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D D M M Y Y Y YUMRN

Sponsor Bank Code Utility CodeH S B C 0 2 I N D I A

FREQUENCY Mthly Qtly H-yrly Yrly As and when presented DEBIT TYPE Fixed Amount Maximum Amount

Bank a/c number

an amount of Rupees

Date

Reference 1

Reference 2

Mobile No.

E-mail IDO P T I O N A L

I/We hereby authorise to debit

Name of customers bankwith Bank IFSC or MICR

PERIOD

From

To

Or Until cancelled

D D M M Y Y Y Y

D D M M Y Y Y Y Signature Primary Account Holder Signature of Account Holder Signature of Account Holder

1. 2. 3.Name as in bank records Name as in bank records Name as in bank recordsThis is to confirm that the declaration has been carefully read, understood and made by me/us. I am authorising the User entity/Corporate to debit my account, based on the instructions as agreed and signed by me.I have understood that I am authorised to cancel/amend this mandate by appropriately communicating the cancellation/amendment request to the User entity/Corporate or the Bank where I have authorised the debit.

I agree for the debit of mandate processing charges by the Bank whom I am authorising to debit my account as per latest schedule of charges of the Bank.

CREATEMODIFYCANCEL

Filling Instructions

1. UMRN – Leave blank for new mandates. Mandatory only for amendment or cancellation.

2. In the ‘Period’ field, either ‘To’ date should be entered OR ‘Until Cancelled’ should be ticked (not both).

3. Certain fields have been prefilled for your convenience. Please fill up all other fields. For detailed instructions refer to the back side of the mandate.

4. Print mandate as per below instructions and please sign the mandate as per the signature(s) maintained with your bank (and company seal where required).

Printing Instructions

1. Mandate should be printed on good quality A4 size paper only (75 GSM and higher).

2. Please ensure mandate is printed without any scaling or zoom options selected. ‘Actual Size’ should be selected during the printing options.

3. Mandate should be printed in ‘Portrait’ mode only such that the mandate image gets printed on the top half of the A4 size page (see image below for the print settings and placement of image in the A4 page)

4. Cut mandate along the edges indicated to get a mandate form of approx. 8 inch x 3.66 inch

F O R

H S B C 0 0 0 2 3 0 0 0 0 0 1 0 0 2

Vodafone India Ltd

V O D A F O N E U S E

Tick

Man

date

Inst

ruct

ion

Form

(A

CH

/EC

S)

Terms and conditions:You acknowledge that the service will be made available to you subject to and upon receipt of your banker's confirmation for the service. Vodafone will request your nominated bankers to debit your nominated bank account for the amount as appearing in your Vodafone bills which may take upto four working days and therefore you shall allow at least four working day time prior to your bill payment due date, to facilitate timely remittance of the payment to Vodafone.

You further agree and undertake to ensure that there will be sufficient clear funds in your account for effecting the payment for the transactions.

That it shall solely be your responsibility to schedule your payments in a manner that Vodafone receives the payment 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 Vodafone, including disconnection of your cellular service.

That if any 2 (two) successive payments/instructions are not received/honoured, the service provider reserves the right to automatically cancel the services.

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.

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 through other mode(s) of payment to avoid late payment charges or disconnection of cellular services etc.

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 acknowledgement.

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.

You agree to indemnify and continue to keep indemnified and hold the service provider and Vodafone, and their officers, agents or employees harmless against all actions, claims, demands, proceedings, losses, changes and expenses whatsoever that the service provider or Vodafone may at anytime 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 banker of payment processing service provider, in good faith taking or refusing to take or omitting to take action on your instruction(s).

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.

The amount over and above the limit needs to be paid by the customer.