Agriwise NACH mandate

Dear customer please fillup the following form to provide your option for EMI collection through NACH

Please enter your name (same as the applicant name for your loan with AGRIWISE)
Please enter your 10 digit mobile number
Please provide an email id if you have. It helps communicating better
Please enter your LOAN APPLICATION NUMBER
Do you want to continue with NACH? * Please provide your option if you would continue with NACH option or discontinue?
Terms and Conditions *
I agree that I have provided all the above information as per my choice and this data can be stored as a legitimate document of my consent in the above suject.
I accept the Terms and Conditions. Please accept the Terms and Conditions
Please verify that you are not a robot!

Agriwise NACH mandate form has been submitted successfully