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ACH_FORM

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UMRN Date 0 5 1 2 2 0 2 4

Utility Code Create Modify Cancel


Sponsor Bank Code I/We hereby authorize TVS Credit Services Limited

to debit (tick ) SB/CA/CC/SB-NRE/SB-NRO/Other Bank a/c number 4 4 7 7 0 2 0 1 0 1 1 6 7 9 4


with Bank UNION BANK OF INDIA IFSC/MICR UB I N 0 5 4 4 7 7 9
an amount of Rupees EIGHT THOUSAND ONE HUNDRED AND TWENTY FIVE ONLY 8125 /-
DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented

Customer ID 0038062305 Prospect No. 3012CD0305837


1.I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank. 2.This is to confirm that the declaration
has been carefully read, understood & made by me/us. I am authorizing the User entity / Corporate to debit my account. 3.I have understood that I am authorized to cancel/amend this mandate by
appropriately communicating the cancellation / amendment request to the User entity / corporate or the bank where I have authorized the debit.

From 0 3 0 1 2 0 2 5
To 0 3 0 1 2 0 3 5
Or Until Cancelled
Signature Primary Account Holder Signature Account Holder Signature Account Holder
Phone No. 8817896146
1. GANESH CHAMAR 2. Name as in bank records 3. Name as in bank records

UMRN Date D D M M Y Y Y Y
Utility Code Create Modify Cancel
Sponsor Bank Code I/We hereby authorize TVS Credit Services Limited

to debit (tick ) SB/CA/CC/SB-NRE/SB-NRO/Other Bank a/c number

with Bank IFSC/MICR

an amount of Rupees
DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented

Customer ID Prospect No.


1.I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank. 2.This is to confirm that the declaration
has been carefully read, understood & made by me/us. I am authorizing the User entity / Corporate to debit my account. 3.I have understood that I am authorized to cancel/amend this mandate by
appropriately communicating the cancellation / amendment request to the User entity / corporate or the bank where I have authorized the debit.

From D D M M Y Y Y Y

To D D M M Y Y Y Y
Or Until Cancelled
Signature Primary Account Holder Signature Account Holder Signature Account Holder
Phone No.
1. Name as in bank records 2. Name as in bank records 3. Name as in bank records

UMRN Date D D M M Y Y Y Y
Utility Code Create Modify Cancel
Sponsor Bank Code I/We hereby authorize TVS Credit Services Limited

to debit (tick ) SB/CA/CC/SB-NRE/SB-NRO/Other Bank a/c number

with Bank IFSC/MICR

an amount of Rupees
DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented

Customer ID Prospect No.


1.I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank. 2.This is to confirm that the declaration
has been carefully read, understood & made by me/us. I am authorizing the User entity / Corporate to debit my account. 3.I have understood that I am authorized to cancel/amend this mandate by
appropriately communicating the cancellation / amendment request to the User entity / corporate or the bank where I have authorized the debit.

From D D M M Y Y Y Y

To D D M M Y Y Y Y
Or Until Cancelled
Signature Primary Account Holder Signature Account Holder Signature Account Holder
Phone No.
1. Name as in bank records 2. Name as in bank records 3. Name as in bank records
TVS Credit Services Limited
Consumer Durables Loan
OSV Declaration
I hereby confirm that I have verified the original KYC document of the below customer, and that the documents and details given below pertain to
verification of Loan Number 3012CD0305837

Snapshot of KYC Details


Prospect Number 3012CD0305837
Customer Name Ganesh SO Raghuveer
Employee/Dealership Name MUSIC MAHAL
Employee Code/Dealership Code CD81300
OSV Esign DateTime 05-12-2024 02:04 PM

Id Proof - AADHAAR Prospect Number - 3012CD0305837 Id Proof Number - 6692

Original of Id Proof has been seen and verfied (Signature of Dealer/Employee) , as on 05/12/2024 02:10 PM
Lat/Long 22.9248933 78.7840182
Address Proof -
Prospect Number - 3012CD0305837 Address Proof Number - 6692
AADHAAR

Original of Address Proof has been seen and verfied (Signature of Dealer/Employee) , as on 05/12/2024 02:10 PM
Lat/Long 22.9248933 78.7840182

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