DISBURSEMENT REQUEST FORM
IDFC BAN K
To,
The Manager
IDFC Bank Limited,
________________ Branch
LUA
Dear Sir/Madam,
Customer Name/s
Loan Number
Disbursement Amount
Disbursal Part disbursal
(Tick as applicable) Full disbursal
For part disbursal case-Stage of disbursement (Tick as applicable)
First disbursement
Subsequent disbursement
Final disbursement
Please disburse the above loan amount to the following beneficiaries as detailed below:
PO Fund Transfer PO Fund Transfer
Beneficiary details _______________________________ Beneficiary details _______________________________
Bank A/c _______________________________________ Bank A/c _______________________________________
Amount (in Rs.)_________________________________ Amount (in Rs.)_________________________________
Payable Location ________________________________ Payable Location ________________________________
Beneficiary Bank ________________________________ Beneficiary Bank ________________________________
Benf. Branch ____________________________________ Benf. Branch ____________________________________
IFSC Code _____________________________________ IFSC Code _____________________________________
PO Fund Transfer PO Fund Transfer
Beneficiary details _______________________________ Beneficiary details _______________________________
Bank A/c _______________________________________ Bank A/c _______________________________________
Amount (in Rs.)_________________________________ Amount (in Rs.)_________________________________
Payable Location ________________________________ Payable Location ________________________________
Beneficiary Bank ________________________________ Beneficiary Bank ________________________________
Benf. Branch ____________________________________ Benf. Branch ____________________________________
IFSC Code _____________________________________ IFSC Code _____________________________________
*Fund transfer includes disbursement payment via. NEFT/RTGS or to IDFC account
1
IDFC BAN K
Terms & conditions:
1. I/We authorize IDFC bank to carry out the fund transfer transaction as per details mentioned above.
2. I/we hereby agree that aforesaid details including IFSC Code and beneficiary account number are correct.
3. I/we further acknowledge that IDFC bank accepts no liability for any consequences arising out of erroneous details
provided by me/us.
4. NEFT/RTGS request is subject to RBI guidelines.
Yours sincerely,
Sr.
Customer Name Customer Signature
No.
1.
2.
3.
4.
5.
Date
D D M M Y Y Y Y
Place: _________________________________
