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Format of Application form for Funds Transfer

Birth Certificate Affidavit FormatBranch office: ____________

Date: _____________

Please transfer through NEFT (National Electronic Funds Transfer)/RTGS (Real Time Gross Settlement)/MT ________________ for Rupees _______________as under.

Account No. for NEFT/RTGS/Name of Beneficiary Beneficiary Bank and Branch Name IFSC (Indian Financial System Code) No./Daft No./MT No. Amount(In Rupees) Commission(In Rupees) Total(In Rupees)


Please debit the total amount Rupees ______________ to my SF/CA/OD/CC account or I tender Rupees ___________by cash /enclose chques______________ drawn on ___________

I agree _____________________________ .

Applicant Name: _________

Applicant Signature______________

Address _____________

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