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DEPARTMENT OF POSTS INDIA

APPLICATION FOR PURCHASE OF NATIONAL SAVINGS CERTIFICATE (VIII ISSUE)

 

To

The Postmaster   ………..................................

Post office                   Serial No………..........

1.

 

I/We hereby tender Rs. ..................................( Rupees ...............................................
..................................  only  ) in cash/ by Cheque No………… ………….…. for purchase of National Savings Certificate (VIII Issue) of the type Single  /Joint A / Joint B.


(a)

In the name(s) of………………………….. and…………………………...............................

(b) In case of minor, his date of birth……………………encashable by the minor’s Parent/guardian Shri/Smt…………………………......................................................
 

2.

 

I/We nominate the person(s) named below who shall, on my/our death, receive payment

 

Sl.No.

1
Name of Nominee

2
Full Address

3
Date of Birth of Minor Nominee
4
   

 
   

 
   

 

 

3. I/We hereby agree to abide by National Savings Certificates (VIII Issue) Rules,1989.

4. The Certificates  may be made over to my/our agent  Shri/Smt............................................... ...................Authority No……………........ or messenger who presents the application.



Signature/thumb impression of Investor
 

 

 

Date ..........................................


 

Signature and Address of witness to nomination
……………………………....................
........................................................
........................................................
……………………………………..........
……………………………....................
……………………………....................


Address
……………………………....................
........................................................
........................................................
……………………………………...........
 

Received the certificate(s)

 



Signature of investor/messenger/authorised agent


Date ........................................
Delete whichever is not applicable

TO BE COMPLETED BY THE POST OFFICE

 

Sl. No.
of Certificates

1
Issue Price
Rs.


2
Date of encashment



3
Initials of
the Postmaster


4
Remarks like transfer,issue of
duplicate etc. with initials
5
 

 

 

 

 

       

TOTAL
       


 



Date: .....................................



Signature of Postmaster

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