Microsoft Word - NEFT for Brokerage.doc



FORM FOR DIRECT CREDIT / NEFT / RTGSName :_____________________Distributor Code: ARN- Name of Bank : Branch Name: ____________Bank account number :____________________________________________________________ IFSC code : ________________________ MICR Code : _________Email Address :___________________________________________________Account type: Savings / Current / Others (Please specify) : Branch Address : _________________________________________________________________City:PIN: I / We hereby declare that the particulars given above are correct and express my/our willingness to receive credit of brokerage through participation in NEFT System of Reserve Bank of India. I/We understand that the above details shall supercede any information provided by me/us earlier in this regard. If the brokerage is delayed or not effected at all for reasons of incomplete or incorrect information, I/we would not hold LIC Mutual Fund / its registrars and other service providers responsible. LIC Mutual Fund reserves the right to pay my / our brokerage by a cheque/demand draft. I / We will also inform LIC Mutual Fund about any changes in my / our bank account.Distributor Signature(s):(*)Name(s) of signatory/ies: (1)(2) (**)Designation(s) :(1)(2) (**)(*) To be signed by authorised official/s in case of non-individual distributors under the company/ agency seal (**) To be filled only in case of non individual distributorsInstructions :1) The remittances will be credited directly to the above account in lieu of issue of warrants.2) A cancelled cheque leaf must be submitted in order to update and validate the details provided. If a cancelled cheque leaf is not provided the request may be rejected. ................
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