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AC
H M
AN
DA
TE
FO
RM
Signature Primary Account Holder
1Name as in Bank Records
Signature of Account Holder
3Name as in Bank Records
Signature of Account Holder
2Name as in Bank Records
SB CA CC SB-NRE SB NRO Others
HL
/ Ver
. 8.0
/ 07
19 /
NE
INDB 0000098
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I have understood that the bank, where I have authorized the debit, may levy onetime mandate processing charges as mentioned in their latest schedule of charges published by the bank.
Place : ____________________________ __ Date : _____________ ___ Signature : __________________________________
![[XLS] · Web viewPassports obtained by proxy (i.e. by application on the holder's behalf) are not recognised Recognised if the document bears the signature of the passport holder Recognised](https://img.dokumen.tips/doc/110x75/5aabfd2e7f8b9a8d678c7f03/xls-viewpassports-obtained-by-proxy-ie-by-application-on-the-holders-behalf.jpg)
