TRADING & DEMAT ACCOUNT OPENING FORM - NJ PMS

BANK MANDATEElectronic Clearing Service (Debit Clearing)/ Direct DebitNJ India Invest Pvt. Ltd.*Mandate Reference No:The Manager*Bank Name:UI Code:*Branch Name:*Address:Telephone No:I hereby authorize you to debit my account for making payment to NJ IndiaInvest Pvt. Ltd. through ECS (Debit) clearing / Direct Debit as per the details givenas under.*Name of First/Sole Applicant:Mode of Payment (Please tick): ECS Direct Debit*MICR-9DigitCode Numbers of the Bank & Branch (Appearing on the MICR cheque issued by the bank):*Mode of Holding: Single Joint Either or Survivor*Account Type: S.B. Account Current Account Cash CreditLedger No / Ledger Folio No:*Bank Account Number:*Account holder names (As per bank’s record):1st A/c Holder:2nd A/c Holder:3rd A/c Holder:Name of the Scheme*Date ofEffectPeriodicity(M/BiM/Qly/etc.)*Amount(Upper Limit)*Number of installments/Valid upto (in case of utility bills)/End DateDaily*Debit Start Date:I/We hereby declare that the particulars given above are correct and complete. If the transaction is delayed or not effected at all for reasons ofincompleteor incorrectinformation,I would not hold the user institutionresponsible.I have read the option invitationletter and agree to dischargethe responsibilityexpectedof me as a participantunderthe scheme.This is to inform that I/We have registered for the RBI’s Electronic Clearing Service (Debit Clearing)/DirectDebit/StandingInstruction and that mypayment towards my loan/investmentin NJ IndiaInvestPvt. Ltd. shall be made from my /our above mentionedbank account with your bank. I/Weauthorizethe representativecarryingthis ECS (DebitClearing/DirectDebit/StandingInstructionmandateform to get it verified& executed.Signature(s) of the account holder(s). (As per bank’s record)*Date:1.2.3.*Indicates mandatary field.For Bank Use OnlyCertified that the particulars furnished above are correct and as per our records.Bank’s StampDate:Signature of the Authorized official from the Bank