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DIS Request Form

This requisition form requests a new delivery instruction slip (DIS) booklet from Paytm Money Limited. The client's old DIS booklet has been lost, misplaced, or stolen. The client agrees to have the new DIS booklet dispatched to their registered correspondence address by courier at their own risk. The client will not hold Paytm Money Limited liable for any issues with the dispatch. The form provides the client ID and signatures of the holders to request the new DIS booklet.

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16elmgate
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1K views1 page

DIS Request Form

This requisition form requests a new delivery instruction slip (DIS) booklet from Paytm Money Limited. The client's old DIS booklet has been lost, misplaced, or stolen. The client agrees to have the new DIS booklet dispatched to their registered correspondence address by courier at their own risk. The client will not hold Paytm Money Limited liable for any issues with the dispatch. The form provides the client ID and signatures of the holders to request the new DIS booklet.

Uploaded by

16elmgate
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,
The Hub, 8/2, Sarjapur
Main Road, Ambulipura
Village, Varthur Hobli,
Bengaluru - 560103

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.

Paytm Money Limited, The Hub, 8/2, Sarjapur Main Road, Ambulipura Village, Varthur Hobli, Bengaluru - 560103

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