Samta Gram

Seva Sansthan

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Indian Money Donation Form

Name of the Individual or Institution  
E-mail  
PAN   
Donation Amount :  
Mobile No :  
Address:  
Donation for  

Bank Details for Transfer

NAME OF BANK            :

 

BRANCH                        : 

 

Branch code                   :

 

ADDRESS BANK          :  

 

CITY                               :  

 

STATE/REGION             : 

 

POSTAL CODE               :

SWIFT (BIC) CODE        : 

 

IFSC code (India only)   :

 

 General Business Account Details (For Indian Money only) :

 

ACCOUNT NUMBER                        :

 

NAME ACCOUNT HOLDER           : 

 

ADDRESS ACCOUNT HOLDER          : 

 

PLACE/CITY                                      : 

 

 

DISTRICT/STATE                               :  PATNA / BIHAR

 

POSTAL CODE                                  : 800007