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E-mandate cancellation
Policy Number*
Please enter Policy Number
Policy Start Date*
Please select Start date
Policy End Date*
Please select End date
Mobile Number*
Please enter Mobile Number
Email*
Please enter Email
Mandate Amount
Mandate On
Account
Card
Please enter Mandate on
Account Details
Registered Name in Bank*
Please enter Registered Name in Bank
Bank Account Number*
Please enter Bank Account Number
Re-enter Bank Account Number*
Please enter re-enter Bank Account Number
Account number doesn't match
IFSC Code*
Please enter IFSC Code
Bank Name*
Please enter Bank Name
Branch*
Please enter Branch
Card Details
Name on Card*
Please enter Name on Card
Card Number*
Please enter Card Number
Re-enterCard Number*
Please enter Re-enter Card Number
Card number doesn't match
Card Type
Visa
Mastercard
Maestro
RuPay
Amex
Diner
Please enter Card Type
Card Expiry Month/Year*
Please select card expiry month/year
Submit
Policy Number
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Policy Start Date
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Policy End Date
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Mobile No
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Email_ID
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Mandate Amount
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Mandate On
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Registered Name in Bank
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Bank Account Number
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Validate Bank Account Number
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IFSC Code
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Bank Name
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Branch
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Name on Card
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Card Number
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Validate Card Number
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Card Type
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Card Expiry Month/Year
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