UMRN Date 2 0 0 6 2 0 2 5
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 9 7 5 6 3 2 8 9 1 4
with Bank AIRTEL PAYMENTS BANK LIMITED IFSC/MICR A I RP 0 0 0 0 0 0 1
an amount of Rupees EIGHT THOUSAND FIVE HUNDRED AND SEVENTY ONLY 8570 /-
DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented
Customer ID 0043189654 Prospect No. 3074CD0716975
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 8 2 0 2 5
To 0 3 0 8 2 0 3 5
Or Until Cancelled
Signature Primary Account Holder Signature Account Holder Signature Account Holder
Phone No. 9756328914
1. PUSHPENDRA 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 3074CD0716975
Snapshot of KYC Details
Prospect Number 3074CD0716975
Customer Name Pushpendra Jagdeesh
Employee/Dealership Name M S Amit Mobiles
Employee Code/Dealership Code CD70957
OSV Esign DateTime 20-06-2025 11:35 AM
Id Proof - Prospect Number - 3074CD0716975 Id Proof Number -
Officially Valid document (OVD) collected through E-KYC with Reference ID 3074CD0716975 dated 20/06/2025 and no physical OVD
collected
Address Proof -
Prospect Number - 3074CD0716975 Address Proof Number - 9797
AADHAAR
Original of Address Proof has been seen and verfied (Signature of Dealer/Employee) , as on 20/06/2025 12:18 PM
Lat/Long 28.3946879 78.6207152
