Bank account form

Charge my bank account every month

Authorisation form

Make your life simpler, avail of our automatic debit facility and your bill amount every month will automatically get debited to your bank account

after 15 days of your bill date.

To avail of automatic debit facility for payment of your Vodafone bills, kindly fill in the following details.

1. Your details

Name Date of birth

Address

Pincode

Tel. (O) (R) Email

2. Your Vodafone number details

Vodafone no. 9 Relationship no.

3. Bank account details

A/c Type Savings Current Overdraft A/c Operation Single Joint

Bank name Branch name

A/c holder's name

Jt. A/c holder’s name Third A/c holder's name

Account number MICR

MICR is a 9 digit number printed on the bottom centre of the cheque leaf and beginning with 400
Do attach a cancelled cheque/photocopy of a cheque for the above mentioned account.

4. Acceptance

I/We hereby declare that the particulars given on this form are correct and complete. I/We hereby apply for payment of my/our Vodafone

bill through debit to my/our bank account through ECS or any other means by the following service providers

Bill Desk Bill Junction

(Choose any one of these service providers by placing ✓ in the box against their name.)

Name Signature

Place Date

Rubber stamps needed in case of companies, partnerships, proprietorships, etc and name and designation of the authorised signatory.

A Vodafone Essar Company

 5. Signature verification request

The Branch Manager

Bank Branch

Dear Sir

Sub: Mandate verification for relationship number

This is to inform you that I/we have registered to avail of the payment facility of Vodafone bills and charges through Bill Junction/Bill Desk.
Such payments will be made from the aforementioned account and be routed to you directly or through the Reserve Bank of India's ECS
mechanism. I/We authorise the bank to honour all such instructions. I/We further authorise the representative of the Company to get this
mandate verified and registered with you. Mandate Verification Charges (if any) may be charged to my/our account.

A/c holder’s signature Jt. A/c holder's signature

Date Place

6. Certification by account holder's bank

We hereby certify that the above account is currently operational and the particulars furnished above are correct as per our records.

MICR Date

Bank’s stamp Authorised signatory

Note
• Ensure that the form is complete in all respects.
• Make sure that a cancelled blank cheque or its photocopy is attached with the form.
• Drop the completed form at any of the Vodafone Store in the city.
• You will continue to receive your physical bill copy as usual.
• For any further clarifications, call 111 (toll-free) from your Vodafone mobile phone or 6664 1111.

Terms & conditions

Vodafone Essar Digilink Limited (VEDL) will facilitate you (customer) to make payments for your Vodafone bills through automatic direct debit to your bank account
(service) as an additional mode of payment, which shall be subject to the following terms and conditions
1. You acknowledge and confirm that you are eligible for availing the facility of payment of Vodafone bills through automatic direct debit to your bank account (service). You understand that the service will be provided by Bill
Junction/Bill Desk (hereinafter referred to as the service provider) chosen by you, in association with your bank. VEDL shall not be liable for any kind of deficiency in the services or any matter relating thereto. 2. For availing
the service, you hereby agree: a. to provide true, accurate, current and complete information as required by the service provider and/or VEDL from time to time and you will keep the same updated and current at all times. b.
that the service will be made available to you subject to and upon receipt of your banker's confirmation for the service. You further agree that you have no objection whatsoever in VEDL providing your bill details (i.e. customer
code, cell no., name, company name, bill no., bill date, previous balance, paid amount, current charge, amount due, due date, to the service providers and visa-versa. c. that you will be fully and wholly responsible for
maintaining the confidentiality of your registration and identification data, in respect the service and will be fully liable for all actions that take place under your service account and/or bank account and/or password. d. to
furnish to the service provider an unconditional Electronic Clearance Service (ECS) mandate, or any other requisite authority as may be required for your availing the service from the service provider (i.e. to debit your bank
account and effect the payments to VEDL and/or to collect the service charges/fees due or payable to the service provider). e. that your submission of the payment instructions from time to time either over the Internet
and/or through a telephone and/or through any mobile or electronic device/machine and/or as a standing instruction shall constitute an irrevocable and unconditional authority to the service provider to initiate the process
for debiting your bank account/s and making the payment to VEDL. f. that the record of instructions as maintained by the service provider shall be conclusive proof and binding for all purposes and can be used as evidence in
any proceedings. g. that, when you choose to avail the services, the service provider will request your nominated bankers to debit to your nominated bank account for the amount as appearing in your Vodafone bills which
may take up to four working days and therefore you shall allow at least four working days time prior to your bill payment due date, to facilitate timely remittance of the payment to VEDL. You further agree and undertake to
ensure that there will be sufficient clear funds in your account for effecting the payment for the transactions. h. that it shall solely be your responsibility to schedule your payments in a manner that VEDL receives the
payments within the due dates and that, in the event of a late payment, you shall be liable for the late payments charges and all other consequences as may be enforced by VEDL, including disconnection of your cellular
service. i. that if any 2 (two) successive payments/instructions are not received/honoured, the service provider reserves the right to automatically cancel the service. j. that the service provider shall be entitled, in its absolute
discretion, to refuse to comply with all or any of your instructions for the service without assigning any reason. k. that the service provider will not be responsible or liable if it is unable to effect any of your payment
instructions due to: (a) incomplete, inaccurate, invalid or delayed submission of details by you (b) insufficient funds to cover your transaction (c) encumbrance or charge on your account or (d) any events beyond the control
of the service provider. And in such circumstances, you shall be responsible to make payment for your Vodafone bill to VEDL through other mode/s of payments to avoid late payment charges or disconnection of cellular
services etc. l. that the details of your Vodafone bills will be provided by VEDL to the service provider and in case of any discrepancy in this regard, the records of VEDL shall be final and binding to all concerned. The service
provider shall, in no way, be deemed to be an agent, representative or assigns of VEDL. m. that the service provider reserve the right to charge and recover from you nominal charge/fees for the service rendered to you. In the
event whereby the service provider, at any time in the future, institutes such charge/fees for the service, the same shall be notified to you. You may then continue with the service by paying such charges/fees or opt for
withdrawal of the service without any liability to the service provider. n. that the service provider/VEDL disclaims all warranties of any kind, whether express or implied including without limitation any representation or warranty,
regarding the use or the results of the service in terms of its correctness, accuracy, reliability, usefulness, completeness, continuity, uninterrupted access, timeliness or otherwise. You expressly understand and agree that you
assume total responsibility and risk for your access and use of the service. o. that while the service provider adopts security measures it considers appropriate for offering this service, it does not assure or guarantee that no
person or entity will overcome or subvert the security measures and gain unauthorised access to the service. The service provider and VEDL specifically disclaim any liability in this regard. 3. You expressly understand and
unconditionally agree that you will not hold the service provider and/or VEDL liable for any direct, indirect, punitive, incidental, special or consequential damages whatsoever, including but not limited to the damages or losses
resulting from: a. use, performance, inability to use or non-performance of the service. b. provision or failure to provide the service. c. unauthorised access to or alteration of transmissions or data. c. such transactions that are
carried out on your instructions in good faith. d. any loss or damage incurred or suffered by you due to any defect, error, failure or interruption in the provision of the service or e. any other matter related to the service. 4. You
agree to indemnify and continue to keep indemnified and hold the service provider and VEDL, and their officers, agents or employees harmless against all actions, claims, demands, proceedings, losses, charges and expenses
whatsoever that the service provider or VEDL may at any time incur, sustain, suffer or be put to as a consequence of or by reason of or arising out of your use or conduct on the service, or out of providing you the service, or
by reason of the service provider, in good faith taking or refusing to take or omitting to take any action on your instruction/s. 5. You agree that the service provider may from time to time make alterations, additions or
deletions to these terms and conditions of service with or without notice to you and that these shall take effect and be binding upon you, on and from the day they are posted on the service provider’s website. You further
agree that you shall be deemed to have agreed, accepted and be bound by such altered terms and conditions of the service. 6. You agree that the service provider may in its sole discretion, with or without notice, terminate
your account or use of the service in whole or in part. In the event you wish to terminate the service you agree to give the service provider a written notice in that regard and obtain an acknowledgment thereof. You agree
that you shall remain liable for all the instructions and transactions that have been submitted by you or processed under your account prior to the date of your obtaining the said acknowledgment. 7. You agree that in the
event you are dissatisfied with any portion of the service or with any of these terms and conditions or alterations thereto, your sole and exclusive remedy is to discontinue the use of the service. 8. You agree that the laws of
India shall govern these terms and conditions and in case of a dispute the matter will be settled as per the rule of Indian Arbitration and Conciliation Act, 1996 and within the exclusive jurisdiction of the courts at Mumbai. 9.
You agree that you shall not use the service for any purpose that is unlawful or prohibited by these terms and conditions. 10. If no choice of the service provider is made, the same will be made at the discretion of VEDL.