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MANADATE INSTRUCTIONS FORM/NACH/ECS/DIRECT DEBIT/STANDING INSTRUCTION
*
UMRN
*
*
Date
*
Tick
CREATE
MODIFY
CANCEL
*
Sponsor Bank Code
*
Uitility Code
*
I/We Hereby Authorize
*
to debit(tick)
SB
CA
CC
SB-NRE
SB-NRO
Other
*
Bank a/c Number
*
With Bank
IFSC
or MICR
*
An Amount Of Rupees
*
Rs
*
Frequency
Mthly
Qthly
H-Yrly
Yrly
As & We presently
*
Debit Type
Fixed Amount
Maximum Amount
*
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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Registered Mobile Number
Please enter valid mobile no starts with 9,8 or 7, And Minimum 10 digit required.
Or
V.C. Number
Minimum 11 digit required.
Please enter your register mobile No. or VC No.