South Eastern Coalfields Limited Tender

MANDATE FORM FOR ELECTRONIC FUND TRANSFER / INTERNET BANKING PAYMENT. 1. Name of the Bidder :………………………………………………………………… 2. Address of the Bidder : …………………………………………………………………. …………………………………………………………………. 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. ( Digital 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. RTGS CODE Account Type Savings Current Cash Credit Account Number(as appearing in the Cheque Book. 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 Company 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 SBI Net / RTGS transfer/NEFT. I agree to discharge responsibility expected of me as a participant under the scheme. Any bank charges levied by the bank for such e-transfer shall be borne by us. Place : Date : Signature of the Party / Authorised Signatory ------------------------------------------------------------------------------------------------------------------------ Certified that particulars furnished above are correct as per our records. Banker’s Stamp Date : (Signature of the Authorised official from the Bank)