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TVS Credit Services Debit Authorization Form

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kiozomr
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0% found this document useful (0 votes)
73 views2 pages

TVS Credit Services Debit Authorization Form

Uploaded by

kiozomr
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 2 1 1 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 0 0 0 0 0 0 4 2 9 8 0 8 9 9 9 4 9


with Bank STATE BANK OF INDIA IFSC/MICR SB I N 0 0 0 1 4 0 4
an amount of Rupees THIRTEEN THOUSAND NINE HUNDRED AND FIFTEEN ONLY 13915 /-
DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented

Customer ID 0037771480 Prospect No. 3054CD1777617


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 1 2 0 2 5
To 0 3 0 1 2 0 3 5
Or Until Cancelled
Signature Primary Account Holder Signature Account Holder Signature Account Holder
Phone No. 9875415788
1. NADEEM AHMED 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 3054CD1777617

Snapshot of KYC Details


Prospect Number 3054CD1777617
Customer Name NADEEM AHMED
Employee/Dealership Name RJ MOBILE HUB
Employee Code/Dealership Code CD115400
OSV Esign DateTime 22-11-2024 11:38 AM

Id Proof - PAN Card Prospect Number - 3054CD1777617 Id Proof Number - DURPA7337C

Original of Id Proof has been seen and verfied (Signature of Dealer/Employee) , as on 22/11/2024 11:59 AM
Lat/Long 22.7492557 88.3725176
Address Proof - Prospect Number - 3054CD1777617 Address Proof Number -

Officially Valid document (OVD) collected through Digi-locker with Reference ID 3054CD1777617 dated 22/11/2024 and no physical OVD
collected

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