Payment Intimation


Name of the Account holder *

:

Amount transferred *

:

Date of Transaction

:

Name of the Bank from which transferred *

:

Branch *

:

Transaction id *

:

Is the scanned copy or print screen enclosed *

:
 Yes  No

Attach scanned copy or print screen

:

For cheque/ Demand draft transactions


Number of the DD/chq/

:

Date

:

Amount

:

Name of the Bank

:

Branch

:

For Electronic Money Order transactions


Number of the EMO

:

Date

:

Amount

:

Location of the Post office

: