FORM NO. E-5

Appendix – VIII

ELECTRONIC CLEARING SERVICE (CREDIT CLEARING)

(MODEL MANDATE FORM)

(INVESTOR/CUSTOMER’S OPTION TO RECEIVE PAYMENTS THROUGH

CREDIT CLEARING MECHANISM)

(HUDCO - 15% INFRASTRUCTURE BOND-SERIES I HALF YEARLY INTEREST PAYMENT))

No.

  1. LEDGER FOLIO NO. :
  2. INVESTOR’S NAME :
  3. PARTICULARS OF BANK ACCOUNT :
A.BANK NAME:

B.BRANCH NAME:

Address:

Telephone:

C.9-DIGIT CODE NUMBER OF 

THE BANK & BRANCH :

(Appearing on the MICR cheque

issued by the bank)

D.ACCOUNT TYPE

(S.B. Account/Current Account or 

Cash Credit with Code10/11/13)

E.ACCOUNTNUMBER

(As appearing on the Cheque Book)

(In lieu of the bank certificate to be obtained as under, please attach a blank cancelled cheque, or photocopy of a cheque or front page of your savings bank passbook issued by your bank for verification of the above particulars).

4.DATE OF EFFECT:

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 have read the option invitation letter and agree to discharge responsibility expected of me as a participant under the Scheme.

(……………………..)

Date:Signature of the Investor/Customer.

Certified that the particulars furnished above are correct as per our records.

(……………………….)

Signature of the Authorised

Official from the Bank.