NIT NO.

CHRD/IE/RFQ-2/SA 8000/2768/2014

Request for Quotation for Re-Certification

and Surveillance Audit of Mines, Refinery,
Smelter, CPP & Corporate Office of NALCO
to SA 8000 Standard

Annexure- C
(To be submitted in duplicate)
MANDATE FORM FOR ELECTRONIC PAYMENT THROUGH INTERNET & RBI
To
National Aluminium Company Limited,
----------------------------------------------------------------------------------------------Dear Sir,
Sub: Authorization for release of payment due from NALCO, _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ through Electronic
fund transfer(RBI-EFT)/Internet / RTGS.
Refer Order No..dtand/or Tender/Enquiry/Letter No..dt..
(Please fill in the information in CAPITAL LETTERS. Please TICK wherever it is applicable)
1.
2.

Name of the Party

Address of the party

:
:
.

City :.Pin Code:.

E-mail Id: ..
Permanent Account Number
:.

3.
Particulars of Bank:
Bank Name
Branch Name
Branch Place
Branch City
Pin Code
Branch Code
MICR No
(9 Digits code number appearing on the MICR Band of the cheque supplied by the Bank. Please attach Xerox copy of a cheque
of your bank for ensuring accuracy of the bank name, branch name and code number)
Account Type
Savings

Current
Cash Credit
Account Number(as
appearing in the Cheque
Book)
RTGS / IFSC Code
4. Date from which the mandate should be effective :
I hereby declare that the particulars given above are correct and complete. If any transaction is delayed or not
effected for reasons of incomplete or incorrect information, I shall not hold National Aluminium Company Limited
responsible. I also undertake to advise any change in the particulars of my account to facilitate updation of records for
purpose of credit of amount through RBI EFT / Internet / RTGS.
Place:
Date:
Signature of the party/Authorized Signatory
-------------------------------------------------------------------------------------------------------------------------------------------Certified that particulars furnished above are correct as per our records.
Banks Stamp:
Date:
(Signature of the Authorized Official from the Banks)
N.B. : RBI EFT / RTGS facilities Centre:
New Delhi,Chandigarh,Kanpur,Jaipur,Ahmedabad,Mumbai,Nagpur,Hyderabad,Banglaore,Chennai,
Trivandrum,Kolkata,Bhubaneswar,Guwahati,Patna.

NIT NO. CHRD/IE/RFQ-2/SA 8000/2768/2014

Request for Quotation for Re-Certification

and Surveillance Audit of Mines, Refinery,
Smelter, CPP & Corporate Office of NALCO
to SA 8000 Standard

N.B. : RTGS charges if any, is to be borne by the party.

NIT NO. CHRD/IE/RFQ-2/SA 8000/2768/2014

Request for Quotation for Re-Certification

and Surveillance Audit of Mines, Refinery,
Smelter, CPP & Corporate Office of NALCO
to SA 8000 Standard

(To be submitted in duplicate)

MANDATE FORM FOR ELECTRONIC PAYMENT THROUGH INTERNET
To
National Aluminium Company Limited,
----------------------------------------------------------------------------------------------.
Dear Sir,
Sub: Authorisation for release of payment due from NALCO, _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _through Electronic
fund transfer by Internet Mode .
Refer Order No..dtand/or Tender/Enquiry/Letter No..dt..
(Please fill in the information in CAPITAL LETTERS. Please TICK wherever it is applicable)
1.
2.

Name of the Party

Address of the party

3.
Particulars of Bank:
Bank Name
Branch Place
Pin Code
Account Type
Savings

:
:
.

City :.Pin Code:.

E-mail Id: ..
Permanent Account Number
:.

Branch Name
Branch City
Branch Code
Current

Cash Credit

Account Number(as
appearing in the Cheque
Book)
Please attach Xerox copy of a cheque of your bank for ensuring accuracy of the bank name, branch name and code number .
4. Date from which the mandate should be effective :
I hereby declare that the particulars given above are correct and complete. If any transaction is delayed or not
effected for reasons of incomplete or incorrect information, I shall not hold National Aluminium Company Limited
responsible. I also undertake to advise any change in the particulars of my account to facilitate updation of records for
purpose of credit of amount through Internet.
Place:
Date:
Signature of the party/Authorized Signatory
-------------------------------------------------------------------------------------------------------------------------------------------Certified that particulars furnished above are correct as per our records.
Banks Stamp:
Date:
(Signature of the Authorized Official from the Banks)