ClickIRR
Technologies

Mandate Instruction Form of NACH/ECS/DIRECT DEBIT
UMRN:    Date: 
 tick (✔)
 Create     
 Modify     
 Cancel     
Sponsor Bank code:        Utility code
     I/We hereby authorize      to Debit tick (✔)

SB

CA

CC

SB NRE

SB NRO

Other

Bank A/C Number  
    With Bank

 IFSC 

MICR 

an amout of Rupees      
Frequency    Mnthly Qtly H Yrly Yrly As & when presented DEBIT TYPE     Fixed Amount  Maximum Amount
Client ID    Phone no.   
Reference ID    E-mail ID   
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.
Period:
From:
To:     
or       ☒ until cancelled

     

 1.

     

 2.

     

 3.

* This 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.
* 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.