[Please print on company letterhead]

To: Manager / Team Leader,Date:_DD/MM/YYYY_

Payroll Department, DOZ B1F2,

Mashreqbankpsc,

Dubai Outsource Zone, Dubai (“Bank”).

Dear Sir,

Sub: Debit Authority Letter for Salary Payment Services - Non-WPS

We, ,[Please insert employer’s name](“Customer”)hereby request that the Bankdebit the Customer’s account, details of which are given below for the Total File Amount and transfer the Total File Amount, representing the wages of the Customer’s employees, to the employees’respective accountsmaintained with the financial entities as per the Customer’s instructions (“Request”).

The account details are as follows.

Customer Account No. / Total File Amount
Total No of Employees / Value Date (Not before)
Payment Purpose / Please tick the appropriate payment purpose code:
/ Salary / End Of Service / Salary Advance
/ Allowances / Leave Salary / Pension
/ Bonus / Overtime / Advance Payment Against End of Service
/ Commission / Tickets / Monetary Claim Reimbursements
/ Compensation / Corporate Card Payment / (Medical Insurance/Auto Insurance Etc.,)
The payment purpose code will be any of one from the above in the debit authority for the respective excel file. For multiple payment purpose codes, customer should provide separate debit authority & their respective excel file.

In case of any communication / clarification on this Request, please contact the following persons as per their details.

Name
Telephone # / Mobile # / Mobile #
E-mail Add

I/We, hereby confirm that we have, read the Mashreq Salary Payment Services Banking Services Terms and Conditions (“Terms and Conditions”) and/orsigned the Mashreq Salary Payment Services Banking Services Agreement (“Agreement”). By our signature on this Debit Authority, we, on behalf of the Customer, hereby confirm our acceptance of the provisionsin the Terms and Conditions and/or Agreement and agree to abide by it.

I / We, the undersigned further confirm that we have been duly authorised by the Customer to issue this Debit Authority and to confirm our acceptance of the Terms and Conditions and/or Agreement. I/We request the Bank to proceed with the Request.

Regards,

For and on behalf of

Customer’s name and stamp:

Sign:Sign:

Name:Name:

Designation:Designation:

(Authorised signatures should be as per account operating mandate)

Attachments

  1. Excel file in non-rewriteable CD/Floppy
  2. Print-out of the Excel File with company stamp and Authorized signature