APPLICATION
FOR ISSUE OF DUPLICATE PASS BOOK
PART-I
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1
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Account No. and type (SB/CTD
etc) whether minor/public/joint account etc. and in respect of CTD/TD
accounts state the category of the account.
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2
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Post Office at which Account
stands (with the name of Head Office) in brackets, if the account is not at a
Head Office.
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3
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Name(s) of the Depositor(s)
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4
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Names(s) of Father/Husband/ Guardian/
Person or Authority operating Accounts.
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(i) Address of the depositor(s)
at the time of opening of Account
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(ii) Present Address of the depositor(s)
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5
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Date of opening of Account and
office at which opened, if different from that item-2.
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6
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Date and particulars of the
last transaction in the account
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7
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Balance at credit after the
last transaction.
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8
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Name of the Post Office from
which the account was last transferred to the office.
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9
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Date and circumstances of loss
of Pass Book and results of efforts made to trace it etc.
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10
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Whether loss was reported to
the police and if so, with what results.
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11
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Remarks:-
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The particulars given above are
true to the best of my knowledge. A duplicate pass book may please be issued
to me. I shall surrender the pass book if found the fee of Rs. 10/- has been
paid by affixing postage stamps.
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(a)
Please score out if exemption has been granted
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Signature (s)
of the depositor/
Guardian/person or
authority operating Account
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NOTE:-
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If accurate information cannot be furnished in respect of 7 and 8
available, particulars may be given.
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KTO….
PART-II
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1
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Has the Account been traced in
the ledger binder/Index to ledger Cards/SOSB ledger and do the particulars
furnished by the applicant(s) tally with records.
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2
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Does the signature(s) of the
applicant(s) tally with the specimen(s) on record? If not has he /she been
satisfactorily identified.
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3
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Has the register of
undeliverable pass book in safe custody at the HO or SBCO or lying
undelivered in the SO.
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4
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Do you consider further
enquiries called for as laid down in rule 68 POSB Man Vol.1
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5
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If answer to (4) is yes, result
of enquiries made
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6
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Recommendation regarding issue
of a Pass Book
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Date:-
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Signature of APM/DPM(SB)/HO
or SPM with designation stamp
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PART-III (ORDER OF THE HEAD POSTMASTER)
Duplicate Passbook may/not be issued.
Signature of HPM
With designation stamp
PART-IV (RECEIPT FOR THE DUPLICATE PASS BOOK)
Received the duplicate pass book
of A/C No. ……………………………………. With a balance of Rs……………………….Dated stamp of the
Post Office.
Signature of the Depositor
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