All India Council for Technical Education
Nelson Mandela Marg, Vasant Kunj, New Delhi – 110070
Mandate Form for Institute/College/University/Other Organisations
1 Name of the Beneficiary Institute
2 Permanent Id of Institute, if any
3 Head of Institute (Tick one) Director/Registrar/Principal/Others (Please Specify)
4 Type of Institute (Tick one) Govt./Govt. aided/Self Finance/Private etc.
5 Address of the Institute
6 PAN No. of the Institute
7 GST No., if allotted
8 E-mail id of Head of Institute
9 Name of the Bank
10 Branch Name & Bank Code
11 Address of Bank with PIN Code
12 Telephone No. of the Bank
13 Name of the Account Holder with Designation
14 Account Type (Tick One) Savings/Current
15 Account Number
16 Bank Branch IFSC Code
17 Bank Branch MICR Code
18 Whether the Account is in the Name of Yes/No
Beneficiary Institute (Tick One)
19 Whether the Account is Operational (Tick One) Yes/No
20 Whether the Account is No-Frill Account (Tick Yes/No
One)
21 Whether the Account is a Joint Account Yes/No
(if yes, give details)
It is declared that all the information provided above are true and complete in all respects.
Signature of Account Holder with Designation Certified that the above details are verified
Or Authorised Signatory on (date)………………………………………..
With Institute Seal
(Banker’s Signature with Seal)
Date: ________________
