MRINAL CREATIONS - Customer Transaction Pay-In Data Entry

Notes Denomination:
Coins Denomination:
Status: Gross Cash Total matches Total Settlement Amount. ₹0 Difference

MRINAL CREATIONS

Your Trusted Partner in Digital Growth.
OFFICE COPY
📍 Faridpur, Dakshin Dauki, Purba Medinipur, W.B - 721450  |  Agent ID: 352122220016
📱 +91-96 35 929 353 / +91-97 33 747 555  |  ✉️ care@mrinalcreations.com  |  🌎 www.mrinalcreations.com
Date:
Time:
Txn Type: [   ] Dep    [   ] Trf    [   ] Wdl
Customer Name:
Mobile No:
Bank / IFSC:
A/C or ID Ref:
RRN / UTR / Txn ID:
Denom (₹) Count Amount (₹)
-- CURRENCY NOTES --
₹500 Note
₹200 Note
₹100 Note
₹50 Note
₹20 Note
₹10 Note
-- COINS --
₹20 Coin
₹10 Coin
₹5 Coin
₹2 Coin
₹1 Coin
Gross Total ₹
Particulars Amount (₹)
Transaction Amount ₹
Fee (Dep/Trf ₹10/1k | Wdl ₹5/1k) ₹
Total Settlement ₹
In Words:
Terms and Conditions:
  1. Customer must verify cash at counter. Discrepancy claims not accepted after leaving.
  2. Fee schedule: ₹10/₹1,000 for deposit/transfer, ₹5/₹1,000 for cash withdrawal.
  3. Biometric/OTP authentication acts as customer consent; RRN/UTR is proof of transfer.
  4. Technical debits resolve per RBI/NPCI turnaround cycle (T+5 business days).
Customer Consent & Acknowledgement: I hereby give my explicit consent to submit my Account / Identification details and biometrics/OTP for processing this transaction. I confirm the transaction amount, denominations, and total settlement amount stated above are accurate and processed with my authorization.
Customer Signature / Thumb
BC Agent Seal & Signature
✂ FOLD OR CUT ALONG DOTTED LINE ✂

MRINAL CREATIONS

Your Trusted Partner in Digital Growth.
CUSTOMER COPY
📍 Faridpur, Dakshin Dauki, Purba Medinipur, W.B - 721450  |  Agent ID: 352122220016
📱 +91-96 35 929 353 / +91-97 33 747 555  |  ✉️ care@mrinalcreations.com  |  🌎 www.mrinalcreations.com
Date:
Time:
Txn Type: [   ] Dep    [   ] Trf    [   ] Wdl
Customer Name:
Mobile No:
Bank / IFSC:
A/C or ID Ref:
RRN / UTR / Txn ID:
Denom (₹) Count Amount (₹)
-- CURRENCY NOTES --
₹500 Note
₹200 Note
₹100 Note
₹50 Note
₹20 Note
₹10 Note
-- COINS --
₹20 Coin
₹10 Coin
₹5 Coin
₹2 Coin
₹1 Coin
Gross Total ₹
Particulars Amount (₹)
Transaction Amount ₹
Fee (Dep/Trf ₹10/1k | Wdl ₹5/1k) ₹
Total Settlement ₹
In Words:
Terms and Conditions:
  1. Customer must verify cash at counter. Discrepancy claims not accepted after leaving.
  2. Fee schedule: ₹10/₹1,000 for deposit/transfer, ₹5/₹1,000 for cash withdrawal.
  3. Biometric/OTP authentication acts as customer consent; RRN/UTR is proof of transfer.
  4. Technical debits resolve per RBI/NPCI turnaround cycle (T+5 business days).
Customer Consent & Acknowledgement: I hereby give my explicit consent to submit my Account / Identification details and biometrics/OTP for processing this transaction. I confirm the transaction amount, denominations, and total settlement amount stated above are accurate and processed with my authorization.
Customer Signature / Thumb
BC Agent Seal & Signature