Auto Debit Authorization Form

Published on June 2016 | Categories: Types, Business/Law | Downloads: 43 | Comments: 0 | Views: 366
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Auto Debit Authorization Form

I my Kotak Mahindra Bank Account Number

, authorize Kotak Mahindra Bank to debit every month for my Kotak credit card number

Minimum Amount Due

Total Amount Due

% of Total Amount Due

Date : Applicant Signature
(please ensure your signature is same as specimen signature with the Bank)

For Bank Use Only Made By Authorised By GL Credited Transaction Sequence No

Notes: 1. The above Debit Authorization will continue to remain in effect till the same is cancelled in writing by the Account Holder. 2. Account holder(s) are required to ensure maintenance of sufficient funds in their bank account selected for the above payment. 3. Notwithstanding what is mentioned herein above, it is understood that Kotak Mahindra Bank is extending such facility to make it convenient for and facilitate customers to make periodic payments towards their credit card dues and it is further acknowledged that the onus to make such payments on the due dates vests solely and absolutely with the customer without any liability on part of the Bank. 4. The auto debit facility will get activated with a lag of one billing cycle. Payment for that billing cycle will have to be made manually. 5. If no option is selected on the form, the default option registered will be Minimum Amount Due 6. An auto debit return would be treated as a cheque return and there would be a charge for the same

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