UMRN Date 0 9 0 4 2 0 2 5
Utility Code Create Modify Cancel
Sponsor Bank Code I/We hereby authorize TVS Credit Services Limited
to debit (tick ) SB/CA/CC/SB-NRE/SB-NRO/Other Bank a/c number 4 6 5 3 1 0 1 0 0 0 1 6 3 8 3
with Bank BANK OF INDIA IFSC/MICR BK I D 0 0 0 4 6 5 3
an amount of Rupees EIGHT THOUSAND NINETY ONLY 8090 /-
DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented
Customer ID 0041175900 Prospect No. 3164CD0085077
1.I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank. 2.This is to confirm that the declaration
has been carefully read, understood & made by me/us. I am authorizing the User entity / Corporate to debit my account. 3.I have understood that I am authorized to cancel/amend this mandate by
appropriately communicating the cancellation / amendment request to the User entity / corporate or the bank where I have authorized the debit.
From 0 3 0 5 2 0 2 5
To 0 3 0 4 2 0 5 5
Or Until Cancelled
Signature Primary Account Holder Signature Account Holder Signature Account Holder
Phone No. 9546704023
1. NURAJAHAO KHATUN 2. Name as in bank records 3. Name as in bank records
UMRN Date D D M M Y Y Y Y
Utility Code Create Modify Cancel
Sponsor Bank Code I/We hereby authorize TVS Credit Services Limited
to debit (tick ) SB/CA/CC/SB-NRE/SB-NRO/Other Bank a/c number
with Bank IFSC/MICR
an amount of Rupees
DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented
Customer ID Prospect No.
1.I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank. 2.This is to confirm that the declaration
has been carefully read, understood & made by me/us. I am authorizing the User entity / Corporate to debit my account. 3.I have understood that I am authorized to cancel/amend this mandate by
appropriately communicating the cancellation / amendment request to the User entity / corporate or the bank where I have authorized the debit.
From D D M M Y Y Y Y
To D D M M Y Y Y Y
Or Until Cancelled
Signature Primary Account Holder Signature Account Holder Signature Account Holder
Phone No.
1. Name as in bank records 2. Name as in bank records 3. Name as in bank records
UMRN Date D D M M Y Y Y Y
Utility Code Create Modify Cancel
Sponsor Bank Code I/We hereby authorize TVS Credit Services Limited
to debit (tick ) SB/CA/CC/SB-NRE/SB-NRO/Other Bank a/c number
with Bank IFSC/MICR
an amount of Rupees
DEBIT TYPE Fixed Amount Maximum Amount FREQUENCY Monthly Quarterly Half Yearly Yearly As & when presented
Customer ID Prospect No.
1.I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank. 2.This is to confirm that the declaration
has been carefully read, understood & made by me/us. I am authorizing the User entity / Corporate to debit my account. 3.I have understood that I am authorized to cancel/amend this mandate by
appropriately communicating the cancellation / amendment request to the User entity / corporate or the bank where I have authorized the debit.
From D D M M Y Y Y Y
To D D M M Y Y Y Y
Or Until Cancelled
Signature Primary Account Holder Signature Account Holder Signature Account Holder
Phone No.
1. Name as in bank records 2. Name as in bank records 3. Name as in bank records
TVS Credit Services Limited
Consumer Durables Loan
OSV Declaration
I hereby confirm that I have verified the original KYC document of the below customer, and that the documents and details given below pertain to
verification of Loan Number 3164CD0085077
Snapshot of KYC Details
Prospect Number 3164CD0085077
Customer Name NURAJAHAO KHATUN
Employee/Dealership Name RIYAJ MOBILE STORE
Employee Code/Dealership Code CD98833
OSV Esign DateTime 09-04-2025 09:50 PM
Id Proof - PAN Card Prospect Number - 3164CD0085077 Id Proof Number - KLWPK5270D
Original of Id Proof has been seen and verfied (Signature of Dealer/Employee) , as on 09/04/2025 09:59 PM
Lat/Long 28.6294621 77.3970127
Address Proof -
Prospect Number - 3164CD0085077 Address Proof Number - 4059
AadharCard
Original of Address Proof has been seen and verfied (Signature of Dealer/Employee) , as on 09/04/2025 09:59 PM
Lat/Long 28.6294621 77.3970127
DOVD Address Proof -
Telephone bill-Landline or Prospect Number - 3164CD0085077 DOVD Address Proof Number - 9546704023
Postpaid
Original of DOVD Address Proof has been seen
(Signature of Dealer/Employee) , as on 09/04/2025 09:59 PM
and verfied
Lat/Long 28.6294621 77.3970127
