Full Name *
Account Number *
Date Of Birth *
Email Id
Address*
Branch* Type to get options
Digital/Non-Digital Complain*
-- Select Type --
Digital
Non-Digital
Complaint Category*
Product And Services
-- Product And Services --
Nature of Complaint
-- Nature of Complaint --
Type of loan*
LOANS Agriculture*
Deposit account number*
Name of deceased*
Third party account number*
Txn amount*
Mobile Number*
Transaction Date*
Reference Number*
Amount Debited*
Charge Account No*
Channel*
-- Select --
ATM
POS
ECOM
User id*
Payment date*
Mode of transactions*
-- Select --
Mobile Banking
Internet Banking
UPI/IMPS/Third Party App
Through Branch
Transaction id*
Loading date*
Corportate id*
POS*
Date of settlement*
Wrong MDR for*
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Credit Card
Debit Card
Disputed amount*
Month*
From date*
To date*
RRN number*
Rem mobile no*
Beneficiary amount*
Loan Account Number*
Amount of loan*
EMI*
Card Number First 6*
Card Number Last 4*
Currency*
POS terminal*
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Branch
Merchant
IPO Name*
Upload (Optional) File Size upto 3mb
Remarks *
