ST. XAVIER'S COLLEGE [AUTONOMOUS]
30, MOTHER TERESA SARANI, KOLKATA - 700 016
MANDATE FORM FOR REFUND OF SECURITY DEPOSIT
(FILL IN THE FOLLOWING INFORMATION IN CAPITAL LETTERS)
Student Name :
Department :
Select Department
ARTS & SCIENCE
COMMERCE [MORNING]
COMMERCE [EVENING]
DEPARTMENT OF BUSINESS ADMINISTRATION
POST GRADUATION IN SCIENCE [P.G.SC]
B.ED
POST GRADUATION IN COMMERCE [P.G.COM]
POST GRADUATION IN ARTS [P.G.ART]
M.A. EDUCATION
Course :
Year of Admission :
College Roll Number :
Mobile No. :
Email ID :
Bank Details
Name of the Account Holder :
Name of the Bank :
Name of the Branch :
Address of the Branch :
Account Number :
Type of Account (SB / CA / OD / Loan Account) :
Select Account Type
SB
CA
OD
Loan Account
IFS Code : (11 character)
I Understand that the refund will be done on the basis of the information provided above.