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NACH Request

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NACH Request Details

Customer Name *

Mobile Number *

Loan Account

Vehicle Registration

Email (For Acknowledgement)

NACH Mandate *

Location *

Reason/Remark *

This is to inform that the declaration has been carefully read, understood & made by me. I am authorizing the corporate to debit my account, based on the instructions as agreed and signed by me. I have understood that I am authorized to cancel this mandate by appropriately communicating the cancellation request to the corporate where I have authorized debit.