhpur Kanpur Kochi Kolkata Kolhapur Kota Lucknow Ludhiana Madurai Mysore Mumbai Nagpur Nashik New Delhi Patna Pondicherry
Date of Debit
15 / 25 15 / 25 15 / 25 15 /25 15 / 26 5/ 15 / 25 / 27 5 / 15 / 25 8 / 23 5/15/27 5 / 15 / 25 5 / 20 5 / 15 / 25 5 / 15 / 27 5/ 10/ 20/ 25 5 /15 /27 5 / 16 /24 5 / 15 / 27 5 /10 /20 /25 5 / 15 / 27 15 / 25 5 /15 /27 5 /10 / 25 8 / 23 5 / 15 / 25 15 / 25 5 / 15 /27 15 /25 5 / 15 / 25 10 / 18 / 25 5 / 10 / 25 5 / 15 / 27 10 /25 5 / 15 / 25 2 / 8 / 15 / 22 15 /25 5 /15 /25 4 4 / 15 / 27 10 / 25 10 / 20 / 25 5 / 15 / 25 5 /15 / 27 5 / 15
Utility Code
2829039 3809082 4009129 3889101 4319034 5609115 3119013 4629161 4009034 3349009 4009034 1609006 5609115 6419106 4009034 4009034 4009034 5609115 4009034 4746038 4009034 5609115 4529043 3029007 1449017 4009034 1809021 3429001 4009034 4009034 4009034 4169018 3240104 2269009 1410891 6258808 5609115 4009034 4009034 4229026 1109205 4009034 5609115
ECS-D
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Branch
Pune Raipur Rajkot Ranchi Salem Shimla Siliguri Solapur Surat Thiruvananthapuram Thiruchirappalli (Trichy) Trichur (Thrissur) Udaipur Vadodara Vijayawada Vishakapatnam
Date of Debit
10 / 25 8 /23 15 / 25 5 / 15 / 27 5/ 10/ 20/ 25 25 5 /15 /27 10 / 25 15 / 25 5 / 10 / 25 5 / 15 /25 5 / 20 5 / 15 / 25 15 / 25 5 /10 /25 5 / 10/ 25
Utility Code
4119219 4925035 3609083 4009034 5609115 4009034 4009034 4130021 3959288 4009034 5609115 4009034 3139018 3909090 5609115 5609115
ECS-D
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What is it ?
Facility from RBIs National Clearing System, just for you in select cities. An automated Payment system where the EMI will be debited to your bank account and remitted to us. No fresh Mandate will be required whenever a change occurs in the EMI repayment schedule (Refer point 6 of the mandate form).
Send an electronic intimation to the Clearing System through our Bankers. Receive the required confirmation from the Bankers. Credit your loan account. Inform you in the unlikely event of money not received.
Please, also
Clear the dues, if any, till the month of the first debit. Maintain a balance and track the debits in your bank account.
ECS-D
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