TO: AXIS BANK LTD.

RTGS Transaction Request Form Customers Instruction (please write in block letters) In Figures Amount to be Remitted Name of Applicant Address of Applicant Beneficiary Banks IFSC CODE (Mandatory 11 characters field) Name of Beneficiarys Bank Address of Beneficiarys Bank Account No. of Beneficiary Name of Beneficiary Address of the Beneficiary Details / Purpose of Payment (Max 140 Characters) Remit less Charges YES / NO Rs.

Date: In Words

Payment Method (includes amount remitted & AXIS charges) (please as applicable) Debit Applicants Account No. Cheque Payment Other (Please Specify)

Cheque No.

Contact Tel. No. (1)

(2)

(3)

I am / we are aware of the RTGS system launched by the Reserve Bank Of India I / we have read the conditions printed overleaf and agree to be bound by them Authorised Signatories 1. 2. 3.

For Bank Use Only Signatures Verified Balance Confirmation ALM Reporting (If applicable) Customer Acknowledgement Date: In figures
Amount to be Remitted Rs. Name of the Beneficiary Debit Applicants Account No.

In Words

Terms & Conditions in respect of RTGS Transactions 1. All instructions relating to RTGS 11. The RTGS Customer / Applicant should operation should be in writing & signed by the verify the statement of account and confirm the authorised signatories strictly as per the correctness of remittances made. In case of any instructions given to the Bank to operate the discrepancy the customer / Applicant should relative account. intimate the bank immediately. 2. Funds Transfer shall be effected only if 12. If any transaction, cannot be settled due to the destination Branch/originating Branch is the fault of the RTGS Customer/ Applicant, AXIS participating in RTGS. Bank will endeavor to advise the RTGS Customer/ 3. The RTGS Customer/ Applicant hereby Applicant of such non- settlement on phone / fax, irrevocably authorises AXIS Bank to debit his/its but AXIS Bank will not incur any liability to the account with the prevailing service charges. RTGS Customer / Applicant, or to any counterparty 4. It is the responsibility of the RTGS or beneficiary in such circumstance. Customer/ Applicant to ensure availability of 13. AXIS Bank shall not be liable for delay in sufficient clear funds in their Account to carry out payments to the beneficiary if: the payment instructions given (including levy of a. Incorrect and insufficient details of service charges). beneficiary are provided by the applicant remitter. 5. Application must be received before the b. If there is dislocation of work due to cut off time as stipulated by the Bank/RBI. If circumstances beyond the control of Remitting/ application is received after the said cut off time, Destination Banks including but not limited to transfer of funds shall only be effected on the circumstances like non-functioning of computer next working day. system, disruption of work due to natural calamities, 6. It is the responsibility of the RTGS strike, riot etc or Netware or internet problem or Customer / Applicant to ensure the correctness of other causes beyond the control of the Branch/ bank the message especially the IFSC code of the resulting in disruption of communication, such recipient / destination branch & account number cases will be settled on the next working day when of the beneficiary. The collecting bank as well as RTGS is functioning properly. the receiving bank will get valid discharge if the 14. The RTGS Customer / Applicant hereby amount is credited to the account number agrees and undertakes that he is aware of all the mentioned in the Application even if the name of RTGS rules set by RBI & to abide by all the the beneficiary account holder differs. AXIS guidelines issued by the RBI or any other regulatory Bank shall not assume any liability or authorities or as communicated by AXIS Bank responsibility arising out of or made liable for any applicable to the transactions relating to RTGS incorrect request or message. whether directly or / and indirectly. 7. It is the responsibility of the RTGS 15. The provisions of the Agreement shall Customer/ Applicant to ensure the genuineness of always be subject to any rules, terms, conditions and the transactions conducted through RTGS & to administrative guidelines issued by RBI that may be ensure that no illegal transactions are conducted enforced from time to time in respect of operation through RTGS. AXIS Bank shall not assume any of RTGS account. liability for ensuring legality of transactions just 16. The RTGS Customer / Applicant hereby because such transactions are routed through agrees and undertakes to indemnify and keep AXIS Bank. indemnified AXIS Bank from time to time against 8. Prior intimation must be given to the all losses, damages, costs (including legal fees), remitting branch for remittance of Rs. 1 (one) penalties and consequences arising in pursuance of Crore and above. handling the said RTGS transactions or/ and by 9. Once the application is submitted or virtue of AXIS Bank acting for and on behalf of the processed or account is debited, the remitter RTGS Customer/ Applicant in pursuance of this cannot revoke the given mandate. agreement. 10. If the date of payment happens to be a holiday at the centre where the recipient branch is situated, the credit will be passed on to the beneficiary on next working day.

Applicants Signature/s :