ANDHRA PRADESH CENTRAL POWER DISTRIBUTION COMPANY LIMITED

  FOR OFFICE USE :

MANDATE FORM

 1.  Consumer Name (In Block Letters)

:

 ...........................................................
 2.  Service Connection Number(s)*

:

1. ..................................... 2. .....................................
3. ..................................... 4. .....................................
4. ..................................... 6. .....................................
 3.  Particulars of Bank
 
 a)  Bank Name : .......................................................................
   Bank Name  & Address : .......................................................................
.......................................................................
 b)  9 Digit Code Number of the Bank Branch :
                 

(Apperaing on the MICR Cheque issued by the bank. Please consult your banker)

 
 c) Account Types (S.B. Account/Current Account/Cash Account) : .....................................................................
 d) Account Number : .....................................................................
 e) Ledger Folio (If appearing on the cheque) : .....................................................................
 f) Name of the Account Holder : .....................................................................

I/We here-by declare that the particulares given above are correct and express my/willingness to settle the payment of regular monthly Electricity bills referred to above through participation in E.C.S. of Reserve Bank of India, Hyderabad and here by authrorise Accounts Officer, Hyderabad Electricity raise debits on such regular monthly Electricity bills as referred to above through this scheme Electronically for adjustment against my/out account in the event of my bank being unable to debit my/our account for what so ever reasons, I/We pay the bills directly to Hyderabad Electricity by cash. I/We will inform Hyderabad Electricity any changes in my/our Bank Account

                                              I/We have given today standing instructions to my/our banks (Copy enclosed).

Address
  ...................................................... ..............
  ....................................................................
  ....................................................................

.....................................................

(Signature of Subscriber)

.....................................................

(In Case name of Subscriber differs from that of A/C holder)

The details Enclose above are correct as per out records.

Bank Stamp

 Authorised Signatory

.....................................................

Name of the Account Holder

(In Block Letters)

------------------------------------------------------ Tearable ---------------------------------------------------

Standing Instructions

"Kindly accept any debit raised by RBI  against my account no..................................... for service numbers ......................., ..........................., ....................................................., ......................................., ......................................., issued to ...........................................(Account Holder's Name) by AP Transco Services".

  ...................................................................................
 

(Signature of the Account Holder)