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ECS Mandate Form for PNB Payments

This document is an ECS mandate form authorizing a bank to debit an account for payments to another bank via electronic clearing service. It contains fields for the customer's name and credit card number, the debiting bank branch code and account details, the ECS user number, validity period, and transaction amounts. The customer confirms the details are correct and agrees to maintain sufficient balance. The bank certifies the customer details match their records. The mandate is created in triplicate for the bank, user company, and customer.

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141 views1 page

ECS Mandate Form for PNB Payments

This document is an ECS mandate form authorizing a bank to debit an account for payments to another bank via electronic clearing service. It contains fields for the customer's name and credit card number, the debiting bank branch code and account details, the ECS user number, validity period, and transaction amounts. The customer confirms the details are correct and agrees to maintain sufficient balance. The bank certifies the customer details match their records. The mandate is created in triplicate for the bank, user company, and customer.

Uploaded by

0sandeep
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

ECS Mandate Form

FOR ELECTRONIC CLEARING SERVICE (DEBIT CLEARING)

Copy to the User Company The Manager --------------------------------


Name of the Card Holder_______________ Bank Name----------------------------------
Branch Name--------------------------------
Primary Credit Card number. Address--------------------------------------
Telephone No.-----------------------------

I hereby authorize you to debit my account for making payment to Punjab National Bank, H.O. :Credit Card Venture Division,
New Delhi through ECS (debit) clearing as per the details given as under:
A. 9-digit code number of the Bank & Branch:

(Appearing on the MICR cheque issued by the bank (to be filled up by the branch)
B. Account Type
(S.B. Account/ Current Account or Cash Credit with code 10 /11 / 13)

C. Ledger no./ Ledger folio no.

D. ECS User No : 1109645

E. Account No. (As appearing on the cheque book)

Name of the Date of effect Periodicity - Amount of bill with upper limit Valid up to (in case of
Scheme Monthly. (Tick as per option exercised) utility bills)
Minimum Total Amount
Amount Due Due

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 under institution responsible. I hereby confirm to
maintain clear balance at the previous day end in my above account. I have read the option invitation letter and agreed
to discharge the responsibility expected of me as a participant under the scheme.

(-------------------------------)
Date Signature of the Customer

Certified that the particulars furnished above are correct as per our records.

(Bank stamp) (------------------------------)


(Signature of the Authorized official from the bank maintaining account of the customer )
(Note: Mandate to be obtained in 3 copies, original for Bank, one for User Co and other for customer)

PS
• The Customer can also send the ECS mandate directly at the following address.

The Chief Manager,


Punjab National Bank
Credit Card Processing Centre,
A-37, Sector 60,
NOIDA (U.P.)

. In case of two consecutive dishonour of ECS mandate, the ECS facility will be discontinued.

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