DEMAND DRAFT / MANAGER’S CHEQUEAPPLICATION FORM

(Application Form to accompany with cheque)

Date :

Please Issue :

Demand Draft payable at

Manager's Cheque

Customer Name Signature

For Bank Use Only

Processed By:

Charges RecoveredRs.:

DD/MC No.:

Authorised By:

Ref. No.:

Day end Checked By:

In favour of

For Amount : Rs. (In figures)

In Words Rs.

Enclosed is Cheque No. drawn

on my/ our account for Rs.

Branch :

favouring HDFC Bank Ltd towards the above DD/BC

issuance. I/We further authorise you to debit my/our said

account for the service charges, as applicable. I/ We

acknowledge that, in case I/We have issued single

cheque/instruction for debit to my/our account for issuing

more than one demand draft/pay order then the same will

effect as multiple debit entries in my/our account.

Ban

kSe

al

For

HD

FC B

ank

Cus

tom

ers

Cop

y :

(To

be p

rodu

ced

by c

usto

mer

whi

le c

olle

ctin

g D

D/M

C fr

om B

ank)

DD

/ M

C f

or R

s.

Dra

wn

On

Cus

tom

er N

ame

:

C

hequ

e N

o.

Cus

tom

er A

ccou

nt N

o

Dat

e :

Please deliver the D

emand D

raft / Manager's C

heque to

the bearer Mr. / M

s.w

hose signature is appended below.

I acknowledge receipt of the D

D/ M

Cas requested overleaf

Bearer's S

ignatureS

ignature of Account

Holder(s)

Signature of R

ecipient