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MANADATE INSTRUCTIONS FORM/NACH/ECS/DIRECT DEBIT/STANDING INSTRUCTION
UMRN Date
Tick


Sponsor Bank Code Uitility Code
I/We Hereby Authorize to debit(tick)




Bank a/c Number
With Bank IFSC or MICR
An Amount Of Rupees Rs
Frequency



Debit Type
Ref 1 Phone No.
Ref 2 Email ID
PERIOD
From
To
Or Until Cancelled 1. 2. 3.

INSTRUCTIONS TO FILL MANDATE

  • UMRN is auto generated during mandate creation and is mandatory to be updated during amendment and cancelation of mandate.(Maximum length-20 Alpha Numeric Characters).
  • Date in DD/MM/YYYY format
  • Sponsor Bank IFSC/MICR code, provided by the blank by the bank to the client
  • Utility Code of the services provider.(Maximum length-18 Alpha Numeric Characters)
  • Name of Service Provider
  • Tick on box to select type of Action to be initiated.
  • Tick on box to select type of Action to be affected.
  • Customer's legal Account Number,(Maximum length-35 Alpha Numeric Characters )
  • Name of Bank and Branch.
  • IFSC/MICR code of customer bank.Maximum length-11 Alpha Numeric Characters )
  • Amount payable for services or maximum Amount per traction that could be processed, in words.
  • Amount in figures, similar to the amount mentioned in words. (Maximum length-13digit Numeric, in paise)
  • Service provider generated consumer reference number.
  • Service provider generated scheme/plan reference number.
  • Tick on box to select Frequency of transaction.
  • Validity of mandate with date in DD/MM/YYYY format.
  • Name of customer/s and signatures as well as seal of company (where required.) (Maximum length-40 Alpha Numeric Characters )
  • Telephone no. Or Mobile no. Of Customer.
  • Email address of customer.
  • Submit form and send the printout to following address:
    Deepak Kumar Sales(R&R)
    DISHTV India Ltd.
    FC - 19, Sector 16 A, Film City,
    Noida, Uttar Pradesh,
    India.
    Pincode - 201 301
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