ANNEXURE I A
Place:
Date:
From : ________________________
______________________________
______________________________
To
The Regional Director
Reserve Bank of India
Public Debt Office
_______________________________
Dear Sir,
Repayment of 9% Relief Bonds Scheme 1999
I / We request and authorise that
the following investment in my/our BLA under 9% Relief Bonds scheme 1999 may
please be paid by credit to my/our SB /Current Account No. ______________________
with your branch / a Payment Order
/ credited to my / our account as per the ECS mandate(Strike out whichever
is not applicable):
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BLA No.
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Date of Investment
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Amount invested
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Date of Maturity
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Interest
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Total Amount
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GRAND TOTAL
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Particulars of Savings Bank / Current Account:
No…………….…..Bank / branch name……………. (Applicable if the Payment Order is
to be sent by post)
Yours faithfully
Signature(s)
Name(s)
ACQUITTANCE
Received from (Branch Name …………………Rs. ( Rupees
__________________________________________________ only) being the principal
amount with accrued interest due on 9% Relief Bonds 1999 against my /our BLA
as per details given above.
No. Name(s) Income Tax
PAN
( if amount exceeds Rs.1 lakh)
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(Revenue Stamp)
Signature(s)
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i.
ii.
iii.
Place:
Date:
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