Application Form For Funds Transfer Through
Real Time Gross Settlement (RTGS) / National Electronic Funds Transfer (NEFT)
Branch Code / Model Colony Maximum Limit for NEFT Transaction
Name
Date HDFC Bank Customer No Limit
Time Non HDFC Bank Customer & Indo-Nepal NEFT Remittance Up to INR 50,000/-
You are requested to remit the proceeds as per details below through RTGS / NEFT . (Tick the appropriate Box) .
Attaching Cheque No. _________ for Rs. _______________. (For RTGS draw cheque favouring “HDFC Bank Ltd – RTGS” and for
NEFT draw cheque favouring “HDFC Bank Ltd – NEFT”)
Beneficiary Details
Beneficiary Name
Beneficiary Account Number
Beneficiary Account Number
Beneficiary Address
Beneficiary Bank Name & Branch /
Beneficiary Bank IFSC Code Account Type : Resident / Non Resident
Amount (in figures) to be credited
Amount (in words) to be credited
My / Our Details (Remitter)
Remitter (Applicant) Name
Remitter Account Number
Cash Deposited (Non HDFC Bank
Customer)
Mobile / Phone Number of Remitter
( Mandatory)
Address of the Remitter (Mandatory
for Non – HDFC Bank Customer)
Remarks
Terms & Conditions
* I / We hereby authorize HDFC Bank Ltd. to carry out the RTGS /NEFT transaction as per details mentioned above. (Tick the appropriate Box)
* I / We hereby agree that the aforesaid details including the IFSC code and the beneficiary account are correct.
* I / We further acknowledge that HDFC Bank accepts no liability for any consequences arising out of erroneous details provided by me/us.
* I / We agree that the credit will be affected solely on the beneficiary account number information and beneficiary name particulars will not be used for the
same.
* I / We authorize the bank to debit my / our account with the charges plus taxes as applicable for this transaction.
* I / We agree that requests submitted after the cut off time will be sent in next batch or next working day as applicable.
* I / We hereby agree & understand that the R
TGS / NEFT request is subject to the RBI regulations and guidelines governing the same.
* I / We also understand that the remitting Bank shall not be liable for any loss of damage arising or resulting from delay in transmission delivery or non-
delivery of Electronic message or any mistake, omission, or error in transmission or delivery thereof or in deciphering the message from any cause
whatsoever or from its misinterpretation received or the action of the destination Bank or any act or even beyond control.
* I/We agree that incase of NEFT Transaction if we do not have an account with the bank, we will produce Original identification proof while giving the
request. In case I/We submit form 60, we will also submit the address proof.
* In case the RTGS and NEFT option is not ticked by us, I / We authorize you to execute the transaction less than Rupees Two Lacs through NEFT and
greater than or equal to Rupees Two Lacs through RTGS and debit the charges as applicable.
Signature of
Authorized
Signatory
____________________ ____________________ ____________________
1st Signatory 2nd Signatory 3 rd Signatory
Please affix stamp wherever applicable
Branch Use Only
Transaction Reference Number
Transaction Inputted by Employee Code Signature
Transaction Authorized by Employee Code Signature
Transaction Authorized by (2nd level) (for amount > Rs. 5 lacs) Employee Code Signature
KYC documentation done by (only for Non-HDFC Bank Branch Stamp,
Customers) Employee Code Signature Date & Sign
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Customer Acknowledgement
Received application for RTGS / NEFT for an amount of Rs. _______________ vide cash / cheque number ___________ to be credited to Account
Number ____________________ of _____________________ Bank with IFSC Code_______________ . Customers will be guided by the Terms and
Conditions mentioned in the form. HDFC Bank will accept no liability for any consequences arising out of erroneous details provided by the Customer.
Date ____ Time_______________ _Branch Stamp & Sign __
