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Form ECS

This document is an Electronic Clearance System Mandate Form for Income Tax Refund for account holder Harish Chandrakant Koyalkar. It requires the account type, branch name, address, and contact number to be filled out and certified by the bank. The completed form must be sent to the Income Tax Department along with a cancelled cheque or bank passbook copy for authentication.

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harishkoyalkar22
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49 views1 page

Form ECS

This document is an Electronic Clearance System Mandate Form for Income Tax Refund for account holder Harish Chandrakant Koyalkar. It requires the account type, branch name, address, and contact number to be filled out and certified by the bank. The completed form must be sent to the Income Tax Department along with a cancelled cheque or bank passbook copy for authentication.

Uploaded by

harishkoyalkar22
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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Bengaluru-560500

Telephone-18001034455 (Toll Free) or 080-46605200

Account HARISH CHANDRAKANT KOYALKAR


Holder Name

PAN Account Number Bank Name Branch IFSC/SWIFT

EJJPK3105C 010015313033 INDIA POST PAYMENT IPOS0000DOP


BANK

Electronic Clearance System Mandate Form for IncomeTax Refund

1 Account Type (i.e. Saving Account or Current Account)

2 Branch Name

3 Branch Address

4 Branch Contact Telephone Number

I hereby declare that the particulars given above are correct and complete.
I agree to discharge the responsibility expected of me under Electronic Clearance System mandate scheme.

Date:
Place:
(...................................................)
Signature of the Account Holder

Certified that the particulars furnished above are correct as per the bank records.

Bank's Stamp
Date:
Place:
(...................................................)
Signature and seal of the authorised official of the Bank

Note:

Please provide the information in rows which are left blank and get it certified by your bank branch manager.

Please send the completed and signed ECS mandate form in original along with this attachment (both pages) to CENTRALIZED
PROCESSING CENTER, INCOME TAX DEPARTMENT, BENGALURU - 560500, India. Kindly ensure to attach a cancelled cheque or
copy of the front page of the bank pass book reflecting the bank account holder's and bank account details as an additional
proof of authentication.

Date:

Place:
Signature of the Taxpayer

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