RTGS NEFT Application Format Rtgs

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APPLICATION FOR FUNDS TRANSFER- RTGS/NEFT

To, Date : ________________


The Branch Manager,
_________________Branch

Dear Sir/ Madam,


Please remit a sum of Rs._______________________ (Rupees _______________________________________________) only
as per details given below and debit the amount with your charges to my/our account with you.

DETAILS OF APPLICANT DETAILS OF BENEFICIARY


NAME : IFSC CODE:
ACCOUNT NO. BANK:
TYPE OF ACCOUNT : HSS/CD/CC/OD BRANCH:
CUSTOMER ID NO. ACCOUNT NUMBER:
ADDRESS: REPEAT ACCOUNT NUMBER:
TYPE OF A/C HSS/CD/CC/OD
TEL/MOBILE NO. NAME :
E-mail ID: TEL.NO./MOBILE NO. :
SENDER PAN NO.
SENDER LEI NO. (for non-individual customer) for txn.
value Rs.50,00,00,000/- (Rupees Fifty Crores) and above:
RECEIVER LEI NO. (for non-individual customer) for txn.
value Rs.50,00,00,000/- (Rupees Fifty Crores) and above:
Terms & Conditions
 This transfer is valid for a single transaction.
 Due care is taken while filling up the beneficiary account number & IFSC Code.
 Transfer of an amount up to Rs.49,999/- in cash permissible using this facility.
 Photo ID proof to be given by non-customer for cash payment.
 For Transaction Rs.50 Crore and above for non-individual customers, LEI No. of sender and receiver is mandatory as per RBI Cir.
RBI/2020-21/82 dt.05/01/2021
Declaration
 We agree to abide by the Real Time Gross Settlement (RTGS) Guidelines/Regulation/Rules etc. issued by Reserve Bank of India
from time to time and also the guidelines and or terms and conditions of Central Bank of India from time to time.
 We understand that as per RBI Circular dated October 14, 2010 credit will be based solely on the account number of beneficiary.
Name of beneficiary will not be considered as a criteria for providing credit.
 Under normal circumstances, the Beneficiary Bank/ Branch would credit the beneficiary’s account on the same days (i.e. on the
date of this application) at the beneficiary Bank/Branch Centre subject to the RTGS guidelines/rules/regulations of RBI.

Yours Faithfully,

________________________
For Office Use only (Applicant’s Signature(s))

Applicant’s Signature(s) Verified by: S.S.No. (Maker): S.S.No. (Checker):


Signature : Signature :
___________ _______________________
S.S.No. Officer-HSS/CD/CC/OD Deptt. Date ___________ Time : ________ Date ___________ Time _______

Transaction Reference No. :


Acknowledgement
Received application from (Name)__________________________________HSS/CD/CC/OD A/C No._____ __________
Rs._____________________________on (Date)____________ at Time ________for funds transfer under RTGS/NEFT.
Reference No. ______________________________________________
Seal Signature of Officer

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