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DIS Request Form

The client is requesting a new Delivery Instruction Slip (DIS) booklet from Paytm Money Limited as the old one has been lost, misplaced, or stolen. The client provides their DP ID and client ID for identification. They agree to have the new DIS booklet dispatched to their registered correspondence address by courier at their own risk. The client signs the request and provides their registered correspondence address for the delivery. Paytm Money Limited notes the serial numbers and date of issue for the new DIS booklet.

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Raj Kumar
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2K views1 page

DIS Request Form

The client is requesting a new Delivery Instruction Slip (DIS) booklet from Paytm Money Limited as the old one has been lost, misplaced, or stolen. The client provides their DP ID and client ID for identification. They agree to have the new DIS booklet dispatched to their registered correspondence address by courier at their own risk. The client signs the request and provides their registered correspondence address for the delivery. Paytm Money Limited notes the serial numbers and date of issue for the new DIS booklet.

Uploaded by

Raj Kumar
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

REQUISTION FORM FOR NEW DELIVERY INSTRUCTION SLIP BOOK

Date:

DP ID: 1 2 0 8 8 8 0 0

Client ID:

To,
Paytm Money Limited,
Ground Floor No. 6/B,
Vaishnavi Summit, 80 Feet Rd,
Koramangala 1A Block,
Bengaluru – 560034

Dear Sir / Madam,

Sub: Request for issuing new DIS Booklet


Please issue me/us with book/s of Delivery Instruction Slips for the Paytm Money Limited Client ID ___________
as the old Delivery Instruction Slip Book has been Lost/Misplaced/Stolen. I/We agree that the Delivery
Instruction Slip book/s be dispatched to my/our correspondence address registered with Paytm Money Limited,
by courier at my/our risk and consequence. I/We shall not hold Paytm Money Ltd. liable in any manner
whatsoever in respect of such dispatch of the Delivery Instruction Slip book/s to the following address.

Correspondence Registered Address (for dispatching DIS)-

Yours Sincerely,

(Signature of First Holder) (Signature of Second Holder) (Signature of Third Holder)

First holder name Second holder name Third holder name

For Office Use


Serial Numbers of DIS Issued: Issued On:

Employee Name:

Signature of the DP official:

Please note the following with respect to the Issue of the Delivery Instruction Booklet:
1. Request for new DIS book/s has to be signed by all the holders.
2. Please update your correspondence address registered with Paytm Money Limited, if any changes.

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