From ______________________ ______________________ ______________________ ______________________

Date :

To, The Manager, ______________ Bank, ______________ Branch ______________ City Dear Sir / Madam, Subject: Authorisation letter for initiating ECS Mandate
I have availed a loan of Rs.___________/- from HDFC Ltd towards housing loan. I wish to give ECS mandate for payment of my monthly instalments from my / our Savings Bank Account No.___________________ maintained in your bank. I / We authorise the representative of HDFC Ltd carrying this ECS mandate form to get it verified and executed by you. Any c harges required to be paid may be debited to my account.

I / We hereby declare that the particulars given above are correct and complete. Yours faithfully,

( Signature of the Account Holder)

ELECTRONIC CLEARING SERVICE (DEBIT CLEARING) MANDATE FORM

CUSTOMERS OPTION TO MAKE PAYMENTS THROUGH DEBIT CLEARING
UTILITY CODE :(Mandatory)

SCHEME NAME PERIODICITY OF PAYMENT 1. CUSTOMERS NAME 2. LOAN ACCOUNT NUMBER 3. TELEPHONE NO. RES / OFF 4. EMAIL ID 5. MAXIMUM AMOUNT 6. DATE OF EFFECT 7. END DATE (This is the current end date.
Could vary with change in repayment schedule)

: :

EMI PAYMENT HDFC LTD MONTHLY

: (Mandatory ) : : : : EMI AMOUNT (DATE) (MTH) (YEAR)

: (Mandatory ) : (Mandatory ) : . : . : . : SB/CA/CASH CREDIT

8.PARTICULARS OF THE BANK ACCOUNT BANK NAME BRANCH NAME MICR CODE ACCOUNT TYPE ACCOUNT NUMBER

: .

I hereby declare that the particulars given above are correct and complete. If the transaction is delayed or not effected at all for reasons of Incomplete or incorrect information, I would not hold the user institution responsible, I hereby authorise my Bank (as mentioned above) to debit my above mentioned account with the amount of instalment & I agree to discharge the responsibility expected of me as a participant under the scheme.

Date : .

(.) Signature of the Customer

Certified that the particulars furnished above are correct as per our records. Banks Stamp : Date : (.) Signature of Bank Official NOTE : PLEASE SEND US A BLANK CANCELLED CHEQUE Please Sign in place, where x is marked