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Adobe Scan 17-Aug-2022

This document is an application form for linking an Aadhaar number to a bank account for receiving Direct Benefit Transfers (DBT) through NPCI mapping. It includes options for the applicant to consent to receive benefits in their specified account and provides a declaration of the accuracy of the information provided. The form also outlines the process of associating a bank with an Aadhaar number for benefit transfers.

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Tanu2205
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59 views1 page

Adobe Scan 17-Aug-2022

This document is an application form for linking an Aadhaar number to a bank account for receiving Direct Benefit Transfers (DBT) through NPCI mapping. It includes options for the applicant to consent to receive benefits in their specified account and provides a declaration of the accuracy of the information provided. The form also outlines the process of associating a bank with an Aadhaar number for benefit transfers.

Uploaded by

Tanu2205
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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s

ttf l Jf J1\ ·\ I 1 SMALL flNAN( [ BANK


I Anne, ure•l
'i INTO BANI'
APPLIC ATION FOR LINKJNOIS EfOINO MOHAR N UMBER ANO RECFIVINO DOl OFNFFIT
ACCOUNT • ( NPCI MAPPINO I' 0,11n

IJr"lnc-t, M.,,naq,,,
Uu ,.,,, Sm.,,, r,nn ncc, !1• • L1n•t10,J
fl,,u,ch

L,n~lngtS ..d,ng of AA!dhHr In NPCl •M tpplng to, Recel¥fng 0I,ect 8 ene f11S
1 I • " r,a , ,it;i •nong a Ban, l<.<-otint No with yr1<1 8r:-in, I
,1 t 5ut,m,t my Aadhanr numoor nnd voluntarily 9Ivo my con s11nII0
0 U~ m1 A1tdh11er Oclml~ 10 ,1ufhent,wle ""' from UI0/1I
0 Ul-f' m) " ""''" Numbfor "'"""""'ed t~low ro, ~m1tl~,q SMS Aleru to me
0 Lon• !ht' A.>1'1~a• Numbt'r 10 11 t my e,istIng'nt1 " lutu,e account, ond nntome, p,ofilt> rCtF J,.,,th / f'IU< Ban•

tS,9naIur'IJ

OPTION FOR RECEMN G 08T BENEFITS (TIC I< ONE)


0 I wiJh to seed my 11ccounI no _ _ _ _ _ _ _ __ _ _ wtlh NPCI moppe, 10 enable me 10 recoIvo Otrect Beno
I f,I Transre, t08Ti mciuding I PG SuDstdy from Govt ol India (GOI) In my above nccount I undorsland
Sene!,r rran~'"' Is due ro me I will receive all tho benefit Ir ans let$ In lhe same account IOf
IhaI ti more lhan one
cu91omer who have nol so tar
~ N"":IOUl1I ..,,th NPCI Mapper)
and
0 t alread) 11.l~e an account w1lh_ __ __ __ (name ol Bank)hav,ng IIN Number' _ _ )
(OBT 13nner,, Accounl
~oeded with NPCI Mappe1 (Of receiving OBT lrom GOI I request you 10 change my NPCI m11ppIno
10 my atnlunt wrlh your Bank
0 I alread~ ha-,e an account wilh another bank_ _ _ _ _ _(name of 8.ink}hav,ng IIN Numoor· _ _ __ and
(DBT Benefit Account)
sPeded with NPCI Mapper lor receMng OBT lrom GOI I do not wonl lo change my NPCI mappmg
lrom lhe e,c,stmg Ben,
0 I do not w.th 10 seed my accounts lrom your Bank 1v,ih N PCI Mapper (I w1ll 110I be gelling OBTJ
hon I have been given 10
3 I\J~e ~ eirplame<I aboul the na ture ol onformaoon lhal may be shared uPon aulhentica
purpose other than menooned
unoerstand 1haI my 1nformaIoon subm1lled 10 lhe bank herewith shall not be used for any
at>ove or as per requireme n ts ot law
4 I hereby declare thar all the above Inlorma11on volunlanly furnished by me Is 1rue
correct and complele

Yours larthlully

(Signature ) 1,r
consent sent through BC/BOO.V Oi
Name I hereby authonze lhe Banking Correspon dent I
Mob<le No I hereby aulhonze the SarpanchN O , B D O
Ema,I To subm1I lhe above consent leller to the bank

(Stgnalure )

,s laciltated by NPCI for Otrect


·NPCI mapping Mapp,ng ts a process of assoctallng a Bank wtlh Aadhaar number whrch
cific Bank accounI lor receIvIng
3ene11r Transfer 10 the respecuve Bank who have ltnked lhe A adhaar Number to a spe
)1recI Benefits 10 which customer has g tven the consent
• IIN number wtll be provided by Bank 1ecelvtng lhe consent Applicalton

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