MAHANAGAR TELEPHONE NIGAM LIMITED
(A Govt. of India Undertaking)

Office of Executive Director, K.L. Bhawan, New Delhi-110050

ELECTRONIC CLEARING SERVICE (DEBIT CLEARING)

MANDATE FORM
SUBSCRIBER AUTHORISATION TO PAY TELEPHONE BILLS THROUGH 
ELECTRONIC DEBIT CLEARING MECHANISM

1 SUBSCRIBER'S NAME    :_____________________________________________________

2. TELEPHONE NUMBER :         
 (if more telephone nos. attach separate list signed by competent authority)

2.A). C.A. NO.   :     

                       
____________________________________________________________________________

3. PARTICULARS OF BANK ACCOUNT:

i) BANK NAME   :_______________________________________________________________ 

ii) BRANCH NAME  :___________________________________________________________ 

iii) 9-DIGIT CODE NUMBER OF THE BANK AND BRANCH 
    APPEARING ON THE MICR CHEQUE ISSUED BY THE BANK :_______________________________
    (PLEASE ATTACH THE PHOTOCOPY OF A CHEQUE LEAF) 

iv) ACCOUNT TYPE                                              SB                Current                Cash Credit
(S.B. ACCOUNT /CURRENT ACCOUNT/ CASH CREDIT)
 WITH CODE 10/11/13 :                                      

v) LEDGER FOLIO NO.
(IF APPEARING ON THE CHEQUE BOOK) :___________________________________________________

vi) ACCOUNT NUMBER 
(AS APPEARING ON THE CHEQUE BOOK) :___________________________________________________

vii) NAME OF THE ACCOUNT HOLDER :_____________________________________________________

4. UPPER LIMIT (if any) : 

5.DATE OF EFFECT : 

I/We being the subscriber(s) of above telephone number(s) hereby express my/our willingness to settle the payment of regular month/bi-monthly telephone bills of the telephone connections referred to above through participation in E.C.S. of National Clearing cell of Reserve Bank of India, delhi and hereby authorise Accounts Officer (ECS), M.T.N.L.Delhi to raise the debits on such regular monthly/bi-monthly telephone bills as referred to above through this scheme electronically for adjustment against Debit in my/our above Account No.___________.

I/We have given today standing instructions to my/our Bank.

 ____________________                                               _______________________

Signature of A/C Holder                                                   Signature of subscriber 

Name in Block Letters _______________                              Name in Block Letters _______________
(in case name of Subscriber differs that of A/c holder)       
                                                                                    Add  ___________________________ 
                                                                                           ___________________________

Above instructions received/accepted

Authorised Signatory of the Bank with seal

Note : After verification of the bank 
Please mail the E.C.S. Registration From to the following address:
A.O. (ECS) 
Room No. 325, 3rd Floor
K.L. Bhawan, Janpath, New Delhi-110050
Tele .No.:23326066  or  1600113399