SBI NEFT / RTGS Form Filler
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Branch Details
Sender Details
Beneficiary Details
Amount Details
Preview — SBI Application for RTGS / NEFT Remittance
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Counter foil
Branch
Date
Received Rs
From
For remittance of NEFT/RTGS by way of (i) Transfer (only NEFT), (ii) Cash (only NEFT), (iii) Cheque (NEFT/RTGS) using
Cheque No.
favoring
Beneficiary A/c No.
(Re-write) Beneficiary A/c No.
IFSC
Bene. Bank
Amount Rs
Charges Rs
Total Rs
...Only)
For office Use,
UTR No. .............Branch Manager
Branch:
Application for RTGS / NEFT Remittance
NEFT
RTGS
Date:
Please remit the sum of Rs (Rs only)
By debiting my/our account No.  by way of (i) Transfer
(only NEFT), (ii) Cash (only NEFT), (iii) Cheque (NEFT/RTGS) using Cheque No. ....................... dated ......................dated
For the total amount including your charges, as per details given below.
Name of Beneficiary
Beneficiary Bank & Branch
IFSC Code
Beneficiary Account Number.
(Re-write) Beneficiary Account Number.
Beneficiary LEI Number.*
(*Please provide the Beneficiary LEI number for remittance of Rs 50 crores and above)
Remittance Amount (in figures) Rs
Remittance Charge Rs
Total (including charges) Rs
Total Amount (including charges in words)
Name of Applicant
Sender LEI Number.*
(*Please provide the Sender LEI number for remittance of Rs 50 crores and above)
Address
Mobile No.    Tel No.
UTR No & Date.
(for office Use)
I have read and understood the T&C printed overleaf.
Signature of Customer (s)/ Applicant (s)