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TVS Credit Debit Authorization Form

The document appears to be a loan application from an individual named MOHD DANISH to TVS Credit Services Limited. It includes details of the applicant's account, loan amount, tenure and signatures authorizing the loan company to debit repayments from the specified bank account between given dates.
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0% found this document useful (0 votes)
177 views2 pages

TVS Credit Debit Authorization Form

The document appears to be a loan application from an individual named MOHD DANISH to TVS Credit Services Limited. It includes details of the applicant's account, loan amount, tenure and signatures authorizing the loan company to debit repayments from the specified bank account between given dates.
Copyright
© © All Rights Reserved
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

UMRN Date 2 4 0 2 2 0 2 4

Utility Code Create Modify Cancel


Sponsor Bank Code I/We hereby authorize TVS Credit Services Limited

to debit (tick ) SB/CA/CC/SB-NRE/SB-NRO/Other Bank a/c number 3 0 4 6 0 4 4 4 5 8


with Bank KOTAK MAHINDRA BANK LIMITED IFSC/MICR KK B K 0 0 0 8 3 1 6
an amount of Rupees FORTY TWO THOUSAND TWO HUNDRED AND FIFTEEN ONLY 42215 /-
DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented

Customer ID 0030962491 Prospect No. 3009CD0748427


1.I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank. [Link] is to confirm that the declaration
has been carefully read, understood & made by me/us. I am authorizing the User entity / Corporate to debit my account. 3.I have understood that I am authorized to cancel/amend this mandate by
appropriately communicating the cancellation / amendment request to the User entity / corporate or the bank where I have authorized the debit.

From 0 3 0 4 2 0 2 4
To 0 3 0 4 2 0 3 4
Or Until Cancelled
Signature Primary Account Holder Signature Account Holder Signature Account Holder
Phone No. 8433441886
1. MOHD DANISH 2. Name as in bank records 3. Name as in bank records

UMRN Date D D M M Y Y Y Y
Utility Code Create Modify Cancel
Sponsor Bank Code I/We hereby authorize TVS Credit Services Limited

to debit (tick ) SB/CA/CC/SB-NRE/SB-NRO/Other Bank a/c number

with Bank IFSC/MICR

an amount of Rupees
DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented

Customer ID Prospect No.


1.I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank. [Link] is to confirm that the declaration
has been carefully read, understood & made by me/us. I am authorizing the User entity / Corporate to debit my account. 3.I have understood that I am authorized to cancel/amend this mandate by
appropriately communicating the cancellation / amendment request to the User entity / corporate or the bank where I have authorized the debit.

From D D M M Y Y Y Y

To D D M M Y Y Y Y
Or Until Cancelled
Signature Primary Account Holder Signature Account Holder Signature Account Holder
Phone No.
1. Name as in bank records 2. Name as in bank records 3. Name as in bank records

UMRN Date D D M M Y Y Y Y
Utility Code Create Modify Cancel
Sponsor Bank Code I/We hereby authorize TVS Credit Services Limited

to debit (tick ) SB/CA/CC/SB-NRE/SB-NRO/Other Bank a/c number

with Bank IFSC/MICR

an amount of Rupees
DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented

Customer ID Prospect No.


1.I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank. [Link] is to confirm that the declaration
has been carefully read, understood & made by me/us. I am authorizing the User entity / Corporate to debit my account. 3.I have understood that I am authorized to cancel/amend this mandate by
appropriately communicating the cancellation / amendment request to the User entity / corporate or the bank where I have authorized the debit.

From D D M M Y Y Y Y

To D D M M Y Y Y Y
Or Until Cancelled
Signature Primary Account Holder Signature Account Holder Signature Account Holder
Phone No.
1. Name as in bank records 2. Name as in bank records 3. Name as in bank records
TVS Credit Services Limited

Consumer Durables Loan

OSV Declaration

I hereby confirm that I have verified the original KYC document of the below customer, and that
the documents and details given below pertain to verification of Loan Number 3009CD0748427

Snapshot of KYC Details


Prospect Number 3009CD0748427
Customer Name MOHD DANISH
Employee/Dealership Name PHONORANGE PVT LTD BOMMANAHALLI
Employee Code/Dealership Code CD36475
OSV Esign DateTime 24-02-2024 10:40 AM

Id Proof - PAN Card Prospect Number - 3009CD0748427 Id Proof Number - GWNPD6645B

Original of Id Proof has been seen and verfied (Signature of Dealer/Employee) , as on 24/02/2024 10:46 AM
Lat/Long 12.8927504 77.6259963
Address Proof - AADHAAR Prospect Number - 3009CD0748427 Address Proof Number - 8674

Original of Address Proof has been seen and verfied (Signature of Dealer/Employee) , as on 24/02/2024 10:46 AM
Lat/Long 12.8927504 77.6259963

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